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Rectal Cancer

The rectum is the lower part of the colon that connects the large bowel to the anus. The rectum's primary function is to store formed stool in preparation for evacuation. Like the colon,

The 3 layers of the rectal wall are as follows: -
  • Mucosa: - This layer of the rectal wall lines the inner surface. The mucosa is composed of glands that secrete mucus to help the passage of stool.
  • Muscularis propria: - This middle layer of the rectal wall is composed of muscles that help the rectum keep its shape and contract in a coordinated fashion to expel stool.
  • Mesorectum: - This fatty tissue surrounds the rectum.
In addition to these 3 layers, another important component of the rectum is the surrounding lymph nodes (also called regional lymph nodes). Lymph nodes are part of the immune system and assist in conducting surveillance for harmful materials (including viruses and bacteria) that may be threatening the body. Lymph nodes surround every organ in the body, including the rectum

Rectal Cancer Causes

The actual cause of rectal cancer is unclear. However, the following are risk factors for developing rectal cancer: -
  • Increasing age
  • Smoking
  • Family history of colon or rectal cancer
  • High-fat diet and/or a diet mostly from animal sources
  • Personal or family history of polyps or colorectal cancer

Rectal Cancer Symptoms

Rectal cancer can cause many symptoms that require a person to seek medical care. However, rectal cancer may also be present without any symptoms, underscoring the importance of routine health screening.

Symptoms to be aware of include the following: -
  • Bleeding
    • Seeing blood mixed with stool is a sign to seek immediate medical care. Although many people bleed due to hemorrhoids, a doctor should still be notified in the event of rectal bleeding.
    • Prolonged rectal bleeding (perhaps in small quantities that is not seen in the stool) may lead to anemia, causing fatigue, shortness of breath, light-headedness, or a fast heartbeat.
  • Obstruction
    • A rectal mass may grow so large that it prevents the normal passage of stool. This blockage may lead to the feeling of severe constipation or pain when having a bowel movement. In addition, abdominal pain or cramping may occur due to the blockage.
    • The stool size may appear narrow so that it can be passed around the rectal mass. Therefore, pencil-thin stool may be another sign of an obstruction from rectal cancer.
    • A person with rectal cancer may have a sensation that the stool cannot be completely evacuated after a bowel movement.
  • Weight loss: Cancer may cause weight loss. Unexplained weight loss (in the absence of dieting or a new exercise program) requires a medical evaluation.


In making a diagnosis of rectal cancer, your doctor will first start by recording your medical history, asking about any symptoms you may be experiencing and conducting a thorough physical examination. He/she also may recommend one or more of the following diagnostic tests:
  • Digital rectal exam involves the doctor or nurse inserting a gloved, lubricated finger into the rectum to feel for an abnormalities
  • Barium enema also known as a lower gastrointestinal series, takes X-rays of the large intestines.
  • Fecal occult blood test is a noninvasive test that detects the presence of hidden, or occult blood in the stool. Such blood may arise from anywhere along the digestive tract. Hidden blood in the stool is often the first, and in many cases the only, warning sign that a person has colorectal cancer.
  • Sigmoidoscopy is performed to see inside the rectum and the lower colon and remove polyps or other abnormal tissue for examination under a microscope.
  • Colonoscopy is performed to see inside the rectum and the entire colon and remove polyps or other abnormal tissue for examination under a microscope.
  • Polypectomy is performed during a sigmoidoscopy or colonoscopy to remove polyps.
  • Biopsy is a test in which a small amount of tissue from the suspected area is removed for examination by a pathologist to make a diagnosis.

Rectal Cancer Treatment

Medical Treatment

The treatment and prognosis of rectal cancer depend on the stage of the cancer, which is determined by the following 3 considerations: -
  • How deeply the tumor has invaded the wall of the rectum
  • Whether the lymph nodes appear to have cancer in them
  • Whether the cancer has spread to any other locations in the body (Organs that rectal cancer commonly spreads to include the liver and the lungs.)

The stages of rectal cancer are as follows: -
  • Stage I: - The tumor involves only the first or second layer of the rectal wall and no lymph nodes are involved.
  • Stage II: - The tumor penetrates into the mesorectum, but no lymph nodes are involved.
  • Stage III: - Regardless of how deeply the tumor penetrates, the lymph nodes are involved with the cancer.
  • Stage IV: - Convincing evidence of the cancer exists in other parts of the body, outside of the rectal area.

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