Rectal cancer

Rectal cancer can be a serious diagnosis. The cancer team at Atrium Health Floyd and Harbin Clinic is here to help you understand this condition, get a diagnosis or second opinion, and get the treatment that’s right for you.

What is rectal cancer?

Rectal cancer is a disease in which malignant cancer cells form in the tissues of the rectum. The rectum is part of the body’s digestive system. The digestive system takes in nutrients from foods like vitamins, minerals, carbohydrates, fats, proteins and water. It then helps pass waste material out of the body.

The digestive system is made up of the esophagus, stomach and the small and large intestines. The colon, or "large bowel," is the first part of the large intestine and is about five feet long. Together, the rectum and anal canal make up the last part of the large intestine and are six to eight inches long. The anal canal ends at the anus, or the opening of the large intestine, to the outside of the body.

What causes rectal cancer?

There are several causes of rectal cancer. Lifestyle causes of rectal cancer include diet, obesity, lack of exercise, alcohol and tobacco use. Genetic causes of rectal cancer include inherited syndromes and family history. Other factors include age, personal history, polyps and inflammatory bowel disease.

What are the symptoms of rectal cancer?

Signs of rectal cancer include a change in bowel habits or blood in the stool. These and other signs and symptoms may be caused by rectal cancer or by other conditions.

Check with your doctor if you have any of the following:

• Blood (either bright red or very dark) in the stool
• Diarrhea
• Constipation
• Feeling that the bowel does not empty completely
• Stools that are narrower or have a different shape than usual
• Frequent gas pains
• Bloating
• Fullness
• Cramps
• Change in appetite
• Weight loss for no known reason
• Feeling very tired

Are there different types of rectal cancer?

There are several types of rectal cancer. Here are a few, with the most common listed first:

• Adenocarcinoma
• Neuroendocrine tumors
• Lymphoma
• Gastrointestinal stromal tumors (GISTs)
• Leiomyosarcoma
• Squamous cell carcinoma
• Melanoma

How is rectal cancer diagnosed?

Tests used to diagnose rectal cancer include:

• Physical exam and medical history: Your doctor will check for general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. Your health history, including past illnesses and treatments, will also be taken into consideration.
• Digital rectal exam (DRE): Your doctor will insert a lubricated, gloved finger, or digit, into the lower part of the rectum to feel for lumps or anything else that seems unusual. In women, the vagina may also be examined.
• Colonoscopy: Using a thin, tube-like instrument with a light and a lens for viewing, your doctor will look inside the rectum and colon for polyps, abnormal areas or cancer. During a colonoscopy, your doctor might also remove polyps or tissue samples to check them for signs of cancer.
• Biopsy: Your doctor examines cells or tissues under a microscope to check for signs of cancer. Tumor tissue removed during a biopsy may also be checked for the gene mutation that causes hereditary nonpolyposis colorectal cancer in order to better plan treatment.

What are the risk factors of rectal cancer?

The odds of contracting rectal cancer increase with the following:

• Colon or rectal cancer in a parent, sibling or child
• A personal history of cancer of the colon, rectum or ovary
• A personal history of high-risk adenomas
• Genetic vulnerability to familial adenomatous polyposis or Lynch syndrome
• A personal history of chronic ulcerative colitis or Crohn’s disease for eight years or more
• Having three or more alcoholic drinks per day
• Smoking cigarettes
• Being Black
• Being obese
• Older age

Rectal cancer treatment & recovery

At Atrium Health Floyd and Harbin Clinic, our caring and attentive staff can guide every step of the way through treatment and recovery.

Prognosis and treatment options for rectal cancer depend on the stage of the cancer, your health and additional considerations including:

• If the tumor has spread into or through the bowel wall
• If cancer is found in the rectum
• If the bowel is blocked or has a hole in it
• If the tumor can be removed entirely by surgery or not
• If the cancer has just been diagnosed or has recurred

Treatments can include surgery, radiation therapy, chemotherapy, active surveillance and targeted therapy.