Rectal cancer: first symptoms. Symptoms of rectal cancer in women Exact symptoms of rectal cancer

Rectal cancer affects men and women equally often and has a high mortality rate in many countries around the world. The incidence of colorectal cancer is increasing every year. Urban residents are more often affected; the disease occurs in all age groups; rectal cancer is most often found in people over 60 years of age.

You can get diagnosed with rectal cancer at the Yusupov Hospital. If any intestinal discomfort develops, you should be examined and tested for tumor markers. During your consultation at the oncology clinic of the Yusupov Hospital, you will be told about modern techniques and individual treatment will be selected taking into account your characteristics of the disease.

Classification: rectal cancer

The rectum is the terminal segment of the large intestine that starts from the sigmoid colon and ends in front of the anus. Stool accumulates in the rectum. In men, this section of the intestine is adjacent to the prostate gland, seminal vesicles and bladder; in women, it is adjacent to the posterior wall of the vagina and uterus.

Based on the type of tumor growth, there are:

• endophytic form of tumor. The tumor grows in the thickness of the wall of the rectum;
• exophytic tumor. Grows into the intestinal lumen, eventually causing obstruction;
• saucer-shaped. Combines both types of tumor growth and occurs in the form of a tumor-ulcer.

Rectal cancer classification according to histological parameters:

• adenocarcinoma;
• mucinous adenocarcinoma;
• glandular squamous cell carcinoma;
• basal cell carcinoma;
• mucocellular cancer;
• squamous cell carcinoma;
• undifferentiated cancer;
• unclassified cancer.

The most common is adenocarcinoma of the rectum.

Symptoms of rectal cancer in the early stages

Signs of rectal cancer, the first symptoms do not appear immediately. The initial stage of tumor development is characterized by a certain discomfort and symptoms similar to those of various intestinal diseases. The first manifestations of a tumor are the appearance of blood streaks in the stool, which appear due to trauma to the tumor by passing feces, pain, diarrhea or constipation.

Rectal cancer, first symptoms: photo

Rectal cancer, first symptoms: tumor markers for diagnosis

Tumor markers are special substances that are released as a result of the activity of a malignant tumor or are produced as a response of healthy tissues and organs to the invasion of cancer cells. Found in the urine and blood of sick people. Testing for tumor markers for rectal cancer allows us to detect cancer at an early stage and preserve the health and life of the patient. Early diagnosis of cancer, carried out at the initial symptoms of the disease, allows the tumor to be removed before the first metastases appear. With the help of analysis for tumor markers, the patient’s health status is monitored after cancer treatment for a certain time - this allows timely detection of the development of tumor relapse. The level of tumor markers may be increased due to non-oncological diseases.

How quickly does colorectal cancer develop?

The initial symptoms of colorectal cancer are often ignored. Several years pass from the onset of tumor development to the appearance of pronounced symptoms. The tumor slowly invades the organ, then grows into its wall and affects surrounding tissues and organs - about two years pass from the beginning of growth to its metastasis.

Colon cancer and rectal cancer: symptoms

Colon cancer and rectal cancer have the same risk factors and causes of development. Of all intestinal cancers, colon cancer accounts for two-thirds of cases, and rectal cancer accounts for one-third. The main symptoms of intestinal cancer are the appearance of streaks of blood and mucus in the stool, pain of varying intensity. As the tumor grows, the symptoms become more pronounced - persistent constipation or diarrhea develops, the temperature rises, the skin turns pale, jaundice develops, nausea, vomiting, pain during bowel movements, the patient loses appetite, body weight, and intestinal obstruction occurs as a complication.

Causes of colorectal cancer

Oncologists at the Yusupov Hospital are often asked the question: “What causes rectal cancer?” The causes of cancer development in humans have not yet been studied. According to research results, the causes of the development of a malignant tumor are:

• heavy smoking and alcoholism;
• living in an area with difficult ecology;
• harmful working conditions;
• drinking large amounts of beer, meat, fats;
• eating food with dyes and carcinogens;
• poor water quality;
• chronic inflammatory processes in the intestines;
• intestinal polyposis;
• haemorrhoids;
• sedentary lifestyle;
• anal sex.

Chemotherapy for colorectal cancer

Chemotherapy is most often prescribed in the postoperative period as an auxiliary treatment. Chemotherapy is used with caution, often as palliative treatment when tumor removal is not possible. Chemotherapy in most cases is carried out by drip infusion. Antiemetics and anti-nausea drugs are used along with chemotherapy.

Symptoms of colorectal cancer in women

Signs of rectal cancer in women often appear at a late stage of cancer development, when the wall of the vagina and bladder is damaged. A fistula appears in the vagina, through which feces and gases escape. Rectal cancer manifests itself with symptoms similar to those of diseases of the stomach, intestines, and genitourinary system. Signs of rectal cancer at an early stage do not have any special manifestations; they are often similar to the manifestations of hemorrhoids and intestinal disorders.

Diagnosis of rectal cancer in women

Diagnosis of rectal cancer in women is carried out at the Yusupov Hospital by several methods - endoscopic examination, X-ray examination, ultrasound, computed tomography, fibrocolonoscopy, radioisotope scanning of the liver to detect metastases, internal urography to assess the spread of metastases. The woman is examined by a gynecologist to rule out tumor growth in the uterus and vagina. If polyps or tumors of the rectum are detected, a biopsy is performed with histological examination of a tissue sample. An analysis is prescribed for tumor markers CA 19-9, carcinoembryonic antigen. Such studies are carried out in conjunction with other studies.

Symptoms of colorectal cancer in men

The first signs of rectal cancer in men are intestinal discomfort, nausea, abdominal pain and the appearance of blood streaks in the stool. As the tumor grows, the following symptoms appear:

• blood discharge increases, pus appears in the stool;
• the patient suffers from persistent constipation that cannot be treated;
• incontinence of feces and gases;
• pain of varying intensity;
• painful urge to defecate;
• rumbling in the stomach and bloating;
• if the tumor affects the lower part of the rectum and sphincter muscles, cancer symptoms appear at an early stage;
• pain forces the patient to sit strictly on one buttock;
• when the tumor of the upper part of the rectum grows into other organs and tissues, the pain intensifies;
• anemia develops;
• exhaustion;
• fatigue, pale skin;
• Rectal cancer often affects the prostate gland and seminal vesicles, manifested by symptoms of dysfunction of the prostate gland, an increase in its size.

Rectal cancer, symptoms: photo

Causes of rectal cancer in men

The most common causes of colorectal cancer in men are a love of beer, alcoholism and heavy smoking. Negative factors influencing the development of the disease: working in hazardous conditions, living in environmentally hazardous areas, obesity, unhealthy diet and heredity, sedentary lifestyle. It is believed that high consumption of meat and animal fats also negatively affects the condition of the intestines and increases the risk of developing cancer due to the characteristics of the microflora.

Heavy smoking is characterized by the negative effects of nicotine on blood vessels. Epidemiological studies have shown that the risk of developing colorectal cancer increases with the amount of beer consumed. Alcohol irritates and damages the intestinal walls and is one of the factors influencing the development and growth of malignant tumors. Regular consumption of beer increases the risk of intestinal cancer. Beer contains a toxic product of ethanol oxidation - acetaldehyde. Ethyl alcohol causes damage to the mucous membrane, which contributes to the development of the inflammatory process, and exposure to a toxic product leads to cell mutation. In men, regular alcohol consumption increases the risk of oral, liver, throat, bowel and prostate cancer.

Rectal cancer: age category

Rectal cancer is rarely found in people under the age of 40; the risk of developing colorectal cancer increases after age 40 and rises sharply after age 60. Intestinal polyposis increases the risk of developing cancer in people over 50 unless they are regularly screened and treated for intestinal disease.

Pain due to rectal cancer

Pain in bowel cancer is observed in 80% of patients. In some cases, the symptoms are similar:

• with acute appendicitis;
• peptic ulcer of the stomach or duodenum;
• colic in urolithiasis, cholelithiasis.

The pain may be combined with muscle tension in the anterior abdominal wall, fever, vomiting and nausea. An increase in pain occurs with an increase in tumor size, tumor growth into neighboring organs and tissues, with the development of intestinal obstruction, the development of an inflammatory process in the tumor, or an abscess.

Diagnosis: types of rectal cancer

The appearance and severity of symptoms are influenced by: the type of tumor, stage of development, nature of spread in the body. Exophytic tumors grow inside the rectum and, over time, create obstruction of the affected part of the intestine. Diffuse infiltrating tumors transform a section of the intestine into a narrow, rigid tube or scar ring (colloid or scirrhous cancer). Squamous cell carcinoma of the rectum mainly begins to develop in the mucous membrane of the anal canal, then spreads further.

Poorly differentiated squamous cell carcinoma of the rectum

The tumor consists of mutated flat epithelial cells; they can be keratinized or non-keratinized. The appearance of the tumor resembles an ulcerative formation, in some cases cauliflower. Ulceration of the tumor indicates a high malignancy of the rectal tumor. Squamous cell carcinoma has symptoms similar to those of hemorrhoids and anal fissures. A poorly differentiated form of squamous cell carcinoma is a highly malignant cancer that tends to rapidly metastasize, affecting nearby organs and tissues, as well as distant ones. The poorly differentiated form of squamous cell carcinoma is prone to relapses, which very often occur in the first two years after treatment.

How to distinguish hemorrhoids from colorectal cancer

Since the symptoms of colorectal cancer are very similar to the symptoms of hemorrhoids, you should learn to distinguish them:

• With hemorrhoids, blood appears at the end of a bowel movement and is found on the surface of the stool. With rectal cancer, the blood is mixed with stool and is often very dark in color, unlike blood with hemorrhoids;
• in case of rectal cancer, mucus may come out of the intestines before and after the appearance of feces, often with an unpleasant odor;
• the nature of the stool changes - a narrowing of the intestinal lumen causes a change in the shape of the feces;
• constipation becomes persistent. Treatment does not work for rectal cancer;
• with the development of an intestinal tumor, pain is always present - in the abdominal area, during bowel movements and at rest;
• the patient begins to lose weight, appetite decreases;
• In the later stages of cancer, fistulas form through which urine exits the anus or feces exit the vagina.

Metastases in rectal cancer: symptoms

Metastasis of a rectal tumor occurs through two systems - lymphatic and circulatory. Through the lymphatic system, metastases spread upward along the rectal vessels and posteriorly along the rectal vessels, to the side walls of the pelvis through the lymphatic vessels into the iliac and hypogastric lymph nodes. Through the lower rectal lymphatic vessels to the inguinal lymph nodes. Retrograde spread of the tumor into the underlying lymphatic systems is also possible.

Through blood vessels, metastases very quickly enter the liver, disperse throughout the visceral peritoneum, and are detected in other distant systems and organs. Metastasis is accompanied by the appearance of symptoms of tumor development in other organs. When the liver is damaged, patients develop jaundice, pain in the right side, nausea, and vomiting.

Where does colorectal cancer metastasize?

The first metastases are detected in nearby lymph nodes. Then metastases spread to distant organs and systems: lungs, liver, skeletal system, ovaries, brain, serous membrane of the peritoneum, heart. The liver and lungs are most often affected.

Treatment methods

Treatment methods for rectal cancer are traditional - the main method of treatment is surgery. The radical method is the most effective method for removing a malignant intestinal tumor. Chemotherapy and radiation therapy are additional treatments.

Surgery for rectal cancer

Radical removal of a rectal tumor involves resection of the affected segment of the intestine. After resection of the affected segment, open areas of the intestine are stitched together, and intestinal patency is restored. In some cases, an ostomy is performed to speed up the healing of the rectum. Metastases in the lymph nodes are removed along with the lymphatic system, and damaged vessels are removed.

Surgery for rectal cancer, depending on the type of tumor, stage of development of the tumor, and the patient’s condition, is performed using several methods:

• laparoscopic (through punctures in the anterior abdominal wall);
• laparotomy (open method, through an incision in the abdominal wall).

Immunotherapy for colorectal cancer

Immunotherapy in the early stages of cancer is prescribed as an additional treatment. At the third stage of colorectal cancer and the fourth stage, it becomes necessary. Defeating cancer requires all the strength of the body and a good response to the treatment. Immunotherapy is the treatment of cancer using anticancer biological drugs (cytokines and monoclonal antibodies). This treatment is carried out over a long period of time, the patient is under the supervision of doctors throughout the entire period. The goal of this treatment is to force our body to recognize cancer cells and destroy them.

Survival Rate: Rectal Cancer

An optimistic prognosis for the survival of patients with rectal cancer is observed in countries with a highly developed level of medicine. In such countries, about 60% of patients survive more than five years from the moment cancer is diagnosed. In countries with a lower level of medicine, this figure does not exceed 40%.

The first symptoms of rectal cancer do not differ from the manifestations of gastrointestinal diseases, therefore, if any intestinal discomfort develops, you should be examined at the Yusupov Hospital and tested for tumor markers. How to diagnose rectal cancer, what tests are taken for tumor markers - you will be told during a consultation at the oncology clinic of the Yusupov Hospital. If you are over 40 years old, you should have bowel cancer diagnosed with a colonoscopy every five years. Call by phone and you will be scheduled for a consultation with an oncologist at the Yusupov Hospital.

Bibliography

• ICD-10 (International Classification of Diseases)
• Yusupov Hospital
• Cherenkov V. G. Clinical oncology. - 3rd ed. - M.: Medical book, 2010. - 434 p. - ISBN 978-5-91894-002-0.
• Shirokorad V.I., Makhson A.N., Yadykov O.A. The state of oncourological care in Moscow // Oncourology. - 2013. - No. 4. - P. 10-13.
• Volosyanko M.I. Traditional and natural methods of preventing and treating cancer, Aquarium, 1994
• John Niederhuber, James Armitage, James Doroshow, Michael Kastan, Joel Tepper Abeloff's Clinical Oncology - 5th Edition, eMEDICAL BOOKS, 2013

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Prices for treatment of colorectal cancer

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Further treatment depends on the accuracy of determining the stage of cancer. Like other cancers, rectal cancer develops in 4 stages, each of which has its own characteristic features. The stages of colorectal cancer change relatively slowly, which increases the chances of successful treatment.

The prognosis for patient survival is directly dependent on the degree of spread of the malignant neoplasm. The smaller the tumor, the greater the chance of surgical removal. Diagnostic staging is based on 3 criteria: the depth of tumor growth into the intestinal wall, the presence of secondary foci in the lymph nodes, the presence of metastases in neighboring and distant tissues and organs.

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First stage (1)

At the first stage, the tumor is located only in the rectal mucosa (or in the submucosa in the case of endophytic cancer). Its dimensions do not exceed 2 cm, and no cancer cells are observed in the nearest lymph nodes.

Sometimes stage 1 does not give any symptoms, except for some feeling of general malaise and discomfort.

Sometimes a sign of the initial stage of cancer is bleeding from the anus, but this symptom is also characteristic of other diseases of the rectal cancer - hemorrhoids, anal fissures.

There are signs that can help distinguish hemorrhoidal bleeding from cancer bleeding. In the first case, blood discharge comes out after the act of defecation, in the second - before it, or the blood is mixed with feces. It is not always possible to notice blood in the stool in the early stages of cancer, even if it is present. There are laboratory tests for occult blood that can determine the presence of foreign secretions in the stool.

Treatment at the first stage allows for surgery with a greater chance of long-term remission in the future. In some situations - when the tumor grows into the intestinal lumen and is small in size, laser ablation of the tumor or endoscopic surgery without an incision is possible.

After tumor removal, chemotherapy and radiation therapy are most often prescribed. Even if there is no obvious metastasis, cancer cells can circulate in the circulatory and lymphatic systems, so treatment with drugs and radiation can be preventive.

Second stage (2)

At stage 2, the severity of symptoms increases.

In addition to bleeding, patients experience:

• pain in the perineum and lower abdomen;
• false urge to defecate (tenesmus);
• digestive disorders - diarrhea, constipation;
• weakness and increased fatigue;
• weight loss.

The tumor itself increases in size up to 5 cm and grows into the layers of the intestine. In some cases, the tumor may occupy more than half the annular circumference of the rectum. Metastases are absent or sporadic.

At stage 2, just as at stage 1, it is advisable to carry out surgical treatment - remove the tumor along with part of the intestine or completely remove the rectal part of the intestine along with the sphincter.

The type of operation depends on the location of the malignant focus. If it is located closer than 7-10 cm to the anus, it will be difficult to maintain intestinal continuity: doctors make a colostomy - an artificial outlet to which a colostomy bag is attached.

Lymphadenectomy is required - removal of the nearest lymph nodes, since single cancer cells most likely penetrate into the lymphatic fluid flow system.

The survival rate of patients after surgery for stage 2 cancer is about 75% - this is exactly the number of patients who overcome the threshold of 5 years. After surgery, patients are prescribed mandatory radiation and chemotherapy. A diet is also prescribed that patients should follow for life.

Third stage (3)

The third stage is characterized by an increase in size of more than 5 cm: the tumor usually occupies more than the semicircle of the rectum. There is infiltration (penetration) of the tumor process into the muscular layer of the rectum and adjacent tissues.

Rectal intestinal cancer at stage 3 gives metastases to regional lymph nodes (the number of metastases can reach 4 or more).

The third stage usually causes obvious symptoms - bleeding, severe pain in the anus, which intensifies after defecation or may be present constantly. Patients may develop anemia due to constant blood loss.

Anemia is accompanied by:

• severe weakness;
• pale skin;
• dizziness;
• drowsiness.

Treatment is prescribed by a doctor based on the clinical picture. In many cases, surgery is performed, although the presence of metastases reduces the chances of recovery by up to 50%. After removal of the rectum (usually at stage 3 it is necessary to perform operations with disruption of the continuity of the digestive tract), a course of adjuvant chemotherapy is carried out.

The life expectancy of patients largely depends on the literacy of the treatment regimen: the correct combination of drugs is important. The prognosis worsens depending on the number of metastatic foci in the body.

Fourth stage (4)

The last stage of rectal cancer is characterized by multiple metastases. Most often, secondary malignant foci are formed with rectal cancer in the liver, lungs, and adrenal glands. In this case, the tumor grows through all layers of the rectum and affects neighboring organs.

May be affected: large intestine, bladder, genitals, perineal tissue.

At stage 4, the most pronounced symptoms appear:

• digestive disorders, including periodic intestinal obstruction (complete obstruction may also develop);
• bleeding;
• perforation of the rectum (in this case, immediate surgery is required);
• vomit;
• pain symptoms (often difficult to tolerate, requiring relief with strong drugs);
• intoxication of the body caused by the disintegration of the tumor.

Metastases in the lungs cause breathing problems, coughing, and shortness of breath. Secondary lesions in the liver cause rapidly developing liver failure. Bladder lesions can cause urinary problems and urinary incontinence.

Since malignant processes at stage 4 are in an advanced state, treatment is palliative in nature - doctors try to prolong life and make the patient’s life more comfortable.

Surgeries are performed to remove individual metastases - for example, in the liver or abdominal cavity. Chemotherapy is almost always prescribed; a large range of drugs is used - 5-fluorouracil, Capecitabine, Irinotecan, Oxaliplatin. Targeted therapy drugs that reduce the activity of metastasis can also be used: monoclonal antibodies that inhibit cancer cell growth factor receptors.

Multiple metastases leave almost no chance for patients to have a positive treatment outcome. Only 5-10% of patients overcome the five-year survival threshold.

In modern oncology, malignant neoplasms of the rectum, combined into one group with malignant tumors, are often called.

Definition and Statistics

Rectal cancer is a disease that develops as a result of tumor degeneration of the epithelial cells of the mucous membrane lining any part of the rectum and has characteristic signs of cellular polymorphism and malignancy.

This means that this disease is characterized by rapid infiltrative growth with germination into adjacent tissues, a tendency to metastasize and frequent relapses even after qualified treatment.

According to medical data, this disease occupies third position in the structure of cancerous tumors of the gastrointestinal tract.

It accounts for 43% of all malignant neoplasms of the intestine and 5% in the general structure of cancerous tumors of any location.

The disease affects representatives of both sexes with equal frequency, belonging to the age category of 45-75 years. Every year, 18 new cases are detected for every 100,000 Russians. Despite its extreme prevalence, rectal cancer ends in a favorable outcome much more often than other oncological pathologies.

The photo clearly shows what a cancerous tumor looks like - adenocarcinoma of the lower ampullary rectum

This is due to the peculiarities of the anatomical location of the rectum, the primary tumors of which make it possible to detect them at the earliest stages of the disease. It is enough for a specialist to perform only a digital examination or an endoscopic examination of the rectum at the first complaints of the patient.

Causes

The main causes of colorectal cancer in men and women are considered to be:

• long-term presence of feces in the ampullary part of the rectum;
• the presence of any chronic ailments of the anorectal area (hemorrhoids, chronic anal fissures, paraproctitis, chronic proctitis, proctosigmoiditis);
• hereditary predisposition (patients who have blood relatives who have had rectal or colon cancer are automatically included in the risk group for this disease);
• the presence of family and colon cancer (if left untreated, by the age of forty it will inevitably end in colon cancer);
• presence of an oncological history (patients who have undergone, as well as women who have recovered from, or ovaries, continue to remain at high risk for rectal and colon cancer);
• belonging to the age category over 60 years;
• increases the risk of developing a malignant tumor of the rectum (women who smoke are 40% more likely to become victims of this disease; in men who smoke, this occurs in 30% of cases);
• the presence of certain strains in the patient’s body (this may be a precancerous condition for a malignant neoplasm of the anal canal);
• exposure to carcinogenic substances (primarily chemicals: nitrates, industrial emissions and poisons, pesticides) and ionizing radiation;
• unhealthy diet, replete with fast food, cholesterol, animal fats and red meat.

Classification

There are several types of classifications of malignant tumors of the rectum. Depending on the location, rectal cancer can be :

• Supraampullary (high). Represented predominantly by dense scirrhus, this form of cancer is characterized by a ring-shaped narrowing of the intestinal lumen, accompanied by rapidly developing stenosis.
• Ampullary, which is the most common and has the structure of adenocarcinoma. This form of tumor can develop as a bulging neoplasm or a bleeding ulcer with a crater-shaped base.
• Anal located in the anal canal area. This form of cancer, which looks like a tumor or ulcer, most often has a squamous cell type of structure.

Another type of classification of rectal cancer, based on the location of malignant neoplasms, divides them into tumors:

• anal region(occurs in 10% of cases);
• rectosigmoid department (30%);
• lower, middle and upper ampullary(60%) parts of the rectum.

Classification based on the type of growth of cancerous tumors divides them into three forms:

• exophytic(20%), growing into the lumen of the affected intestine;
• endophytic(30%), developing inside the tissues that make up the wall of the rectum;
• mixed(50%), characterized by a combination of exophytic and endophytic growth.

Depending on the characteristics of the histological structure of tumor tissues rectal cancer can be represented by:

• mucous;
• solid;
• fibrous;
• undifferentiated malignant neoplasms.

Squamous cell carcinoma of the rectum

The histological structure of squamous cell carcinomas is represented by atypical epithelial squamous cells, which in rare cases have the ability to become keratinized.

Externally, squamous cell cancers of the rectum resemble ulcers with undermined edges; in every tenth case they look like overgrown cauliflower.

Ulcerated tumors are characterized by early metastasis to the lymph nodes and internal organs, rapid growth, the most malignant course and a disappointing prognosis.

Features of squamous cell carcinoma include:

• the highest degree of malignancy (once it appears, the tumor soon occupies more than a third of the intestinal lumen);
• large (over 5 cm) length along the length of the rectum;
• germination into the tissue of adjacent organs (ureters and bladder, prostate, vagina);
• rapid penetration into the lymph nodes through the lymphatic vessels;
• dependence on the level of cell differentiation (well-differentiated squamous cell tumors have a better prognosis and patient survival rate);
• high ability to recur (most often relapses occur within two years after surgical treatment).

Survival for squamous cell carcinoma directly depends on the extent of the tumor process in the intestine, the number of metastases in the lymph nodes and distant organs, the patient’s age, the duration of the disease, and the depth of tumor growth into the intestinal wall.

Patients who begin treatment six months after the onset of the disease have the best chances of survival. The five-year survival prognosis for squamous cell rectal cancer overall is 33%. Most patients die within the first three years.

Clinical manifestations

The insidiousness of rectal cancer lies in the complete asymptomatic nature of the initial stages of its development.

Over a fairly long period of time, the malignant neoplasm increases in size and steadily grows into the tissue of the intestinal wall, without showing itself in any way.

The appearance of specific signs of cancer, when the patient, suspecting something is wrong, goes to the doctor, indicates that the oncological process has already gone quite far. In many patients, by then the tumor has metastasized to other organs and lymph nodes.

What are the first symptoms?

The initial symptom of rectal cancer, which occurs in 60% of cases, is slight bleeding, the presence of which can be guessed only by noticing minor blood impurities or dark clots in the stool.

They differ from bleeding hemorrhoids in that the release of blood precedes the act of defecation.

In addition to bloody discharge from the anus, the patient may experience:

• unexplained fatigue caused by iron deficiency anemia due to constant blood loss;
• shortness of breath that appears even after minor physical exertion;
• feeling of insufficient bowel movement after bowel movement;
• constant nausea caused by self-poisoning of the body with a disordered digestive system.

General symptoms

General symptoms, indicating a sharp deterioration in the patient’s condition, develop when the whole organism is involved in the tumor process. This includes:

• extreme weakness;
• decreased ability to work;
• increased fatigue;
• a sharp decrease in body weight;
• complete loss of appetite;
• pale and dry skin;
• sallow complexion.

All these phenomena are caused by daily blood loss and severe tumor intoxication.

Signs of anal tumor

• The most common and early symptom of this disease is a slight admixture of scarlet blood in the stool. Since this same symptom is a characteristic manifestation of hemorrhoids, it often misleads inexperienced doctors and patients themselves. In addition to blood, pus and mucus are often released from the patient's anal canal. This symptom, indicating the development of a concomitant perifocal (located next to the tumor focus) inflammatory process, is characteristic of the late stages of the disease.
• The second characteristic symptom is pain in the anus. At first they occur only during bowel movements; Intensifying day by day, they become permanent, radiating to the lower abdomen, genitals and thighs. A number of patients experience such pain after sitting on a hard chair for a long time. Pain syndrome is associated with rich innervation of the rectum.
• Constipation, often occurring with this type of cancer, are caused both by conscious retention of feces, associated with the patient’s fear of experiencing severe pain during bowel movements.
• The most painful manifestations of the disease are tenesmus– frequent (from five to fifteen times during the day) false urge to defecate, ending with a slight discharge of pus, blood and mucus. After such a bowel movement, the patient, who does not experience satisfaction, continues to feel the presence of a foreign body in the rectum.
• Pathological discharge from the anus often causes severe anal itching.
• Tumor growth into the anal sphincter leads to incontinence of gases and feces, and if the pelvic floor and urethra are affected - to urinary incontinence.
• The narrowing of the narrowest part of the rectum inevitably ends in the development intestinal obstruction.

Ampullary department

Rectosigmoid region

• A cancerous tumor of this section can be represented by either ulcerated adenocarcinoma (in this case it manifests itself with mucous secretions and blood at the time of bowel movement), or scirrhus, characterized by progressive constipation.
• As the tumor grows, constipation becomes more frequent and prolonged, accompanied by bloating of the left abdomen.
• Further development of the tumor process, accompanied by the inevitable addition of inflammatory changes, leads to partial or complete intestinal obstruction. This stage of the disease is characterized by the presence of cramping pain in the abdominal cavity, frequent retention of stool and gas, and periodic bouts of vomiting.

Differences in signs of colorectal cancer in men and women

Although most symptoms of rectal cancer (especially in the initial stages) are in no way related to the gender of patients, there are still some differences in its clinical course in women and men.

Rectal cancer in women can grow into the tissue of the uterus or vagina. Cancer of the uterus does not affect the overall clinical picture of the disease, but tumor growth in the tissue of the posterior vaginal wall can lead to the formation of a rectovaginal fistula. As a result, gases and feces begin to be released from the female vagina.

A malignant tumor in men can grow into the wall of the bladder, causing the formation of a rectovesical fistula, leading to the release of feces and gases from the urethra. The bladder often becomes infected. The infection that enters it penetrates through the ureters into the kidneys, causing.

How is it different from hemorrhoids?

Chronic hemorrhoids can be distinguished from rectal cancer by a combination of signs:

• With hemorrhoids, scarlet-colored blood is released after defecation and ends up on the surface of the stool, while with rectal cancer, the release of blood that has a darker color and mixed with feces precedes the act of defecation.
• In case of rectal cancer, this act can also be preceded by mucous discharge mixed with pus, which has an unpleasant color and a repulsive odor. After a bowel movement, fragments of tumor tissue may be present in the stool, detached from the malignant neoplasm itself. With hemorrhoids there is no such discharge.
• The shape of stool during hemorrhoids is practically no different from the stool of a healthy person during a single constipation. A malignant tumor, which blocks the intestinal lumen as it grows, changes the shape of feces over time, making it ribbon-like (the thickness of this “ribbon” in cross-section does not exceed one centimeter).
• In a patient with hemorrhoids, constipation is most often caused by the fear of experiencing pain during bowel movements; in cancer they are associated with intestinal obstruction.
• The weight loss of a patient frightened by pain due to hemorrhoids may be associated with his conscious refusal to eat (neither his appetite nor the feeling of hunger disappears). Unexplained weight loss in rectal cancer is accompanied by a persistent lack of appetite.
• The oncological process, as a rule, is accompanied by an increase in body temperature to the level of subfebrile values.

Only a competent doctor can evaluate the listed symptoms.

To make a correct diagnosis, a physical examination of the patient is required, including palpation of the abdomen and digital examination of the rectum, as well as a series of endoscopic examinations and laboratory tests.

A preliminary answer to the question of what the patient is suffering from: rectal cancer or hemorrhoids, may be the result of a laboratory test.

Stages and survival prognosis

Rectal cancer, which goes through stage 4 in its development, develops quite slowly over several years.

Having first affected the tissues of the mucous membrane, it begins to spread up and down the intestinal wall, growing through it, increasing in size and gradually filling the entire lumen of the rectum.

• Stage 1 rectal cancer has the form of an ulcer or a small (up to 2 cm) mobile tumor occupying an area of ​​the mucous membrane that has clear boundaries. The depth of penetration is limited to the submucosal layer. The life expectancy of patients with high-grade, low-grade rectal cancer detected at stage I is 80% and lasts for decades. Unfortunately, at this stage the disease is detected only in a fifth of patients.
• A stage 2 cancerous tumor, which has grown to five centimeters, is limited to the intestine and occupies approximately half of its circumference. Metastases are either absent (stage IIA) or affect single lymph nodes localized in the tissues of the perirectal tissue (stage IIB). The prognosis for five-year survival at this stage depends on the onset of metastasis. In the absence of metastases, 75% of patients survive; with their appearance in single lymph nodes, this figure drops to 70%.
• A stage 3 tumor process is characterized by the presence of a tumor whose diameter exceeds five centimeters. Having occupied more than half of the intestinal lumen, it grows through all layers of the intestinal wall and gives multiple metastases to the adjacent lymph nodes. The five-year survival rate of patients with single metastases in the lymph nodes is no more than 50%. With metastatic damage to more than 4 lymph nodes, only 40% of patients survive.
• A grade 4 malignant neoplasm is a significant disintegrating tumor that actively grows into adjacent organs and tissues, and also gives numerous metastases to lymph nodes and distant organs, entering them hematogenously. There are no cases of five-year survival of patients with this stage of rectal cancer. On average, they have three to nine months to live.

How long do patients live?

No specialist will give a definite answer to how long people live with rectal cancer, since the survival prognosis is compiled individually for each patient and consists of many indicators.

Basically, this indicator depends on the depth of damage to the mucous layer. If the tumor process has not crossed its boundaries, the chance of five-year survival remains in 90% of patients.

• The most disappointing prognosis (even at stages 1-2) is for cancer tumors localized in the lower ampullary region and in the anal canal of the rectum, which require disabling surgical intervention and often recur.
• The prognosis for poorly differentiated tumors is always more favorable than for highly differentiated ones.
• Life expectancy is significantly reduced by the patient’s advanced age and the presence of concomitant diseases.
• If surgical treatment of operable forms of rectal cancer (stages I-III) is refused, the patient dies within a year.

Metastasis

Highly differentiated malignant tumors of the rectum have the highest propensity to metastasize.

Most often they metastasize into tissues:

• (retroperitoneal, regional, pelvic);
• peritoneum;
• hollow abdominal organs;

Complications

Rectal cancer may be accompanied by:

• acute intestinal obstruction;
• the formation of interorgan fistulas (pararectal, vesico-rectal, vaginal-rectal);
• cancer intoxication of the body;
• bleeding from a tumor;
• perforation of the rectal wall.

The cause of intestinal perforation is excessive stretching of its walls located above the location of the tumor, which provoked intestinal obstruction. There are also frequent cases of perforation of the intestinal walls in the area of ​​the tumor itself.

With perforation into the abdominal cavity, fecal peritonitis develops; with perforation in the tissue of the perirectal tissue, phlegmon or an abscess develops.

How to define a disease?

The level of modern oncology allows at any stage of development. For this purpose, a clear diagnostic algorithm has been developed. Here is a diagram of the examination of a patient with suspected rectal cancer. A biopsy is possible only with an integrated approach that involves the use of:

• surgical exposure;
• remote or contact before or after surgery;

Leading importance is attached to surgical treatment; Chemotherapy and radiotherapy are auxiliary.

The tactics of surgical intervention primarily depend on the localization of the tumor process:

• If intestinal obstruction develops, a unloading transversostomy is performed and the patient's condition is stabilized. After this, radical surgery is performed to remove the cancerous tumor.
• For rectosigmoid cancer, a Hartmann operation is performed, which consists of obstructive resection of the rectum with the application of a flat sigmoid stoma.
• For cancer of the upper and middle ampulla, anterior resection of the rectum is performed with removal of lymph nodes and lymphatic vessels (lymph dissection) and pelvic tissue. To restore intestinal continuity, a primary anastomosis is performed.
• If the middle and lower ampullary sections are affected, the rectum is removed almost completely, leaving only the sphincter apparatus intact. To preserve natural bowel movements, the sigmoid colon is brought down and fixed to the anal sphincter.
• In case of anorectal cancer and damage to the musculoskeletal system, the Quenu-Miles operation is performed, during which the rectum is completely removed along with the lymph nodes and sphincter, replacing it with an unnatural anus (removed for life).

Chemotherapy, which consists of the intravenous administration of a combination of anticancer chemicals, can be used:

• in combination with surgical treatment;
• as the only method of treating inoperable tumors;
• to prevent relapses during postoperative treatment.

In modern oncology, two types of radiation treatment are used: external, consisting of exposure to small doses of radiation using special equipment, and internal (with the introduction of a sensor into the rectum).

Radiation treatment can be used:

• before surgery to reduce the tumor to a resectable state;
• as an independent therapeutic method for the treatment of elderly or inoperable patients;
• for palliative purposes: to alleviate the condition of hopelessly ill people.

Consequences after surgery

Surgeries related to the removal of rectal cancer are sometimes associated with a number of consequences that can disrupt the functioning of the intestinal tract.

They can lead to:

• fecal incontinence.

In addition, an inflamed unnatural anus can provoke intestinal prolapse and cause a delay in bowel movement.

Prevention

The best prevention of rectal cancer is to eliminate the main risk factors that increase the likelihood of its development. To do this you need:

• Treat all chronic diseases of the rectum (fistulas, hemorrhoids, anal fissures, polyposis) in a timely manner.
• Prevent constipation.
• Eat healthy foods, stop eating fast food, limit the consumption of animal fats, replacing them with vegetable oils if possible, and do not overuse red meat.
• Minimize exposure to harmful chemicals.
• Get rid of excess weight.
• To live an active lifestyle.
• At least once a year, undergo a preventive medical examination.

Video about resection of a rectal tumor with the formation of a colostomy:

Rectal cancer is a malignant tumor. The source of the disease is the cells lining the intestine. The formation can grow into the intestinal membranes and manifest itself in its lumen.

The disease most often affects people who have crossed the 50-year mark. Every year, 510,000 patients with colon cancer are registered worldwide, of which 40% are rectal cancer.

Why does it occur?

The causes of colorectal cancer have not yet been fully understood.

Possible causes of the disease:

• Proctitis is an inflammation of the sigmoid colon and its mucous membrane. It has a specific nature (helminthic infestations, gonorrheal, syphilitic, tuberculosis, etc.), or is a consequence of acute diseases that have not been treated.
• Chronic fissures and ulcers in the anal canal.
• Genetic predisposition.
• Lack of physical activity.
• Overeating and obesity.
• Smoking.

If someone in the family has had cancer, for example, polyposis (the formation of many benign tumors on the mucous membranes of the rectum), which can subsequently turn into cancer due to gene mutations in chromosomes, the risk of getting sick is high.

The occurrence of the disease is also influenced by a person’s diet, abuse of meat and fatty foods, insufficient consumption of grains and vegetables, which disrupt the stool.

Digestion and stool disorders contribute to irritation of the intestinal mucosa due to toxins, which as a result penetrate into the blood.

How do hemorrhoids affect the development of colorectal cancer?

One of the causes of colorectal cancer is advanced hemorrhoids. Hemorrhoids are the most common disease, affecting 80% of the population. It means inflammation, swelling, prolapse and bleeding of the venous internal nodes of the rectum.

During the course of the disease, the cavernous bodies increase in size, which is caused by varicose veins. When the flow of blood through the veins is disrupted, it coagulates, thickens, and hemorrhoids are formed, sometimes they are mistaken for a tumor formation, but these are only compacted veins overflowing with blood.

At rest they decrease and fall, and when stressed they increase and swell. The course of chronic hemorrhoids is wavy, the condition either improves or becomes more complicated.

If hemorrhoids are not treated seriously, they will begin to progress over time and eventually turn into an acute form, since prolapsed nodes are easily subject to thrombosis or strangulation.

In this form, severe bursting pain and a pronounced sensation of a foreign body in the anus appear.

Symptoms become stronger and more intense when walking, defecating and sitting. A complication begins, as a result of which the following begin to appear:

• Massive bleeding.
• Necrosis of hemorrhoids.
• Blood poisoning.
• Swelling of the anal canal.

The worst of them is the transition of neglected hemorrhoids to rectal cancer, which occurs in several stages.

Course of the disease

Rectal cancer is accompanied by metastases - screenings from the main lesion, identical in structure and capable of growing, disrupting the functions of the organs in which they have entered. They form as the formation grows, as a result of which, due to the increase in tissue, there is not enough nutrition for all elements and some of the cells begin to be eliminated. After this, they enter the blood, affecting organs and settling in them, continuing to develop.

Pathology, as it develops, goes through the following main stages:

First, the tumor metastasizes to the lymph nodes, which are located in the intestine. The first cases of damage to distant organs include the liver, where metastases settle.

The lungs are in second place in terms of frequency of metastases. They can also affect the abdominal region and skeletal system.

There are chances of recovery with a single metastasis, but with multiple metastases this is impossible, and in this case only maintenance therapy is prescribed.

Signs and symptoms of hemorrhoids turning into rectal cancer

The symptoms of advanced hemorrhoids and the onset of colorectal cancer are very similar and not different at all. The patient can find out about his problem only after diagnosis.

It is important not to let hemorrhoids progress, but rather to treat them at the first stage of development, when simple pharmaceutical preparations in the form of suppositories and ointments can help, and there is no need to resort to surgical intervention.

Symptoms and first signs of the onset of colorectal cancer are:

The same symptoms are observed with advanced hemorrhoids.

A growing tumor can restrict blood flow, causing the intestines to fail to pass through. As it grows, nausea and vomiting may begin.

Later, a change in stool frequency occurs; it may contain blood clots of bright red or dark color. There is a feeling of discomfort in the abdomen (cramps, bloating, increased gas formation, frequent pain). The patient begins to lose weight, diarrhea or diarrhea appears, and the symptoms are pronounced.

Photo

Video: how to treat hemorrhoids?

Rectal cancer is a low-quality tumor that grows in the mucous layer of the final section of the large intestine. According to available statistics, the pathology is diagnosed in men and women over the age of 40 equally. Most often, cancer cells are a consequence of chronic inflammatory processes (ulcers, colitis, proctitis), post-hemorrhoidal complications (anal fissures, fistulas, polyps).

Anatomical features

The final section of the digestive tract, the large intestine, consists of several segments: the cecum, colon, sigmoid and rectum. It is into the large intestine that food partially digested by the stomach enters, where it is further broken down and feces are formed.

Thanks to the peristalsis of the intestinal walls, they move through the intestine and enter its final section, ending in the anus with a sphincter (a muscular ring that narrows the end of the rectum and allows you to control the exit of feces from the body) through which they exit the body. In terms of diagnosis frequency, rectal cancer accounts for 65% of the most frequently detected neoplasms.

Causes of cancer development

There is no one specific reason that provokes the growth of cancer cells in the rectum. In medicine, there are a number of unfavorable conditions that create all the conditions for the degeneration of normal cells into tumor cells:

• Nutrition - according to statistics, colorectal cancer is detected 1.5 times more often in those people whose diet contains a lot of meat products, including pork (fatty, hard to digest food). The absence in the menu of cereals, vegetables and fruits enriched with plant fiber, which support normal intestinal motility, also creates favorable conditions for pathogenic microorganisms.
• Hypovitaminosis (vitamin deficiency) - a lack of vitamins A, C, E leads to the fact that too many carcinogens enter the intestines (factors and chemicals, the impact of which on the human body increases the likelihood of healthy cells mutating into cancer cells).
• Excess weight - obesity has a detrimental effect on the normal functioning of the entire intestine as a whole. Excess weight disrupts blood circulation in the organ and its peristalsis, which leads to frequent constipation and, as a consequence, favorable factors for the development of low-quality formations.
• Bad habits (alcohol abuse, smoking) - nicotine and alcohol have a detrimental effect on blood vessels, impair blood circulation, irritate the mucous walls of the intestines, which promotes the growth of cancer cells and the development of cancer of the rectum and other organs.
• Hereditary predisposition - genes are part of the chromosomes that are passed on to the child at conception. And if during the course of their lives the parents had changes in oncogenes (cancer) responsible for controlling cell division, then the already mutated genes are often passed on to the child. It is unknown how they will behave in the body of an adult and how they will contact the environment. But under the influence of unfavorable factors, they most often lead to the formation of malignant tumors.
• In rare cases, extremely unfavorable and harmful working conditions can cause cancer.

An important factor that creates the prerequisites for the development of low-quality formations in the rectum are precancerous pathologies:

• – growths on the intestinal mucosa that are benign in nature. Small tumors are usually not dangerous. But with intensive growth of the polyp and its size exceeding 2 cm, constant monitoring by a specialist is required;
• diffuse polyposis is a genetically transmitted disease. With it, multiple foci of polyps are formed in the large and straight intestines. In some cases from 100 or more;
• papillomavirus infection of the anus - viruses cause cell degeneration, change their properties, which can lead to the formation of cancerous lesions.

Symptoms and clinical manifestations

Signs by which the presence of pathology can be detected depend on the size of the neoplasm, stage of development, location and growth pattern of cancer cells:

• – in 90% of patients this is the most common sign of cancer. Feces, passing through the intestinal duct, injure the tumor located in the mucous tissue. With a small formation, blood leaves the organ in small quantities (these may be blood clots mixed with feces or red streaks). Considering that in the first stages of the disease the blood loss is very small, the development of anemia is excluded.
• Discharge of mucus or pus from the anus are symptoms of rectal cancer, characteristic of the last stages of an overgrown tumor. The release of mucus and pus occurs due to complications caused by the formation: in the later stages, the tumor disintegrates and begins to actively spread metastases to neighboring and distant lymph nodes and organs, causing severe inflammation in the mucous tissue of the organ.
• Problems with stool - failures can manifest themselves in different ways: frequent or diarrhea, painful urge to defecate, strong. The problems are caused by the inflammatory process in the mucous tissue and muscles of the intestinal walls.
• – a sign of pathology of the last stage of rectal cancer. The expanded cancer completely blocks the intestinal duct, causing chronic constipation (no bowel movements for more than 3 days). Poisoning of the body with stuck feces begins: the patient experiences pain, nausea, and vomiting.
• Severe pain - it can appear in the early stages of rectal cancer if the tumor is located directly on the sphincter. The patient cannot sit on hard surfaces because the pain intensifies. In medicine, this symptom is called “stool syndrome”. If cancer has affected the upper part of the intestine, then unbearable pain occurs only when it grows through the wall and when cancer cells damage neighboring organs.
• Severe changes in the general physiological condition of a person - the patient complains of weakness, lack of strength, loses weight, appetite, and quickly gets tired. The skin changes its color: it becomes pale, gray, sometimes earthy or bluish in color. At first, the signs manifest themselves very weakly; as the tumor increases in size, the severity of the person’s general poor health also increases.

Diagnostics

If the formation of a cancerous tumor in the rectum is suspected, the specialist conducts a survey of the patient, digital examination and visual examination of the intestine, prescribes instrumental examinations and tests.

Patient Interview

During the interview, the doctor records the patient’s complaints and the time of the onset of problems in the body, finds out the diet, existing bad habits, and place of work. To diagnose and clarify the nature of the clinical picture of the development of the disease, it is very important to establish a possible genetic predisposition.

Finger examination

Digital examination of the rectum is a simple method that allows you to detect the presence of abnormal formations in the intestine. By touch, the proctologist assesses the elasticity of the intestinal walls and the presence of any abnormalities.

Digital examination cannot confirm rectal cancer with 100% accuracy. But any deviations from the norm are immediately subject to further diagnostics to confirm or refute the diagnosis.

Instrumental studies

To identify low-quality neoplasms, a specialist prescribes a whole range of different diagnostic procedures:

• – the internal space of the intestine is examined using a sigmoidoscope (fiber optic tube with a diode lamp at the end). The proctologist inserts a device into the rectum and pumps air inside it to expand the lumen and visually examine the walls. During the procedure, polyps, erosions, ulcers, blood clots, tumor formations, etc. can be detected.
• Irrigography is an X-ray examination of the rectum using a polar substance (barium sulfate). Before the procedure, the patient's intestines must be clean. 1-2 days before the procedure, the patient should consume a sufficient amount of fluid (at least 1-2 liters per day). Difficult to digest foods should be completely excluded from the daily menu. Immediately before the procedure, the patient is given a cleansing enema. With the help of irrigography, various pathologies are identified: ulcers, neoplasms, their size and extent.
• Computed tomography - used in rare cases when the results of ultrasound and x-rays contradict each other. Using computed tomography, a layer-by-layer image of the organs of the pelvic region is obtained, which allows a reliable diagnosis to be made.
• Biopsy is a microscopic examination of a small piece of tissue. It is pinched off from the detected tumor in order to identify the nature of the pathology (malignant or benign). This is the most important test in diagnosing colorectal cancer.

If during an examination by a proctologist a low-quality tumor is detected, additional instrumental examinations are prescribed to identify metastases:

• X-ray of the abdominal organs - the examination is carried out without the use of a contrast agent. Using the procedure, the doctor assesses the condition of the intestines and neighboring organs.
• Fibercolonoscopy – distant parts of the intestine are viewed. This makes it possible to detect secondary foci of formations in regional organs: the sigmoid and colon.
• Radioisotope liver scan – in case of rectal cancer, secondary cancer cells most often affect the liver, which is clearly visible on the images.
• Laparoscopy is a microsurgery in which miniature cameras are inserted into the abdominal cavity through small holes in the abdomen. This allows you to assess the condition of all organs in this area, identify metastases, and take a sample of material for further research.
• Intravenous urography is used to detect metastases in distant organs: kidneys, ureters, bladder. Pathologies are detected using a polar substance (urografin or omnipaque), which is administered intravenously.

Lab tests

To identify the stage and extent of spread of a malignant formation, the patient is prescribed a set of laboratory procedures:

• Test for tumor markers (taking blood from a vein) – tumor markers are proteins released into the blood by cancer cells. Their content in the blood increases with the progression of the pathology. The test detects not only the presence of the tumor itself, but also the appearance of metastases even at an early stage, but only in conjunction with other diagnostic methods.
• Carcinoembryonic antigen is a substance present in the blood of the fetus while it is in the mother’s womb. In adults, its content in the blood is absent. High levels of antigen are detected only in the presence of cancerous formations in the rectum.
• Cytological examination is a microscopic examination of cellular elements in order to identify their nature (malignant or benign).

Types of tumor

Rectal cancer is classified according to several indicators: the types of cells in the tissue, the direction of the source of spread. All this directly affects further treatment and outcome of the disease.

Classification of tumors by cellular structure

Rectal tumors are divided into several types depending on their structural and functional structure:

• Adenocarcinoma is the most commonly diagnosed type of neoplasm in the rectum. In this case, the differentiation of the tumor is taken into account (the distance of pathogenic cells from normal healthy cells of neighboring organs). The lower the degree of differentiation, the more malignant the formation is and the more unfavorable the outcome of the disease.
• Signet ring cell carcinoma is diagnosed in 3% of cases. Under a microscope, pathological cells look like rings with a stone, which is why they get their name. Cancer with the most unfavorable course. The tumor grows rapidly and metastasizes to distant organs. Most patients die within three years of diagnosis.
• Solid cancer is very rare. Develops from poorly differentiated glandular tissues of the intestine. Modified cells are arranged in the form of layers.
• Squamous cell carcinoma is a common complication that occurs after a human papillomavirus infection. It is found mainly in the lower part of the rectum near the anus. Squamous cell tumors are characterized by rapid spread of metastases throughout the body.

Classification of tumors depending on the direction of growth

There are three forms:

• exophytic - a pathological formation develops mainly inside the rectum, gradually blocking its lumen;
• endophytic - a malignant tumor develops deep into the wall of the rectum, and the tumor gradually grows through it;
• mixed - a form characterized by signs of an exophytic and endophytic tumor.

Stages of rectal cancer

It is impossible to prescribe effective treatment without a clear understanding of the extent of the disease. Therefore, you should initially accurately determine the stage of the detected pathology. It depends on the size of the malignancy and the degree of damaged or undamaged organs.

• Stage 0 is epithelial cancer that develops in the inner part of the rectum.
• Stage I – the neoplasm is localized in the mucous tissue of the organ and occupies no more than 1/3 of the intestinal lumen, there are no metastases. When a tumor is detected at this stage, the prognosis is favorable, more than 80% of patients survive.
• Stage II – the size of the neoplasm does not exceed 5 cm. Lymph nodes are not affected or 1-2 in neighboring organs are affected. Once diagnosed, approximately 60% of patients survive.
• Stage III - the tumor closes the intestinal duct by more than 50%, affects more than 3 lymph nodes in nearby organs. Survival rate is low - 20%.
• Stage IV is the stage with the most unfavorable prognosis. The expanded tumor metastasizes to all neighboring organs (urethra, vagina, pelvic bones, uterus, etc.). Secondary foci of rectal cancer are also found in distant organs. The diagnosis is inoperable cancer, survival rate is 0%. At this stage, treatment and procedures are aimed at alleviating the patient’s condition and eliminating pain.

Features of treatment

The main and only method of eliminating rectal cancer is surgery. The organ or area affected by the tumor is removed. Radiation and chemotherapy are used as additional therapy to exclude possible relapses of the disease.

Surgical treatment

Currently, there are several options for surgical intervention.