Risk factors for rectal and colon cancers
Age and Gender
- Age: The risk of colon and rectal cancers increases significantly after the age of 50. Most cases are diagnosed in individuals aged 60 and older.
- Gender: Both men and women are at risk, but men have a slightly higher incidence rate compared to women.
Family History and Genetic Factors
- Family History: A family history of colorectal cancer or polyps increases risk. This is particularly true if a first-degree relative (parent, sibling, or child) has had the disease.
- Genetic Syndromes: Inherited conditions such as Familial Adenomatous Polyposis (FAP) and Lynch Syndrome (Hereditary Nonpolyposis Colorectal Cancer or HNPCC) significantly increase the risk. Individuals with these syndromes often develop colorectal cancer at a younger age and may have multiple cancers.
DIET
- Red and Processed Meats: High consumption of red meat (e.g., beef, pork) and processed meats (e.g., bacon, sausages) has been associated with an increased risk of colorectal cancer. These meats may contain carcinogenic compounds formed during cooking or processing.
- Low Fiber Intake: Diets low in dietary fiber, commonly found in fruits, vegetables, and whole grains, may increase risk. Fiber helps in maintaining regular bowel movements and may protect against cancer by producing beneficial compounds during digestion.
- Calcium and Vitamin D: Adequate intake of calcium and vitamin D may offer some protective effects against colorectal cancer. They are believed to play a role in regulating cell growth and differentiation.
Lifestyle Factors:
- Smoking: Tobacco use is a known risk factor for various cancers, including colorectal cancer. The carcinogens in tobacco can contribute to cancer development in the colon and rectum.
- Alcohol Consumption: Heavy and prolonged alcohol use is associated with an increased risk of colorectal cancer. Alcohol can act as a carcinogen, affect nutrient absorption, and contribute to liver disease, which may further impact cancer risk
Lifestyle Factors:
- Physical Activity: Regular physical activity is associated with a reduced risk of colorectal cancer. Exercise helps maintain a healthy weight and can positively influence gut motility and immune function.
- Obesity: Excess body weight, particularly abdominal obesity, is linked to a higher risk of colorectal cancer. Obesity can lead to chronic inflammation and insulin resistance, which are factors associated with cancer development.
Medical History:
- Previous Colorectal Polyps: Having a history of adenomatous polyps or other colorectal polyps increases the likelihood of developing colorectal cancer.
- Inflammatory Bowel Disease (IBD): Chronic inflammatory conditions like ulcerative colitis and Crohn's disease can elevate risk, particularly after years of persistent inflammation.
Symptoms of rectal cancer
Blood in motion/stools
Blood in the stool or rectal bleeding may occur when a tumor erodes into blood vessels in the rectal area, resulting in bright red or dark, tarry stool.into account your unique needs and circumstances.
Change in Bowel Habits
- Altered Stool Consistency: Patients may experience persistent diarrhea or constipation, with changes in stool consistency. Diarrhea can result from a tumor causing irritation or inflammation in the rectal area, while constipation may occur due to obstruction.
- Narrower Stools: A tumor may cause the stool to become narrower or ribbon-like as it partially obstructs the rectal lumen. This change is due to the tumor’s physical presence constricting the space through which stool passes.
- Increased Frequency: There may be a noticeable increase in the frequency of bowel movements as the body attempts to clear an obstruction or manage irritation caused by the tumor.
- Urgency and Incomplete Evacuation: Patients might feel an urgent need to have a bowel movement, or experience frequent, painful bowel movements that do not relieve the sensation of needing to go. and treatment options to ensure that our patients receive the best possible care.
Unexplained Weight Loss
Weight loss without a clear cause may result from decreased appetite, difficulty eating, or the body’s increased energy expenditure due to the presence of the tumor.
Tests done for Rectal cancer
Sigmopidoscopy/Colonoscopy
- Purpose: Visualizes the entire colon and rectum, allows for direct biopsy of suspicious lesions, and assesses the extent of the disease. To see for any other suspicious lesions in the colon.
MRI
- MRI is crucial in managing rectal cancer, offering detailed imaging that supports diagnosis, treatment planning, and monitoring. It helps assess tumor depth, lymph node involvement, and the distance from the tumor to the anal verge, which is essential for staging and planning appropriate treatments. MRI also plays a significant role in guiding surgical decisions, particularly in determining the feasibility of sphincter-saving procedures, which aim to preserve the anal sphincters and maintain bowel function. Postoperatively, MRI is used to detect any residual disease and identify complications, contributing to effective ongoing care.
CT Scan (Computed Tomography)
- Purpose: Evaluates the abdomen and pelvis to determine the size of the tumor, check for lymph node involvement, and detect metastases with in abdomen like liver metastases.
Biopsy Analysis
- Purpose: Confirms the diagnosis of rectal cancer, determines the histological type and grade of the tumor through microscopic examination of tissue samples.
Blood Tests
- Routine Blood Tests: Includes Complete Blood Count (CBC) to detect anemia and liver function tests to check for liver involvement.
Serum Marker
- Carcinoembryonic Antigen (CEA): A blood test used to measure levels of CEA, a protein that may be elevated in individuals with colon cancer. It helps in monitoring the disease, assessing treatment response, and detecting recurrence.
Treatment of Rectal Cancer
Surgery For Rectal cancer
Surgical treatment for rectal cancer is a fundamental aspect of therapy, tailored based on the tumor's stage and location, as well as the patient’s overall health. Here’s a summary of the main surgical approaches:
Types of Surgery:
- Local Excision: Suitable for very early-stage cancers (T1). The tumor and a small margin of surrounding tissue are removed through the rectum, often using a minimally invasive technique.
- Low Anterior Resection (LAR): For tumors in the upper and middle rectum. The rectum is removed, and the remaining bowel is reconnected, aiming to preserve the anal sphincters and maintain normal bowel function.
- Abdominoperineal Resection (APR): For tumors in the lower rectum or those involving the anal sphincters. The entire rectum and anus are removed, necessitating the creation of a permanent colostomy. This approach is used when a sphincter-preserving surgery is not feasible.
- Pelvic Exenteration: For advanced cases where cancer has spread to nearby organs. It involves removing the rectum, bladder, and possibly other pelvic organs, with reconstruction options based on the extent of the surgery.
Preoperative Considerations:
- Neoadjuvant Therapy: Chemoradiotherapy may be administered before surgery to shrink the tumor and improve the chances of a successful resection while preserving sphincter function.
- Surgical Planning: Detailed imaging, particularly MRI, is used to assess tumor extent and involvement of surrounding structures, guiding the surgical approach.
