What is rectal cancer?
The portion between the lower part of the large intestine known as sigmoid colon and the anal canal is known as rectum. Cancers of this region are known as rectal cancers. Though usually clubbed with colon cancers, rectal cancers behave and are treated somewhat differently, Rectal cancers are among the more common cancers.
What causes rectal cancer?
What are the symptoms of rectal cancer?
You can hear Dr Anil Kamath speaking on various aspects of Colorectal Cancer:
Who gets rectal cancer?
Both men and women get rectal cancer, though men are slightly more likely to have the disease when they are over the age of 50. However, it is possible for teens and young adults to occur rectal cancer, as well.
How is rectal cancer diagnosed?
The most important test for diagnosis of rectal cancer is a colonoscopy. In this a lighted tube attached to a camera is passed up the anal canal. If any suspicious lesions are seen biopsy is done and sent to the pathologist. The pathologist will see the tissue under a microscope and confirm if there is cancer or not.
Once confirmed the next step is to assess the spread. For these various tests like PET CT scan or MRI is required.
How is rectal cancer treated?
Treatment for rectal cancer depends on several factors, including the size, location and tumour
Broadly treatment is as follows
For very early-stage rectal cancer which has not gone very deep and not spread to the lymph nodes the main treatment is surgery.
For intermediate stage cancers combination treatment is required. This is usually chemotherapy and radiation followed by surgery and further chemotherapy after surgery
For advanced stages where disease cannot be cured treatment usually chemotherapy. It is not possible to cure the disease and the intent is to reduce complications and prolong survival.
What is the type of surgery performed for rectal cancer?
The surgery is performed depending on the location of the tumour. For the purpose of surgery rectal cancer is divided into upper, middle, and lower.
The main challenge in rectal cancer is to preserve the anal sphincter when suitable and to prevent the nerves supplying the penis responsible for erection and ejaculation.
In upper rectal cancers preservation of the sphincter is not much of an issue. In most cases the affected portion of the rectum along with its covering known as mesorectum can be cut and the ends joined. This procedure is called as high anterior resection.
For tumours involving the anal canal where the sphincters are involved or cannot be saved the rectum and anal canal must be removed, necessitating a permanent colostomy. This procedure is known as abdominoperineal resection.
Tumours of the mid and lower rectum which are close but not involving the sphincters can be surgically quite challenging. The size of the tumour in these cases is reduced by using chemotherapy and radiation. If there is a good response to chemotherapy and radiation then a sphincter preserving surgery can be performed. This procedure is known as low anterior resection.
Can rectal cancer surgery be performed robotically?
Robotic surgery has found a major application in rectal cancers. This is especially so for mid and lower rectal cancers. The benefits of robotic surgery are :● Magnified vision enabling better visualisation of the anatomy facilitating preservation of the nerves and sphincters.
● Early post operative recovery
● Lesser pain