UW Health Colon and Rectal Surgeons in Madison, Wisconsin are experts in the surgical management of rectal cancer.
Rectal cancer is a malignancy in the most distal (farthest away point of attachment) part of the gastrointestinal tract, the rectum. The rectum sits just above to the anal opening.
Symptoms of Rectal Cancer
Presenting symptoms for digital rectal cancer may vary depending on the patient. Symptoms may include blood in the stool or change in bowel habits, such as thin stools, diarrhea or constipation. More insidious symptoms such as shortness of breath and fatigue may indicate anemia from chronic blood loss associated with a tumor.
Diagnosis of Rectal Cancer
Bowel habit changes and/or symptoms worrisome for rectal cancer require a full workup.
A complete physical examination including rectal examination is required.
Further investigation involving bowel preparation and subsequent colonoscopy or flexible sigmoidoscopy is necessary to visualize the inside of the colon or rectum.
Suspicious masses or polyps can be biopsied or removed if they are small enough. These biopsies are studied under the microscope to differentiate benign lesions (polyps) from malignant tumors (cancer).
In order to assess for metastatic disease (tumor outside the colon), a CT scan of the abdomen and pelvis must be obtained. Further investigations with a chest X-ray, laboratory evaluations and trans rectal ultrasounds are often ordered as well.
Treatment of Rectal Cancer
The rectum, although an extension of the colon, has a different treatment approach than the more proximal colon. In many instances dependent on the stage, rectal cancers are treated with chemo radiation prior to surgical intervention.
Much like colon cancers, rectal cancer can be surgically removed both by an open approach or minimally invasive laparoscopic surgery. This requires removal of a portion or all of the rectum dependent on the tumor level. In some cases this may require a permanent colostomy (colon brought through the abdominal wall).
Additional chemotherapy after surgery may be required depending on the tumor stage. In very select, early cancers, a transanal approach for removal may be possible.