About Rectal Cancer

Rectal cancer is a malignancy inside the rectum, which comprises the last several inches of the large intestine. The rectum starts at the end of the final segment of the colon and ends at the short, narrow passage leading to the anus.

Rectal cancer can occur simultaneously or separately from colon cancer. While similar to colon cancer, rectal cancer is treated differently because of its location. The rectum is in a tight space and barely separated from other organs in the pelvic cavity. Complete surgical removal of rectal cancer is difficult and highly complex. Rectal surgery must be done by experienced surgeons such as those at Virginia Mason with the expertise to ensure that nearby organs are spared.

To reduce the chance of the cancer’s return, additional treatments are often needed before or after surgery. Virginia Mason’s Gastroenterology services are ranked in the top 5 percent in the nation, so it is the best place to have these pre- and post-surgical treatments that may include chemotherapy and radiation

Symptoms of Rectal Cancer

In the past, long-term survival of rectal cancer was rare. But treatment advances over the past 30 years have meant that rectal cancer can now, in many instances, be cured.

Symptoms of rectal cancer include:

  • A change in bowel habits
  • Blood or mucus in stool
  • Abdominal pain and/or painful bowel movements
  • Iron deficiency anemia and unexplained weight loss
  • A feeling that the bowel hasn't emptied completely
  • Weakness or fatigue

Rectal Cancer Risk Factors

The factors that increase the risk of rectal cancer are the same as those that increase the risk of colon cancer and include:

  • Older Age — Colorectal cancer can occur in people younger than 50 but it occurs much less frequently.
  • African-American Descent — People of African ancestry born in the United States are at greater risk than people of European ancestry.
  • A Personal History of Colorectal Cancer or Polyps — Someone who's had rectal cancer, colon cancer or adenomatous polyps, is at greater risk.
  • Inflammatory Bowel Disease — Chronic inflammatory diseases of the colon and rectum, such as ulcerative colitis and Crohn's disease, increase risk.
  • Hereditary Syndromes — Genetic syndromes passed through generations of a family that increase the risk of colorectal cancer include FAP and HNPCC.
  • Family History of Colorectal Cancer — People more likely to develop colorectal cancer are those with a parent, sibling or child with the disease. If more than one family member has colon cancer or rectal cancer, the risk is even greater.
  • Dietary Factors — Colorectal cancer may be associated with a diet low in vegetables and high in red meat, particularly when the meat is charred or well-done.
  • A Sedentary Lifestyle — Regular physical activity may reduce this risk.
  • Diabetes — People with poorly controlled type 2 diabetes and insulin resistance may have an increased risk of colorectal cancer.
  • Obesity — Obese people have an increased risk when compared with people considered normal weight.
  • Smoking — People who smoke may have an increased risk.
  • Alcohol — Regularly drinking more than three alcoholic beverages a week may increase risk.
  • Radiation Therapy for Previous Cancer — Radiation therapy directed at the abdomen to treat previous cancers may increase the risk.

Regular Screenings Are Important

Everyone, even seemingly healthy people, should talk to their doctor about when to start getting screened for colorectal cancer. Guidelines generally recommend having the first colorectal cancer screening test at age 50. If there are other risk factors, such as a family history of colon or rectal cancer, earlier or more frequent screenings may be advised.

A colonoscopy is the most accurate test. During a colonoscopy, a doctor examines the lining of the rectum and large intestine using a long, flexible tube with a tiny video camera at its tip (a colonoscope). If a polyp or suspicious-looking area of tissue is found, the doctor can take tissue samples from these areas with instruments inserted in the colonoscope.

Prompt Access to Specialized Care

Survival of rectal cancer depends on a prompt and accurate diagnosis and treatment at a first-class facility such as the Virginia Mason Cancer Institute. Our patients often see a provider the same day they call so that early detection is possible and treatment can begin immediately. Care before and after treatment is designed to rapidly restore health and get patients back to normal activity as soon as possible.

All Virginia Mason patients have their cases reviewed at a weekly Rectal Cancer Tumor Board by a multidisciplinary group of experts experienced in treating this disease ensuring that the best treatment is matched with each individual patient.

If you have questions about rectal cancer or would like to make an appointment with one of our specialists, please call us at (206) 341-0060.