Rectal cancer

Malignant tumors that arise in the rectum are called Rectal cancer or Rectal cancer designated. Rectal cancer is one of the colorectal carcinomas, which in Germany is the second most common type of cancer in both men and women.

What is rectal cancer?

Rectal cancer often does not produce clear symptoms at the beginning. As the disease progresses, the tumor can cause stomach cramps and constipation or an obstruction of the intestines.
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Rectal cancer is the collective name for all malignant tumors of the rectum. The rectum is part of the rectum and therefore also part of the large intestine. It is the approx. 15-18 cm long section of the intestine between the sigmoid colon and the anal canal.

It is used to store intestinal contents until the next defecation and is lined with intestinal mucosa, which differs significantly from that of the upstream colon sections. Cancer of the rectum (rectal carcinoma) can be differentiated from colon cancer (colon carcinoma), although both types of cancer are similar and are therefore often grouped under the term colorectal carcinoma.

causes

A Rectal cancer usually develops as adenocarcinoma, i. H. the tumor arises from glandular tissue. The tumor cells multiply in an uncontrolled manner and regardless of the surrounding tissue. As with other types of cancer, mutations in rectal cancer are responsible for the uncontrolled division of tumor cells.

In about 95% of the cases the fatal gene mutations arise sporadically, in only 5% they are hereditary. It is believed that rectal cancer takes several benign preliminary stages to develop into malignant cancer. The preliminary stages are called colon adenomas or polyps and can exist as benign growths for years before they degenerate.

Symptoms, ailments & signs

Rectal cancer often does not produce clear symptoms at the beginning. As the disease progresses, the tumor can cause stomach cramps and constipation or an obstruction of the intestines. The constant pain is usually associated with reduced performance and fatigue. People generally feel very exhausted, with tiredness increasing as the disease progresses.

Usually there is also a loss of appetite, which can lead to weight loss. Rectal cancer manifests itself as visible bleeding from the anus and pain when defecating. The chair habits can change for no apparent reason. These signs are accompanied by general symptoms such as fever and increasing malaise.

Symptoms of rectal cancer develop insidiously, often over several years, and get worse over time. In the advanced stage, chronic stomach pain sets in. Patients also develop intolerance to certain foods, especially meat, spicy foods, alcohol and coffee.

If left untreated, the cancer will progress and cause serious complications. Untreated cancer is usually fatal. First of all, the physical condition decreases sharply and the person concerned becomes bedridden, which leads to further health problems.

Diagnosis & course

Colorectal carcinoma is one of the most common cancers in Germany. The annual number of new cases is 20 to 40 per 100,000 inhabitants, with the incidence peak in the 6th and 7th decades of life.

Older insured persons are entitled to colonoscopies and stool tests at regular intervals for early detection. In addition, symptoms such as blood in the stool, a noticeable change in bowel movements, pain, weight loss and fatigue can lead the patient to the doctor. The previous history and current complaints are used for diagnosis.

The diagnosis is confirmed by a colonoscopy, which also includes biopsies. A pathologist then examines the tissue sample to differentiate between benign and malignant growths. Further apparatus-based examinations can be X-ray contrast enemas, computer tomography or ultrasound examinations.

The diagnosis is confirmed Rectal cancer, the tumor stage must be determined. For this purpose, it is checked how deep the tumor cells have penetrated into the intestinal wall and whether they have already metastasized to neighboring organs or lymph nodes or even affected structures such as the liver or lungs.

Complications

Rectal cancer initially leads to indigestion and severe pain. Typical complications are also bowel obstruction due to the tumor and, as a result, perforation of the bowel wall. This can lead to peritonitis with life-threatening sepsis. Sometimes the cancer spreads to neighboring organs (bladder, vagina, liver) or presses off vital blood vessels.

This can lead to tissue necrosis, i.e. an infarction and death of the intestine or the surrounding organs. Well advanced rectal cancer often metastasize. These can affect the liver and cause coagulation disorders, edema and inflammation. Ultimately, liver failure occurs and the patient dies. Wound infections, bleeding, and pain may occur after colon cancer surgery.

A temporary bowel failure can lead to intestinal paralysis and, as a result, digestive problems. In addition, so-called anastomotic leakage can occur, in which the seam between two intestinal ends is leaky. Occasionally, complications such as digestive problems, incontinence, and bladder and sexual function disorders persist. Complications caused by the prescribed drugs (e.g. side effects, allergic reactions, interactions), on the other hand, usually do not last long.

When should you go to the doctor?

Persistent or increasing digestive problems should be clarified by a doctor. If you experience repeated discomfort during bowel movements, this should be discussed with a doctor. If you are tired, have a loss of appetite or feel exhausted, a doctor's visit is advisable. Rapid exhaustion while doing everyday as well as light physical tasks is a cause for concern. If this condition occurs despite a restful night's sleep, a doctor is required. If there is an unwanted weight loss, deterioration in general performance or stomach problems, a doctor should be consulted. Pain in the upper abdomen or intestines, a general feeling of illness or malaise should be examined and treated by a doctor.

Discomfort when going to the toilet, blood leaking from the intestines and pain in the anus are also signs of an existing irregularity. A doctor's visit is necessary so that the cause can be clarified. Fever, social withdrawal, irritability and a decrease in well-being indicate a health impairment. Since rectal cancer can lead to fatal disease if left untreated, a doctor should be consulted as soon as the first discrepancies arise. If the symptoms increase in scope and intensity, we urgently recommend consulting a doctor. If you have intolerance to food, spicy food, caffeinated drinks or alcohol, you should consult a doctor.

Treatment & Therapy

Therapy planning at Rectal cancer depends on various aspects, u. a. on the size and spread of the tumor, the degree of metastasis and the general condition of the patient. In most cases, treatment begins with surgical removal of the tumor tissue from the intestine. Nowadays, natural stool passage can often be obtained. If the sphincter has to be removed, an artificial exit of the large intestine (so-called colostomy) is created. In order to kill remaining tumor cells and prevent recurrence, chemotherapy or radiation therapy is used after the operation.

These can also be indicated as palliative therapy if a cure is no longer possible, but the life expectancy and / or quality of life of the patient can still be improved. Careful follow-up care of the tumor is also essential for patients with a good prognosis: regular follow-up checks should be carried out up to 5 years after successful tumor resection. The 5-year survival rate for rectal cancer is 40 to 60%.

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Outlook & forecast

The stage of the disease at diagnosis is decisive for the chances of recovery and survival. If the metastases have not yet formed, there is a good chance of recovery. Five years after starting therapy, around three quarters of such patients are still alive. Significantly poorer prospects arise with metastasis on the lungs or liver. Such forms can no longer be successfully remedied.

Like many other tumor diseases, rectal cancer carries a high risk of relapse. If you want to live symptom-free for life, you cannot avoid regular follow-up care. The life-threatening tumors arise when the original tumor has not been completely removed. The experience and skill of the surgeon therefore have a decisive influence on the prognosis.

The risk of illness increases significantly in old age. Most patients are 60 and older at diagnosis. It is noticeable that they often include long-term smokers. People with an intense alcoholic past can also sometimes be found. In total, around 30 out of 100,000 residents develop rectal cancer each year. Refraining from treatment turns out to be a serious mistake. Because the disease progresses continuously. The infestation of vital organs can no longer be stopped in the event of a late diagnosis.

prevention

An advanced age is a major risk factor for Rectal cancer. But there are also risk factors that can be influenced: Long-term smoking significantly increases the risk of the disease.

A high consumption of red meat is also suspected of increasing the risk of colon cancer. The consumption of fish and fiber, on the other hand, should have a protective effect, as well as an adequate supply of vitamin D, which can be ensured through food or sufficient sun exposure. The preventive check-ups also serve: Early detection and preventive removal of polyps can help prevent them from turning into rectal cancer. People with a family history of colon cancer in particular should take advantage of the screening tests.

Aftercare

After the actual treatment of rectal cancer, those affected need ongoing care. In addition to regular medical examinations and the use of other therapies, a change in lifestyle is also part of the follow-up care. Those affected now have to build quality of life again.

The support of the responsible doctors as well as acquaintances and friends is also important in coping with the disease. Those affected can call in cancer counseling centers and psycho-oncologists; it may help to go to a self-help group to exchange information. Visiting a self-help group is also an important part of aftercare.

The aftercare plan is drawn up together with the doctor and is based on the symptoms, the general course of the disease and the prognosis. Follow-up care is particularly important in the first phase, when patients are still processing the consequences of the disease and treatment. It is crucial to support the patient until a remission is achieved.

The risk of relapse decreases every year. The rule of thumb is five years, and the stage of the cancer is also decisive. Medical rehabilitation may also include taking antihormones and other medications. In the case of protracted illnesses, follow-up checks and follow-up care merge. The details of aftercare will be discussed during the discharge interview or at a separate appointment. The further course of rectal cancer depends very much on the time of diagnosis, so that no general predictions can be made.

You can do that yourself

Dealing with cancer is particularly challenging in everyday life. Contacting self-help groups can be helpful. Sick people can exchange ideas here in an anonymous setting and give each other tips on how to cope with various challenges. A cure for the disease is very unlikely without medical care. Therefore, it is very important to work with the treating doctor.

In individual cases there have been reports that a change in lifestyle has alleviated the symptoms. However, there is no proven and statistically verifiable method. A healthy lifestyle helps to improve general well-being. The diet should be balanced and wholesome. The intake of lots of fiber, vitamins and minerals is particularly important. In spite of a loss of appetite or nausea, an adequate food intake must be ensured. The consumption of harmful substances and toxins such as nicotine, alcohol and drugs should be avoided as a matter of principle.

Relaxation techniques are recommended for mental support and stabilization of the psyche. Yoga, meditation, autogenic training or Qi Gong are the methods that are used particularly frequently. If your health allows, physical activity can be promoted through adequate exercise. Walks or light exercises to strengthen the muscles promote well-being. At the same time, excessive stress on the organism must be avoided.