Rectal Cancer Questions and Answers
1.What is rectal cancer?
It is the cancer located above the dentate line to the junction between sigmoid colon and rectum. In layman’s terms, it is a cancer that occurs in the rectum. The rectum is the last section of the large intestine connected with the anus, which is about 15 cm long.
2.What age group is prone to rectal cancer?
Rectal cancer is more likely to occur in middle-aged and elderly people above 40 years old, and the incidence ratio of men and women is basically equal. It is worth noting that the incidence of rectal cancer among young people in China has gradually increased in recent years. The young people we are talking about here are under 30 years old.
3.Is rectal cancer a genetic disease?
Rectal cancer is not a genetic disease, but there is a genetic tendency, that is, people with rectal cancer in their immediate family have a significantly higher risk of rectal cancer, which is about 2-3 times higher than that of ordinary people.
4.Is rectal polyp cancer?
Rectal polyp is not cancer, it is a benign lesion, but it can be malignant lesion, if it is benign lesion, we call it rectal polyp, such as rectal adenoma, if it is malignant lesion, then we directly call it rectal cancer. Benign rectal polyps can be transformed into cancer, i.e. cancer of polyps. Rectal polyps, especially adenomatous polyps, are currently recognized as precancerous lesions, and a significant portion of rectal cancer is transformed from these precancerous lesions.
5.What are the symptoms of early rectal cancer?
Blood in stool: Blood in stool is the most common symptom of rectal cancer and one of the earliest symptoms of rectal cancer. Initially, blood in stool is mostly painless, intermittent, small amount of blood in stool or blood on the surface of stool, which can be bright red or dark red.
2, change in bowel habits: increase in the number of stools without obvious reasons, change in the nature of the original stool, such as thinning, thinning and flattening of stool, etc.
3, the feeling of falling stool, the feeling of incomplete evacuation.
6.Is the presence of blood in stool a symptom of rectal cancer?
Blood in stool is not a symptom unique to rectal cancer. There are many causes of blood in stool, but the most common diseases of blood in stool are benign lesions of anus and rectum, such as hemorrhoids and anal fissure. Rectal cancer is, after all, a minority compared to these common diseases, but blood in the stool should not be simply attributed to hemorrhoids, anal fissures and other diseases, resulting in misdiagnosis and delayed treatment, the correct way is to go to the hospital to find a professional physician for examination.
7.How to distinguish between bleeding hemorrhoids and rectal cancer?
1.Bleeding nature: bleeding from hemorrhoids is fresh blood, while bleeding from rectal cancer is mostly dark red or with mucus in the blood.
2. Frequency of bleeding: bleeding from hemorrhoids is continuous for many days, while bleeding from rectal cancer is mostly intermittent.
3.Bleeding volume: bleeding from hemorrhoids can be dripping or even jet-like bleeding with more volume, while bleeding from rectal cancer is usually less in volume and mostly without jet-like bleeding.
8.What are the most common tests to diagnose rectal cancer?
The most commonly used and easiest examination method is rectal finger examination. Since more than 75% of rectal cancers in China are low rectal cancers, most of rectal cancers can be detected during rectal finger examination, and rectal finger examination does not require any auxiliary equipment and patients do not need intestinal preparation, so it is simple and easy to perform.
9.What other methods can diagnose rectal cancer besides rectal finger examination?
1.Colonoscopy: it can directly see the general shape of the lesion and take biopsy for further pathological examination to determine the nature of the lesion, which is the most accurate examination method for rectal cancer and is called the “gold standard” of rectal cancer examination.
2.CT and MR examination: although the tumor shape cannot be visualized like colonoscopy, the size of the tumor and the infiltration and spread of rectal cancer in the pelvic cavity can be understood, and whether there is invasion of uterus, bladder and pelvic wall, which is important for guiding surgery and is a routine preoperative examination method.
3.Tumor markers: the most commonly used is carcinoembryonic antigen, but it has no specificity and is only used for clinical reference.
To summarize: no method is perfect, each has its own advantages and limitations. Carcinoembryonic antigen is inaccurate and only for reference; CT and MR can see the whole picture, but cannot be biopsied and characterized; colonoscopy is intuitive and can be pathologically characterized, but cannot observe the invasive metastasis of tumors outside the intestinal cavity.
10.How to detect rectal cancer at an early stage?
1.Middle-aged and elderly people over 40 years old should pay special attention to the stool condition, and timely examination should be conducted to detect early rectal cancer if there is blood in stool, change of bowel habit and shape.
2, people with a family history of rectal cancer have a significantly higher risk of rectal cancer than normal people, so it is recommended that colonoscopy be performed every 2-3 years to detect problems for timely treatment.
3.Patients suffering from precancerous lesions such as rectal polyps should be surgically removed early once the diagnosis is clear in order to reduce the chance of cancer.
11.What are the types of surgical treatment for rectal cancer?
There are mainly the following surgical methods for rectal cancer.
1.Local excision.
2. combined abdominal perineal resection (without preserving the anus and permanent colostomy)
3, transabdominal proctocolectomy (with preservation of the anus)
4.Transabdominal rectal cancer resection, proximal colostomy and distal closure (preserving the anus and colostomy); the specific type of operation should be determined by the clinician according to the patient’s condition.
12.Does permanent colostomy seriously affect life?
The reasons for refusing or fearing stoma are mostly that the stoma is too dirty, affects the absorption of nutrients in the intestine, and fears other people’s jokes, in fact, this is a misunderstanding of colostomy, because
1, now there are reliable quality, very easy to use series of stoma products, the application of stoma bag stool will not pollute the surrounding, no odor, very hygienic.
2, removal of rectum and part of the sigmoid colon will not have any effect on the absorption of nutrients.
3, colostomy patients can live and work normally after recovery, with the extension of time, the stool will also resume its regularity, even if the number of stools is slightly more, due to the protection of the stoma bag, there will be no embarrassment of involuntary spillage of stool to pollute clothing. According to our clinical observation for many years, colostomy has little impact on patients’ working life, and patients can psychologically adjust themselves for a period of time after surgery and return to normal life soon.