Rectal Cancer: Advances in Research and Promising Therapies

 Understanding Rectal Cancer:

What is rectal cancer?

Rectal cancer is a type of cancer that forms in the cells of the rectum, the last six inches of the large intestine. Rectal cancer arises when malignant cells grow within the rectum, a section of the large intestine. The rectum positions itself between the colon and the anus and serves as a chamber for the final stages of waste elimination.

 

Who does rectal cancer affect?

Rectal cancer can affect people of various age groups and both genders. While it is more common in older adults, particularly those over 50, it can also occur in younger individuals. Certain risk factors, such as a family history of colorectal cancer, a personal history of other types of cancer, inflammatory bowel disease, or a sedentary lifestyle, may increase the likelihood of developing rectal cancer. Regular screenings and early detection are essential to improving the prognosis and treatment outcomes for those affected by this disease.

You can win the battle against Rectal Cancer

What is the first stage of rectal cancer?

Oncologists refer to the first stage of rectal cancer as Stage 0, or carcinoma in situ. At this stage, the cancerous cells are confined to the innermost lining of the rectum and have not yet invaded further layers of tissue or spread to nearby lymph nodes or distant organs. Stage 0 rectal cancer is considered the earliest and most treatable stage, with a high chance of successful treatment and cure if detected and treated promptly.

 

What is the difference between rectal and other cancers affecting the large intestine?

The main difference between rectal and other cancers affecting the large intestine is their specific locations within the digestive system.

• Rectal Cancer: Rectal cancer develops in the cells of the rectum, the last part of the large intestine. The sigmoid colon and the anus surround the rectum. Due to its location, rectal cancer may have unique symptoms and treatment considerations.
• Colon Cancer: Colon cancer, on the other hand, originates in the cells of the colon, which is the portion of the large intestine. Experts divide the colon into different segments: ascending colon, transverse colon, descending colon, and sigmoid colon. Tumours can form in any part of the colon. Symptoms and treatments for colon cancer may vary based on the tumour location. 

While rectal and colon cancers fall under the broader category of colorectal cancer, they are distinct entities due to their specific locations within the large intestine. Nevertheless, they share many similarities in risk factors, symptoms, and treatment options. Regular screenings and early detection are essential for both types of cancer to improve outcomes and increase the chances of successful treatment.

 

What are the warning signs of rectal cancer?

The warning signs of rectal cancer can vary, but some common symptoms to be aware of include:

Frequent Changes in bowel habits:

• Another warning sign of rectal cancer is persistent diarrhoea, constipation, or a sensation that your bowel is not completely emptying.
• Blood in the stool: Rectal bleeding or blood in the toilet after a bowel movement may occur in rectal cancer, especially if the blood is bright red or mixed with the stool.
• Abdominal discomfort: Cramps, pain, or a feeling of bloating in the abdomen may be present.
• Unintended weight loss: Significant and unexplained weight loss may occur.
• Fatigue and weakness: Feeling constantly tired or weak without a clear cause
• Narrow stools: One warning sign of rectal cancer is narrow stools, which means the stools become thinner than natural for you.
• Tenesmus: The feeling of needing to pass stool even when the rectum is empty.
• Anaemia: Low red blood cell count, resulting in fatigue and weakness due to chronic bleeding.

It is essential to remember that these symptoms can also be associated with other non-cancerous conditions. If any warning signs persist or cause concern, it is crucial to consult a healthcare professional for a thorough evaluation. Early detection and prompt medical attention can significantly improve the prognosis and treatment outcomes. Drs. recommend regular screening for colorectal cancer for individuals over 50 or those with a higher risk due to family history or other factors.

 

What is the prime cause of rectal cancer?

The cause of rectal cancer, like many other types of cancer, is not attributed to a single factor but rather to a combination of risk factors. Some of the prime factors that can increase the risk of developing rectal cancer include:

• Age: The risk of rectal cancer increases with age factor, and experts diagnose it in individuals over 50.
• Family history: A family history of colorectal cancer or certain hereditary conditions, such as Lynch syndrome or familial adenomatous polyposis (FAP), can increase the risk.
• Personal history of colorectal polyps or cancer: Individuals with previous colorectal cancer have a higher risk of developing rectal cancer.
• Inflammatory bowel disease (IBD): Chronic inflammatory colon conditions, such as ulcerative colitis or Crohn's disease, can increase the risk of rectal cancer.
• Diet: A diet high in processed foods and red meat and low in fibre may contribute to an increased risk of rectal cancer.
• Sedentary lifestyle: Lack of regular physical activity increases the risk of colorectal cancer, including rectal cancer.
• Smoking and alcohol consumption: Surgeons link tobacco use and heavy alcohol consumption to an increased risk of rectal cancer.
• Obesity: Being overweight or obese is a risk factor for various cancers, including rectal cancer.

It's important to note that while these factors can increase the likelihood of developing rectal cancer, not everyone with one or more of these risk factors will develop the disease. Regular screenings, adopting a healthy lifestyle, and early detection via screenings can help identify rectal cancer and improve treatment outcomes.

 

How is rectal cancer treated?

In treating rectal cancer, medical professionals employ combo approaches depending on the cancer stage and the patient's overall health. The primary treatment options for rectal cancer include:

• Surgery: Surgeons perform the prime treatment for early-stage rectal cancer, removing the tumour and surrounding healthy tissue to eliminate cancer cells. In some cases, surgeons use minimally invasive techniques like laparoscopic or robotic-assisted surgery to reduce complications and hasten recovery.
• Radiation therapy: Oncologists use high-energy X-rays or particles to target and destroy cancer cells. It is often applied before surgery (neoadjuvant) to shrink the tumour for easier surgical removal. Doctors use it after surgery (adjuvant) to eradicate any remaining cancer cells and decrease the risk of recurrence.
• Chemotherapy: Powerful drugs are employed to kill or inhibit the growth of cancer cells. Chemotherapy can be used with radiation therapy (chemoradiotherapy) or after surgery (adjuvant chemotherapy) to reduce the risk of recurrence or metastasis.
• Targeted therapy: Experts use Specific drugs to target particular molecules or pathways in cancer growth. Surgeons may combine it with chemotherapy for advanced or metastatic rectal cancer.
• Immunotherapy: Though less commonly used in rectal cancer and other cancer types, ongoing research explores the potential benefits of immunotherapy. It leverages the body's immune system to combat cancer cells.

The treatment plan is tailored based on the cancer stage, location, the patient's overall health, and preferences. A multidisciplinary team comprising surgeons, medical oncologists, radiation oncologists, and other specialists collaborates to create personalised treatment strategies. Patients play a crucial role in decision-making by discussing treatment options, potential side effects, and expected outcomes with their healthcare team. Regular follow-up and surveillance are essential for monitoring signs of recurrence or new developments.

 

What are the recent updates in rectal cancer treatment?

• Advancements in Minimally Invasive Surgery: Minimally invasive techniques, such as laparoscopic and robotic-assisted surgery, have become increasingly popular in rectal cancer treatment. These approaches offer the benefits of faster recovery, reduced pain, and shorter hospital stays.
• Organ Preservation Strategies: Medical researchers are exploring organ-preserving approaches, particularly for early-stage rectal cancer. These methods aim to avoid a permanent colostomy and maintain normal bowel function whenever possible.
• Precision Medicine and Targeted Therapies: Researchers are investigating specific molecular targets and genetic mutations that play a role in rectal cancer. This knowledge may lead to the development of targeted therapies that can effectively treat specific subtypes of rectal cancer with fewer side effects.
• Immunotherapy: Immunotherapy, which enhances the body's immune response against cancer cells, has revolutionised the treatment of various cancers.
• Enhanced Radiotherapy Techniques: Improvements in radiotherapy delivery, such as intensity-modulated radiation therapy (IMRT) and image-guided radiation therapy (IGRT), help to precisely target the tumour while sparing healthy surrounding tissues, reducing side effects and improving treatment outcomes.
• Personalised Treatment Approaches: With advancements in molecular profiling and genomic analysis, there is increasing interest in personalised treatment plans tailored to the unique characteristics of each patient's cancer.

Please note that the knowledge of cancer research and treatment is continually evolving, and there may have been significant developments in rectal cancer treatment beyond the last update. For the latest information and updates, it's best to consult reputable medical sources, research journals, and healthcare professionals specialising in oncology.