Are you hitting your 50s, and have you noticed bright red blood mixed with your stools? Or just blood coming from your anus instead of faeces? Have your bowel habits changed recently? It is highly recommended to visit your medical practitioner and get yourself an appointment for diagnostic testing.
There may be little to worry about because rectal cancer can be cured successfully if diagnosed early and treated promptly. That’s why the American Society of Colon and Rectal Surgery recommends annual screening tests for rectal carcinoma at age 45.
Rectal cancer occurs when cancer cells develop in the epithelial lining of your rectum (the last 6-inch segment of your digestive tract just above the anus). Cancer cells are abnormal cells that keep forming new cells like themselves, causing various symptoms in the body. When such abnormal cells develop in rectal tissue, the condition is called Rectal Carcinoma.
Rectal cancer is the third most common type of cancer in America. It is also the second most lethal cancer, making its early diagnosis and treatment crucial. According to the 2020 worldwide cancer data, rectal cancer is the second commonest cancer in women and the third most typical cancer in men.
Sad to say, the American Cancer Society forecasts a little less than 45000 new cases of rectal cancer in 2022.
Common Symptoms of Rectal Cancer
At very early stages, rectal cancer may not show any symptoms at all. Sometimes, it is accidentally found on routine screening examinations by your doctor.
As the tumour progresses, rectal bleeding is the earliest symptom. This is an alarming sign of rectal cancer and should be taken seriously. Rectal bleeding means bright red or very dark blood discharged from your anus. You may notice it on your toilet paper, in the toilet bowl’s water, or mixed with your stools.
Your bowel movements may also change, causing diarrhoea, constipation, or a change in the consistency of your stool. Some other common symptoms of rectal cancer include:
- Narrower diameter of your stool (tumour mass obstructing the opening of your anus)
- Feeling that your bowel hasn’t emptied completely
- Feeling pain while passing stools.
- Unintentional weight loss
- Pelvic or lower abdominal pain
- Frequent abdominal bloating and cramps
- Feeling tired all the time
You may possibly have iron-deficiency anaemia resulting from blood loss in rectal bleeding.
Who Is At Risk For Rectal Cancer?
The exact cause of rectal cancer is not known. But many factors can increase your chances of having rectal cancer in your lifetime. Common risk factors for the development of rectal cancer include:
- Old Age. Rectal cancer can occur at any age. However, most people with this cancer are above their 50s. Nonetheless, its incidence in the younger population is also increasing nowadays.
- Race. African-Americans are at a higher risk of rectal cancer than other populations.
- Family History. If you have a parent, sibling, or child diagnosed with rectal cancer, you are twice as likely to have it as compared to others.
- Inflammatory Bowel Diseases. Being a chronic patient of inflammatory diseases of the colon and rectum, such as ulcerative colitis or Crohn’s disease, can also elevate your risk of rectal cancer.
- Previous History Of Rectal Cancer. If you’ve already had adenomatous polyps, colon cancer, rectal cancer, your risk of developing it again is high.
- Genetics. Genetic syndromes such as Lynch Syndrome and FAP can increase your risk of developing rectal cancer.
- Unhealthy Lifestyle. Smoking, alcohol drinking, eating processed foods, and very few vegetables can also increase your risk of rectal carcinoma.
- Radiation Therapy For Previous Cancers.
If you have any of the risk factors mentioned above, it is highly recommended to get yourself a screening test for rectal cance (discussed below) as soon as possible.
Tests For Rectal Cancer Diagnosis
If there is a suspicion that you might be having rectal cancer, the following tests may be advised to reach the diagnosis.
Physical Examination
While performing your physical examination, your physician will feel your abdomen to see if there’s any enlarged organ or a mass there and examine the rest of your body. An essential part of this may be Digital Rectal Examination. Your doctor will first lubricate your anus and then insert a gloved finger inside it to see if he can feel any lump or mass there. You wouldn’t feel any pain during this procedure.
Faecal Immunochemical Test (FIT)
This is a screening test for colorectal cancer. It means that it can detect rectal cancer in its early stages when no other symptoms have developed.
FIT is very specific for rectal blood in the stools, meaning that the chances of getting a false negative result are very minimal. When rectal cancer is just beginning to develop and has not grown much in size, it only causes a very minute amount of blood in the stool. FIT detects the presence of this hidden blood in the stool, which otherwise is invisible to your eyes.
If you meet any of the risk factors listed above, the American Society of Colon and Rectal Surgery recommends annual screening via FIT beginning at 45.
Feel like getting yourself screened for rectal cancer? We are here to help you at a minimal cost. GastroLife provides the best FIT testing services all across Ireland. You can order our home testing kit to collect your stool sample in a few easy steps and send it back to the laboratory. Once the tests are completed, you will get notified about the results.
Blood Tests
Your doctor may also recommend blood tests such as CBC or haemoglobin levels to see if you have anaemia due to rectal bleeding. Another critical test is to measure the levels of CEA in your blood.
CEA (or carcinoembryonic antigen) is a protein secreted by many cancer cells (including rectal cancer). Typically, its levels are almost around zero in the blood. CEA levels more than 5ng/mL suggest malignancy.
However, rather than diagnosing rectal cancer, the CEA test is vital in follow-up and checking if anticancer treatment (chemotherapy, radiotherapy) is working effectively against the tumour. Decreasing levels of CEA after following a treatment regimen indicate the regression of rectal cancer. On the other hand, if CEA levels spike again after the tumour mass has been removed surgically, it shows recurrence of the disease.
Colonoscopy and Sigmoidoscopy
During these procedures, your doctor inserts a thin tube (containing a camera and a light at the end) in your anus to visualise the inside of your rectum and colon. Your doctor may also collect a sample of your rectal tissue for biopsy. During the biopsy, tissue is examined under a microscope to see if cancerous cells are present.
Imaging Tests
If you’re diagnosed with rectal carcinoma, your doctor may prescribe a CT scan, PET Scan, or MRI of your body. These tests are mainly done to see if rectal cancer has spread to your body’s other tissues (liver, lungs, brain).
Treatment of Rectal Cancer
Your doctor may consider many things while recommending a suitable treatment for your condition. Tumour size and its spread, your age, and health conditions must be considered before starting your treatment.
Depending on the stage of your rectal cancer, your doctor may opt for endoscopic or surgical removal of the tumour mass, with or without chemotherapy and radiation therapy, to halt the further growth of cancer cells. You may also need a colostomy after surgical resection of your rectum to help you excrete faeces easily.
Take-Home Message
If you note having any of the risk factors for rectal cancer, it is highly recommended that you contact your GP. You can also get yourself booked for the Faecal Immunochemical Test for early detection of your condition. A few clicks to GastroLife, and we will take care of the rest for you.
