Rectal and colon cancers are rated among the top five cancers in incidence around the world with variable incidences in various nations. The incidence is very high in western countries and far east countries and is frequently observed in Indian subcontinent. Rectal cancers among the abdominal cancers generally have very good prognosis with advancements of surgical techniques with radiotherapy and chemotherapy. However, they remain challenging when compared to colon cancers because of sphincter function involved especially in lower rectal cancers.
Common causes and risk factors of colon cancers
- high consumption of fat and red meat in diet
- Family history and hereditary predisposition of colon cancers
- Genetic history of colon cancers
- Inflammatory bowel disease like ulcerative colitis.
Common symptoms of colon cancers
- Alteration of bowel habits ( constipation/ loose stools)
- Pain in localised to pelvis with occasional cramps while passing stools
- Blood and mucous in the stools
- Lower back pain
- Weight loss and loss of appetite
- Symptoms related to involvement of adjacent organs urinary bladder, stomach or pancreas depending upon location.
- Symptoms of spread to lungs, liver and brain
Diagnosis and investigations
These symptoms should not be ignored and consulted with ur clinician/ surgeon for further examination and advice. After clinical examination, patient is advised to undergo blood investigations and colonoscopy and biopsy for further examination of colon. Contrast enhanced computerised tomography ( CECT) abdomain is done to assess the location, size, spread and involvement of surrounding structures.
Magnetic resonance imaging(MRI) of the pelvis is done to assess the local involvement of muscles and anal canal shin yet complex. PET scan can be used in high suspicion of spread to other major organs of the body. Once the stage of the cancer is determined treatment is planned in accordance with surgeon and cancer specialist in best interest of patient.
Treatment for rectal cancers
Surgery remains the mainstay of the treatment and provides definitive cure to the patient. Surgery depends upon the part of the colon involved( Low anterior resection, Ultra low anterior resection, abdominal perineal resection, Trans anal mesorectal excision are commonly done surgeries). Use of minimal invasive surgery ( laparoscopic/ robotic surgery) have tremendous benefits in improving the outcomes for colon and rectal cancer surgeries and is applied at many hospital across globe. Conventional open surgery always remain an option.
Radiation therapy plays key role in rectal surgeries where preoperative Chemotherapy and radiotherapy is used to shrink the size of tumours and kill the cancers cells in local area. Chemotherapy is almost always used after surgery except in very early stages of rectal cancer to kill the cancer cells in the body operative stay in hospital after colon resection surgeries is usually 3-7 days depending upon the recovery of the patients.
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