Rectal cancer, characterized by malignant growths developing in the cells of the rectum, ranks as one of the prevalent cancer types in the United States. Recent data from the American Cancer Society reveals that in 2023 alone, there were 46,050 new cases of rectal cancer, impacting both men and women.

Management of rectal cancer involves a range of treatment options tailored to individual cases. Factors such as tumor size, location, familial predisposition, and general health play pivotal roles in determining the suitable course of action.

What is the Diagnosis of Rectal Cancer?

Early detection of rectal cancer significantly enhances the prospects of successful management and recovery. The diagnostic process commences with a comprehensive medical history and physical examination, during which your physician will inquire about your symptoms, risk factors, and family cancer history.

Your healthcare provider will employ various diagnostic techniques to detect and evaluate rectal cancer:

• Colonoscopy: This procedure entails inserting a flexible tube equipped with a camera (endoscope) into your rectum and colon, enabling the visualization of the rectal lining and the identification of any abnormal growths or tumors.

• Digital rectal examination (DRE): Involving the insertion of a gloved finger into the rectum to palpate for any abnormal masses or growths near the rectal opening.

• Endorectal Ultrasound: This imaging modality utilizes sound waves to generate images of the layers of the rectum and nearby lymph nodes, aiding in determining the depth of tumor infiltration and its involvement with adjacent tissues.

• MRI (Magnetic Resonance Imaging): Offering high-resolution images that comprehensively assess the tumor's size, location, and relationship with neighboring structures.

• CT (Computed Tomography) Scan: Providing detailed cross-sectional images of the abdomen and pelvis, facilitating the evaluation of tumor extent and its impact on adjacent organs.

• Biopsy and pathology: If a suspicious growth is identified during a colonoscopy or imaging study, a biopsy may be conducted. During this procedure, a small tissue sample is extracted from the tumor for examination by a pathologist.

With advancements in medical technology and the adoption of a multidisciplinary approach, healthcare professionals are better equipped to accurately diagnose rectal cancer, enabling timely initiation of treatment and fostering an improved quality of life.

Types of Treatment for Rectal Cancer

Upon receiving a positive diagnosis of rectal cancer, the treatment process entails employing diverse strategies to effectively combat the disease and optimize outcomes. Here are three pivotal treatment modalities:

Surgical Interventions:

• For localized tumors—those confined to the rectum—surgery stands as a viable treatment option. Various surgical techniques include:

• Low Anterior Resection (LAR): This procedure involves excising the cancerous portion of the rectum and reconnecting the remaining healthy segments, restoring normal bowel function.

• Abdominoperineal Resection (APR): Reserved for more advanced tumors, this approach entails removing both the rectum and anus, followed by the creation of a permanent colostomy—a surgical opening in the abdominal wall for waste disposal via a bag.

• Transanal Endoscopic Microsurgery (TEM): A minimally invasive technique utilizing specialized instruments to extract early-stage tumors through the anus.

• Local Excision: In this approach, the cancer is removed via the rectum, obviating the need for extensive incisions.

Surgery aims to excise the cancerous growth, with the surgeon removing the affected part along with surrounding healthy tissue to ensure thorough eradication.

Chemotherapy:

• Utilizing drugs to annihilate cancer cells or impede their proliferation, chemotherapy can be administered before or after surgery, either independently or in conjunction with other therapies. Pre-surgery, neoadjuvant chemotherapy may be employed to shrink the tumor for easier removal, while post-surgery, adjuvant chemotherapy aims to eradicate residual cells and diminish the likelihood of recurrence. In cases where cancer has metastasized to the liver or beyond, systemic chemotherapy may be recommended, targeting cancer cells throughout the body via oral medication or intravenous infusions.

Radiation Therapy:

• This treatment modality employs high-energy radiation beams to target and obliterate cancer cells. It can be utilized before or after surgery to diminish tumor size, enhance surgical outcomes, or eradicate lingering cancerous cells. External beam radiation administers focused radiation externally, whereas internal radiation (brachytherapy) involves placing a radioactive source in close proximity to the tumor site.

Treating Rectal Cancer in Maryland

If you are looking for more information on the treatment options for rectal cancer, pleasecontact us today.Bowie Internal Medicine is committed to the overall health and preventative care of our patients.