Rectum Cancer

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Rectum Cancer

What is Rectum Cancer?

It is known that there are different "risk factors" that are effective in the development of colorectal cancer (CRC). These; being over 50 years old – due to fat

rich, fiber-poor diet – Presence of “synchronous” or “metachronous” (developed later) colorectal adenoma or CRC – “Amsterdam-I” “Amsterdam-II”, which relates cancer cases in the family to the possible cancer risk of other family members ” and “Hereditary risk factors” expressed by “Bethesta criteria” – can be counted as the “risk of developing CRC” that develops in the advanced stages of ulcerative colitis and Crohn's disease.

Rectum cancer (RC) constitutes approximately of CRCs, which are seen with a frequency of 50 per 100 000 in developed societies and rank 4th among all cancers. The main feature that distinguishes the rectum from the colon is the difference in its location.

When viewed from the perspective of macroscopic pathology, we mostly see RCs in the "polypoid (vegetarian) - ulcerous - infiltrative" types, and they are the least common infiltrative types. Microscopically, is "adenocarcinoma".

Symptoms

While some patients with RC may remain asymptomatic until the disease reaches an advanced stage, they may consult a physician with complaints such as changes in defecation patterns (newly occurring constipation or diarrhea, recurrent), rectal bleeding, decrease in stool diameter, difficulty in defecation, and similar complaints. Perianal pain - anal sphincter, nerve tissues or bone involvement, and tenesmus (painful feeling of defecation) are symptoms of "advanced disease", suggesting a decrease in rectal capacity caused by a large-volume tumor. Stenosis that prevents passage through this area causes abdominal swelling, nausea, vomiting and colic-like pain. In some cases, the rectum may become obstructed by a tumor mass and a "bowel obstruction" situation may develop.

The most common symptom due to RC is change in defecation habits, and the second most common symptom is rectal bleeding.

Tumors can be detected by examining the anal canal and rectum with "finger" or "endoscopy".

Definitive Diagnosis

It is diagnosed by “endoscopy” and “biopsy”.

Carcinoembryonic antigen (CEA) is measured before surgery and used for comparison in postoperative follow-ups.

The most important prognostic indicator is the degree of “tumor extent” at diagnosis. Carcinoma in situ (Tis) is also considered as “high-grade dysplasia” and lymph node invasion is not observed. In tumors limited to the intestinal wall (T1, T2), lymph node metastasis is seen at a rate of %5 and , respectively, whereas in tumors that completely cover the rectal wall and extend to neighboring structures (T3, T4), lymph node involvement exceeds . When the number of involved lymph nodes exceeds 4, the prognosis is negatively affected. The most common distant metastasis in CRC occurs in the liver and is due to hematogenous spread through invasion of portal vein branches.

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