Rectal Cancer Treatment

Like any other part in our body, rectum is also susceptible to many diseases and unpleasant conditions such as the dreadful cancer. Cancer of the rectum is more aggressive in comparison with colon cancer; often the prognosis is catastrophic if not treated.

According to American Cancer Society, Colon/Rectal cancer is the 3rd most common carcinoma for both men and women excluding skin cancer. The most recent estimate made by ACS shows 39,510 new cases of rectal cancer has been diagnosed each year in US alone.

In most cases, the cause of rectal cancer is unknown however there are several risk/contributing factors that are attributable in developing the disease.

Risk factors that cannot be change or modify are age, Personal history of colorectal polyps or colorectal cancer, Personal history of inflammatory bowel disease, Family history of colorectal cancer, inherited syndromes, and racial and ethnic back ground.

There are also Lifestyle-related factors such as certain types of diets, Physical inactivity, Obesity, Smoking, Heavy alcohol use and Type 2 diabetes. This lifestyle related factors are modifiable depending on each individual.

The mortality rate of rectal cancer has noticeably decline through public awareness and early screening of the disease before it progress. Through extensive research, treatment for rectal carcinoma has greatly improved as a result the survival rate of patients suffering from rectal cancer increase over time.

Treatment:

Powerful combinations of traditional and innovative therapies are available to treat the disease. There are several types of treatment that can be used in conjunction with each other to obtain maximum benefit. The goal of treatment is to eradicate any tumor forming cells and to prevent metastases of cancer cells throughout the entire body.

There are four types of treatment that can be used for rectal cancer: Surgery is the main treatment for rectal carcinomas however doctors may opt to use different kinds of surgery depending on the case, stage, and severity of the disease.

Polypectomy and local excision this procedure is used to eliminate superficial cancers or polyps with the use of instruments inserted into the anus without making any opening in the abdomen.

Local transanal resection (full thickness resection) also known as transanal excision. This procedure removes all layers of the rectum containing the cancer tumor as well as the surrounding normal rectal tissues with the use of instruments inserted into the anus without making any opening in the abdomen. This is indicated for patients whose cancers are relatively small and not too far from the anus.

Transanal endoscopic microsurgery (TEM) uses a specially design magnifying scope that is inserted into the anus to the rectum. This procedure can be use for patients with early stages of cancer that are higher in the rectum.

Low anterior resection involves an incision in the abdomen by a trained surgeon; he then removes an affected portion of the rectum containing the tumors and a portion of normal tissue along with nearby lymph nodes around the rectum. The colon is reattached to the remaining rectum so that after recovery you can still move your bowels the usual way.

Proctectomy with colo-anal anastomosis is used on some stage I to III rectal cancers involving middle and lower third of the rectum. The procedure requires the removal of the entire rectum (proctectomy). The rectum is removed as well as the surrounding lymphnodes and fatty and fibrous tissue to prevent metastases on nearby organ. After the removal of the entire rectum, colo-anal anastomosis (colon is then connected to the anus) is done.

Pelvic exenteration is recommended if the rectal cancer is growing nearby an organ. This involves the removal of the entire rectum and if the cancer tumors already affected the nearby organs such as bladder, uterus or prostate colonostomy may be required after pelvic exenteration.

Cryosurgery can also be used in treating rectal cancer. It freezes and kills the cancer cells using liquid nitrogen, having a temperature of 196 degrees below zero centigrade. This procedure instantly kills the tumor as extreme cold cannot be tolerated by our body. The tumor/Infected skin will fall off like a scab after the area liquefies. Cryosurgery itself is a painless and uncomplicated procedure however the treated area may become distended and painful after it thaws.

To make the treatment more powerful additional procedure is required in conjunction with surgery.

Radiation therapy is a cancer treatment that uses high-energy x-rays to kill cancer cells or keep them from growing, proliferating on other areas of the body. Two types of radiation therapy can be done to a cancer patient, one is External radiation. It involves the use of a machine outside the body to send radiation toward the cancer site. Before undergoing external radiation simulation using CT scan and precise measurement should be performed for accurate mapping of the tumors.

Second, Internal radiation also known as brachytherapy uses a radioactive implants sealed in needles, seeds, wires, pellets, balloons and tubes that are placed directly into or near the cancer lesion. Radiation therapy is given depending on the type, stage, and severity of the cancer being treated. If a person refuses surgery, radiation Therapy can be given.

Endocavitary radiation therapy involves the use a small device that is place inside the anum into the rectum to deliver high frequency radiation to the affected part for a few minutes. The main advantage of this treatment is that it reached the target area with minimal damage to the surrounding tissue causing fewer side effects.

Chemotherapy on the other hand consists of introducing drugs into the patient's bloodstream to stop the growth of cancer cells, either by killing or stopping them from dividing. Chemotherapy can be best taken by mouth, injected into a vein or muscle. These drugs enter the bloodstream targeting the cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity, the drugs mainly affect cancer cells in specific areas and are called regional chemotherapy.

Other types of Treatment involve the use of Targeted Therapies; this involves the use of drugs such as Bevacizumab marketed as Avastin and Cetuximab or Erbitux. These drugs are monoclonal antibodies that targets a specific protein in DNA that can be used for patients who’s suffering from advanced colorectal cancer, that is not responding to. Those drugs aimed to target a certain protein called epidermal growth factor receptor (EGFR) that is responsible in promoting cell division thereby blocking the receptors resulting to stopping the abnormal proliferation of cells.

What to Know Before the Procedure

Cancer is an incredibly diverse and resilient disease and each case poses unique challenges to the patient and the oncologist. Each method of surgery and treatment has pros and cons and there is no one “right” combination of treatments. All forms of cancer treatment come with attached risks and side-effects, some of which can have long term implications on quality of life. In order to treat it effectively, it is vital to have candid conversations with your doctor about your medical history, other pre-existing conditions, your lifestyle, and your personal preferences to determine the best course of action.

What to Know After the Procedure

The suggested recovery practices and possible side-effects of cancer treatment vary wildly upon the type of treatment chosen. Your doctor will give you detailed instructions about how to follow through with recovery and ongoing treatment based upon your particular case. Follow these directions and contact your doctor if any questions or complications arise.

If you Need to Travel Outside of your Local Hospital

Cancer treatment is a prolonged, multiple session affair that requires constant communication between the patient and the doctor. This must be considered when determining where to have treatment performed. Ideally, you will want to work with the same doctor and the same team throughout the process to ensure complete understanding and consistency from beginning to end. At the same time, you also want to work with the most highly qualified team available to you. These factors should be the most heavily weighted when deciding whether/where you should travel to have your cancer treated.