When the cells present in the rectum divide uncontrollably and form a tumor, it is referred to as rectal cancer or rectal carcinoma. The rectum forms the last few inches of the gastrointestinal tract.
Rectal cancer often starts with the growth of abnormal masses called polyps. Over time, these polyps become cancerous and lead to rectal cancer.
Rectal cancer is seen in both men and women, and its risk increases with age. Rectal cancer is commonly diagnosed among individuals who are 50 and older. Those with a positive family history of rectal cancer also have a higher chance of developing it. Lastly, in a few cases of rectal cancer, individuals have an inherited predisposition caused by certain genetic disorders.
Rectal cancer is one of the top ten common cancers globally. Nonetheless, its prevalence is relatively low in India.
A few reports in recent times have shown that the incidence of rectal carcinoma is increasing gradually, and the possible reasons for this include changed food habits, a sedentary lifestyle, and screening practices.
Rectal cancer and colorectal cancer are terms that are often used interchangeably. However, there is a slight difference between the two. Rectal cancer refers to the cancer of the rectum only, and colorectal cancer refers to the cancer of the colon and rectum, which are the parts of the large intestine.
Rectal cancer is classified into different types, based on the cell from which it originates. These rectal cancer types may present at both early and advanced stages, and their symptoms may vary depending on their type. The following are the various types of rectal cancer:
Adenocarcinoma forms in glandular cells that line the inner walls of the rectum, and it is the most common type of rectal cancer, accounting for over 95% of rectal cancers.
Carcinoid tumors of the rectum form in the neuroendocrine cells of the rectum. These cells produce specific hormones, and when the tumor becomes larger, these hormones are released into the bloodstream, causing various symptoms. These are further classified into typical and atypical carcinoid tumors. While typical carcinoid tumors are slow-growing and benign, atypical carcinoid tumors are fast-growing and cancerous. Carcinoid tumor is one of the less common rectal cancer types.
Lymphoma or rectal lymphoma forms in the lymph tissue of the rectum. Rectal lymphoma is rare and often seen among those with immune-deficiency diseases. This type of rectal cancer is commonly seen among older individuals and is also one of the less common rectal cancer types.
Gastrointestinal stromal tumors (GISTs) of the rectum form in the interstitial cells of Cajal, which are the specialized cells present in the gastrointestinal tract. These cells are predominantly present in the stomach and small intestine and are scarcely present in the colon and rectum.
In some cases, rectal carcinomas develop due to an inherited predisposition. Having genetic conditions like familial adenomatous polyposis (FAP) and hereditary nonpolyposis colorectal cancer (HNPCC), also known as Lynch syndrome, can increase one’s risk of developing rectal cancer. These are the various types of rectal cancer. Rectal cancers are treated best when they are diagnosed in the early stages. Being mindful of the early signs of rectal cancer and opting for regular screening can help in effectively managing rectal cancer.
Rectal cancer staging is done to determine the progression of the disease. The rate at which rectal cancer progresses depends on its type – some rectal cancer types progress more rapidly, while others have a slower growth rate. Rectal cancer staging will also help doctors make better treatment decisions. The following are the different stages of rectal cancer.
Rectal cancer is confined to the inner lining of the rectum and has not spread to the underlying tissues.
Rectal cancer has grown beyond the lining and started spreading to the rectum wall.
Rectal cancer has grown into the rectum wall and may have spread to nearby tissues.
Rectal cancer has spread to the nearby lymph nodes.
Rectal cancer has advanced significantly and spread to distant organs in the body. Rectal cancer staging is done through various diagnostic procedures, namely PET/CT scan, ultrasound scan, and biopsy.
Those experiencing persistent symptoms related to rectal cancer, especially rectal bleeding, changed bowel habits, abdominal pain, and unintended weight loss, should consult a doctor for a proper evaluation. Also, those with a family history of rectal carcinoma should consider regular screening. This can help in the early detection and timely treatment of rectal carcinoma.
In some cases, rectal cancer presents with early symptoms, whereas in other cases, patients do not experience any symptoms until the disease reaches its advanced stages. It is important not to ignore any symptoms that could indicate the presence of a tumor in the rectum.
Being able to recognize the common symptoms of rectal cancer can help catch it in its early stages and receive appropriate treatment.
The following are some common signs and symptoms of rectal cancer:
A change in bowel habits is one of the early symptoms of rectal cancer. Patients often begin experiencing sudden changes in their bowel movements. These changed bowel habits are persistent and may not go away with medication.
Blood in the stool and rectal bleeding are also early symptoms of rectal cancer. The tumor irritates the rectum lining, which in turn leads to bleeding. Another reason why rectal bleeding occurs is because the tumor makes the blood vessels fragile. Usually, bleeding happens after bowel movements; however, it can happen at other times, too.
Rectal tumors cause obstruction and narrowing of the rectum, which leads to thin, pencil-like stools. This is one of the most important symptoms of rectal cancer.
Those with rectal cancer often experience a sensation of incomplete bowel emptying after their bowel movements. This happens because of the presence of a tumor in the rectum.
Rectal cancer patients often experience pain, cramping, and discomfort in their lower abdomen. It is one of the rectal tumor symptoms often ignored, as abdominal pain is caused by other less serious health problems, too. If the pain lasts for more than two weeks, one should see a doctor for a proper evaluation.
One of the important signs of rectal cancer is unintentional weight loss, which happens for no apparent reason.
Generalized weakness or fatigue is also one of the crucial symptoms of rectal cancer. Those suspected of having rectal cancer will feel exhausted even after resting adequately. Most of the signs and symptoms of rectal cancer discussed above are the same as those of other less serious GI problems. Therefore, it is important not to panic and to promptly see a doctor for a definitive diagnosis.
We do not have enough information on the exact causes of rectal cancer. However, we do know that certain lifestyle and non-lifestyle factors can contribute to an increased risk of rectal cancer.
Having these risk factors does not guarantee a rectal cancer diagnosis. It only means that those having these risk factors have a higher chance of developing this condition.
The following are possible causes of rectal cancer:
Increasing age is one of the biggest risk factors for rectal cancer. Those between the ages of 55 and 64 have a higher chance of developing cancer of the rectum.
Rectal cancer is found to be more common in men than women. There are various reasons for this.
Lifestyle habits, such as smoking, drinking alcohol, and eating highly processed foods, which are relatively more common among Indian men, make men more susceptible to rectal cancer.
Studies show that estrogen has a protective effect against rectal cancer. Men have lower estrogen levels, making them more susceptible to rectal cancer.
Men tend to pay a little less attention to their health when compared to women. So, the chances are high for them to ignore the early signs of rectal cancer. This may lead to a delayed diagnosis and a poor prognosis.
African Americans are found to have the highest risk of developing rectal cancer. Asians, on the other hand, have a lower risk of developing rectal cancer. Various factors, such as food habits, genetics, and other lifestyle and non-lifestyle factors, have contributed to the increased or decreased risk of developing rectal cancer across various ethnic groups.
A positive family history of rectal cancer is one of the possible causes of rectal cancer. Certain inherited genetic syndromes, namely Lynch syndrome, familial adenomatous polyposis (FAP), juvenile polyposis, and Cowden syndrome, can cause the formation of multiple polyps in the rectum and lead to rectal cancer formation.
Having certain GI-related issues can be one of the possible causes of rectal cancer. These GI issues increase rectal cancer risk by causing chronic inflammation. The following gastrointestinal disorders may increase one’s risk of developing rectal cancer
Inflammatory bowel syndrome, or disease, is a collective term given to inflammatory diseases of the GI tract. IBD is characterized by rectal bleeding, loose stools, abdominal pain, etc. Crohn’s disease and ulcerative colitis are the two main bowel-related inflammatory diseases.
Crohn’s disease is a form of chronic inflammatory bowel disorder. Crohn’s disease can affect any part of the GI tract; however, it most commonly affects the small intestine and colon. This disease spreads to deeper layers of the bowel wall. Crohn’s disease can lead to the formation of ulcers, fissures, and abscesses. Crohn’s disease, if left untreated, can increase one’s risk of developing rectal cancer.
Ulcerative colitis is another form of inflammatory bowel syndrome in which chronic inflammation is seen in the colon and rectum. Unlike Crohn’s disease, ulcerative colitis limits itself to the inner lining of the colon and rectum. This condition can cause ulcer formation and rectal bleeding, and if left untreated, it can increase the risk of rectal cancer.
Eating highly processed meat leads to increased rectal cancer risk. This is because processed meat contains chemicals that are classified as carcinogens. These chemicals can cause damage to the DNA structure and trigger tumor formation in the rectum.
Obesity contributes to increased rectal cancer risk by causing chronic inflammation in the body. Another way it increases cancer risk is by altering the gut microbiome.
The signs of rectal cancer are almost identical among men and women. The presence and absence of symptoms of rectal cancer in males or females and their severity may vary from one patient to another. Also, some rectal tumor symptoms are similar to those of other less serious GI conditions; therefore, it is important to not ignore any GI symptoms and diligently see a doctor for a proper evaluation.
It is important to see a doctor if you are experiencing rectal tumor symptoms like rectal bleeding, blood in stools, changes in bowel habits, and persistent abdominal pain. Despite looking like the signs and symptoms of rectal cancer, these symptoms could indicate other GI conditions, and therefore, you need to see a doctor for a definitive diagnosis.
When the cells present in the rectum divide uncontrollably and form a tumor, it is referred to as rectal cancer or rectal carcinoma. The rectum forms the last few inches of the gastrointestinal tract.
Rectal cancer often starts with the growth of abnormal masses called polyps. Over time, these polyps become cancerous and lead to rectal cancer.
Rectal cancer is seen in both men and women, and its risk increases with age. Rectal cancer is commonly diagnosed among individuals who are 50 and older. Those with a positive family history of rectal cancer also have a higher chance of developing it. Lastly, in a few cases of rectal cancer, individuals have an inherited predisposition caused by certain genetic disorders.
Rectal cancer is one of the top ten common cancers globally. Nonetheless, its prevalence is relatively low in India.
A few reports in recent times have shown that the incidence of rectal carcinoma is increasing gradually, and the possible reasons for this include changed food habits, a sedentary lifestyle, and screening practices.
Rectal cancer and colorectal cancer are terms that are often used interchangeably. However, there is a slight difference between the two. Rectal cancer refers to the cancer of the rectum only, and colorectal cancer refers to the cancer of the colon and rectum, which are the parts of the large intestine.
Rectal cancer is classified into different types, based on the cell from which it originates. These rectal cancer types may present at both early and advanced stages, and their symptoms may vary depending on their type. The following are the various types of rectal cancer:
Adenocarcinoma forms in glandular cells that line the inner walls of the rectum, and it is the most common type of rectal cancer, accounting for over 95% of rectal cancers.
Carcinoid tumors of the rectum form in the neuroendocrine cells of the rectum. These cells produce specific hormones, and when the tumor becomes larger, these hormones are released into the bloodstream, causing various symptoms. These are further classified into typical and atypical carcinoid tumors. While typical carcinoid tumors are slow-growing and benign, atypical carcinoid tumors are fast-growing and cancerous. Carcinoid tumor is one of the less common rectal cancer types.
Lymphoma or rectal lymphoma forms in the lymph tissue of the rectum. Rectal lymphoma is rare and often seen among those with immune-deficiency diseases. This type of rectal cancer is commonly seen among older individuals and is also one of the less common rectal cancer types.
Gastrointestinal stromal tumors (GISTs) of the rectum form in the interstitial cells of Cajal, which are the specialized cells present in the gastrointestinal tract. These cells are predominantly present in the stomach and small intestine and are scarcely present in the colon and rectum.
In some cases, rectal carcinomas develop due to an inherited predisposition. Having genetic conditions like familial adenomatous polyposis (FAP) and hereditary nonpolyposis colorectal cancer (HNPCC), also known as Lynch syndrome, can increase one’s risk of developing rectal cancer. These are the various types of rectal cancer. Rectal cancers are treated best when they are diagnosed in the early stages. Being mindful of the early signs of rectal cancer and opting for regular screening can help in effectively managing rectal cancer.
Rectal cancer staging is done to determine the progression of the disease. The rate at which rectal cancer progresses depends on its type – some rectal cancer types progress more rapidly, while others have a slower growth rate. Rectal cancer staging will also help doctors make better treatment decisions. The following are the different stages of rectal cancer.
Rectal cancer is confined to the inner lining of the rectum and has not spread to the underlying tissues.
Rectal cancer has grown beyond the lining and started spreading to the rectum wall.
Rectal cancer has grown into the rectum wall and may have spread to nearby tissues.
Rectal cancer has spread to the nearby lymph nodes.
Rectal cancer has advanced significantly and spread to distant organs in the body. Rectal cancer staging is done through various diagnostic procedures, namely PET/CT scan, ultrasound scan, and biopsy.
Those experiencing persistent symptoms related to rectal cancer, especially rectal bleeding, changed bowel habits, abdominal pain, and unintended weight loss, should consult a doctor for a proper evaluation. Also, those with a family history of rectal carcinoma should consider regular screening. This can help in the early detection and timely treatment of rectal carcinoma.
Several controllable and non-controllable risk factors are associated with the development of rectal cancer. Controllable risk factors are those that can be changed or controlled through lifestyle modifications. Non-controllable risk factors, on the other hand, cannot be changed. It is not possible to alter the cancer risk associated with non-controllable factors.
Learning about different rectal cancer risk factors is important, as this can help determine whether one is a high-risk or low-risk individual for rectal cancer.
Along with knowing about the factors that contribute to increased rectal cancer risk, it is important to know about different rectal cancer prevention measures that help bring down the risk of this cancer.
A large percentage of rectal cancer cases are caused by controllable risk factors. Managing them through certain lifestyle modifications can help reduce the rectal cancer risk significantly.
Consuming too much red, processed, or charred meat can increase the risk of rectal cancer. Highly processed and charred meats contain high levels of harmful chemicals, namely heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs), which are carcinogenic and trigger tumor formation by damaging the DNA structure of the cells present in the colon and rectum regions.
Exercise is necessary to keep the colon and rectum healthy. Studies show that not exercising regularly can increase the risk of rectal cancer. A sedentary lifestyle leads to visceral fat accumulation, which in turn can lead to chronic inflammation and hormonal imbalance. If chronic inflammation and hormonal imbalances are not managed effectively, they can lead to cancer formation.
Obesity is another important risk factor for rectal cancer. Excess weight can lead to increased levels of insulin and other hormones in the body. It can also lead to chronic inflammation, which leads to cancer formation if left unmanaged.
Smoking is also one of the rectal cancer risk factors. Cigarette smoke contains harmful chemicals or carcinogens that may damage the DNA structure of the cells present in the rectum and lead to tumor formation.
Excessive alcohol consumption can lead to an increased risk of rectal cancer. When alcohol is broken down in the body, harmful metabolites are formed. These may damage the DNA structure of the cells present in the colon and rectum and lead to cancer.
Those risk factors that cannot be modified by any means are referred to as non-controllable risk factors. The following are the common non-controllable rectal cancer risk factors:
Increasing age is a risk factor for rectal cancer. With age, it is normal for individuals to be exposed to multiple factors that can increase their rectal cancer risk. Also, with age, it is normal for mutations to occur in the cells that line the colon and rectum. Lastly, with increasing age, the immune system’s ability to identify cancer cells and attack them may also be affected. All these make increasing age a non-controllable risk factor for rectal cancer.
Genetic conditions, like Lynch syndrome and Familial Adenomatous Polyposis (FAP), are characterized by the formation of multiple polyps in the colon and rectum, which may turn into tumors. Having a family history of these genetic conditions can increase the risk of rectal cancer.
Those who have been diagnosed with colorectal cancer in the past are also at an increased risk of developing rectal cancer. Previous cancer treatments that are administered to treat cancers in the pelvic region can also increase the risk of developing rectal cancer.
Inflammatory bowel diseases cause inflammation in the colon and rectum, and if this inflammation is left untreated, it can cause damage to cells in the colon and rectum and create a favorable environment for tumor growth. It is, therefore, important to effectively manage inflammatory bowel diseases and opt for rectal cancer prevention measures like regular screening to bring down the risk of rectal cancer.
Those with a positive family history of colorectal cancer must pay extra attention to their health, as they have a higher risk of developing rectal cancer. In such cases, one can opt for regular screening, which helps in catching rectal cancer in its early stages and receiving timely treatment.
It is possible to modify one's lifestyle to lower the risk of rectal cancer. These rectal cancer prevention measures can help reduce one’s rectal cancer risk significantly.
Having a balanced diet that is rich in fruits, vegetables, and fiber and low in animal and dairy fat improves gut health, prevents inflammation, and, most importantly, brings down rectal cancer risk.
Exercising regularly helps prevent chronic inflammation and hormonal imbalances, which contribute to increased rectal cancer risk.
Maintaining a healthy weight is another important rectal cancer prevention measure. Maintaining a healthy weight prevents chronic inflammation, insulin resistance, and hormonal imbalance, all of which contribute to an increased risk of developing rectal cancer.
Some studies have reported how HRT may play a role in reducing one’s risk of developing colorectal cancer. However, none of the studies have found a significant link.
Hormone replacement therapy uses estrogen, progesterone, or a combination of these hormones to help women manage menopausal symptoms. It is important to note that HRT has been found to slightly increase the risk of breast cancer, ovarian cancer, and uterine cancer. Therefore, it is important to ensure that the benefits of HRT outweigh the risks before opting for this treatment.
Lastly, it is important to note that HRT is not a recommended rectal cancer prevention measure or a treatment option.
To reduce the risk of rectal cancer, it is important to opt for proven or doctor-recommended rectal cancer prevention measures, have healthy food habits, opt for an active lifestyle, maintain a healthy weight, and refrain from tobacco and alcohol consumption. These measures are highly effective in reducing rectal cancer risk.
For those wondering how to prevent rectal cancer, here is something important to know: There is no known way to completely prevent rectal cancer. However, a few lifestyle changes may serve as rectal cancer prevention measures and can bring down one’s risk of developing rectal cancer:
Maintaining a healthy weight is one of the most important rectal cancer prevention measures. Having a balanced diet and opting for regular exercise can help reduce one’s rectal cancer risk. By maintaining optimum weight, one can prevent visceral fat accumulation, inflammation, and hormonal imbalance, all of which serve as major rectal cancer risk factors.
Regular exercise can help prevent fat accumulation and, thereby, obesity, which contributes to an increased rectal cancer risk. Opting for exercise five days a week can help maintain a healthy weight and reduce one’s rectal cancer risk.
Food choices play a pivotal role in reducing the risk of cancer and many other health problems. A diet that is rich in whole grains, fruits, and vegetables and low in processed meat and dairy can help reduce the risk of rectal cancer.
Studies have found that the use of aspirin and certain other NSAIDs may play a role in bringing down one’s rectal cancer risk. However, these medications are associated with certain side effects, and therefore, their role in rectal cancer prevention must be thoroughly discussed with a doctor before their use.
