Tumor of the rectum symptoms and treatment. Benign tumors of the rectum. Symptoms of a tumor of the rectum

Rectal cancer is a malignant neoplasm that develops from the tissues of the intestine (its inner epithelium). The resulting tumor can affect not only the intestinal wall, but also grow and block the digestive tract, grow into the lymph nodes, liver and other organs.

How cancer manifests itself in the rectum in men and women, what is prescribed as a diagnosis and treatment of this disease - we will consider further.

What is rectal cancer?

Rectal cancer is a disease that develops as a result of tumor degeneration of the epithelial cells of the mucous membrane lining any of the sections of the rectum and has characteristic signs of cellular polymorphism and malignancy.

Life expectancy in rectal cancer depends on many characteristics: the structure, type of growth and location of the tumor. But the most important factor is the early diagnosis of the disease, which tenfold increases the chances for a further full life!

At the initial stages, unfortunately, there are no very clear signs of the presence of a tumor in the body. The neoplasm itself develops quite quickly and has a malignant nature. In a certain phase, it begins to metastasize to the nearest lymph nodes and organs.

If we consider in more detail the anatomical structure of the rectum, we can distinguish three main areas:

• Anal part. It is here that the sphincters are located, with the help of which defecation is carried out. This is the final section of the intestine and its length is about 3 cm.
• ampoule part. In this area, excess fluid is removed from the feces and their further formation before excretion from the body. Its length is slightly less than 10 cm.
• Nadampular. The initial section of the rectum is about 5 cm long, which is closed by the peritoneum.

If we talk about the areas most often affected by the tumor, then here the most "popular" is precisely the ampullar section of the rectum. It is in this part that cancer cells are formed in 80% of cases of intestinal lesions.

Classification

For aggressiveness:

• Highly differentiated - the tumor grows rather slowly and is not aggressive.
• Poorly differentiated - fast-growing malignant tissues quickly metastasize.
• Moderately differentiated - Has a moderate rate of growth and development.

Another type of classification of rectal cancer, based on the localization of malignant neoplasms, divides them into tumors:

• anal (occur in 10% of cases);
• rectosigmoid department (30%);
• lower, middle and upper ampullae (60%) of the rectum.

There are the following forms of tumor growth of the rectum:

• into the intestinal lumen (there is a tumor component in the intestinal lumen - endophytic, from the Latin "endo" - inside);
• towards fatty tissue and pelvic organs (as such, there is no external component of the tumor, it forms a single mass with surrounding tissues - exophytic, from the Latin "exo" - outward).

The reasons

Possible causes of the disease:

• - inflammation of the sigmoid colon and its mucous membrane. It has a specific nature (, gonorrheal, syphilitic, tuberculosis, etc.), or is a consequence of acute diseases that have not been treated.
• Chronic fissures and ulcerative formations in the anus.
• genetic predisposition.
• Lack of physical activity.
• Overeating and obesity.
• Smoking.

Intestinal tumors have recently taken 3rd place in men and 4th place in women in terms of frequency of occurrence, and rectal cancer is in 5th place. The peak incidence falls on the age period of 70-74 years and is 67.1%.

First signs

Cancer is an insidious disease symptoms may not appear for a long time until the neoplasm reaches a significant degree of development.

At first, the disease does not manifest itself outwardly, while cancer cells form and spread in the body. When answering the question of how to recognize bowel cancer at an early stage, doctors do not give a definite answer. The disease is detected by chance - during the passage of a planned medical examination or treatment of another diagnosis. Over time, inflammation makes some adjustments to the patient's usual life.

When the pathology progresses in a patient, the first signs of rectal cancer may be as follows:

• pain during bowel movements;
• change in the consistency of feces during bowel movements;
• the presence of mucus and blood in the stool;
• decline in performance.

Note that at an early stage of the disease, symptoms can be confused with hemorrhoids and other similar diseases. However, a distinctive feature of the disease should be noted the appearance of blood from the anus, which, unlike hemorrhoids, occurs before the act of defecation, and not after it. Also, as a result of the development of a tumor, mucus and pus are often observed in the feces.

stages

The classification of rectal cancer depending on the stage of the tumor process is based on the following characteristics of the disease:

• The size of the primary tumor;
• The prevalence of the tumor in relation to the intestinal wall and lumen;
• Involvement of adjacent organs in the tumor process;
• The presence of metastases in the lymph nodes;
• The presence of metastases in distant organs.

Rectal cancer is accompanied by metastases - screenings from the main lesion, identical in structure and capable of growing, disrupting the functions of the organs into which they have fallen.

The stages of rectal cancer take into account the characteristics of the neoplasm itself, its size, ingrowth into the surrounding tissue, and the nature of metastasis. So, domestic oncologists distinguish four clinical stages of the course of the tumor:

• Stage 1, when the tumor is no more than two centimeters, grows no deeper than the submucosal layer and does not metastasize.
• At stage 2, the neoplasm is up to 5 cm, does not go beyond the boundaries of the organ, but can manifest itself as metastases in local lymph nodes.
• Stage 3 is accompanied by the germination of all layers of the intestinal wall and the appearance of metastases in local lymph nodes.
• In stage 4 rectal cancer, the entire body suffers. The spread of metastases is accompanied by insufficiency of the organ in which the new tumor growth began. With damage to vital organs (heart, lungs, brain, and so on), the syndrome of multiple organ failure develops, which is the main cause of death for cancer patients.

Symptoms of rectal cancer in adults

Most often, the following pattern is observed in the development of the disease. Initially, an adenomatous polyp forms in the rectum. This neoplasm does not pose a direct threat to life and is not malignant. However, over time, changes occur in the polyp. The neoplasm becomes malignant and turns into a cancerous tumor that spreads throughout the body in the form of metastases.

Symptoms of rectal cancer are determined by the stage and location of the formation. These include:

• Various dyspeptic disorders;
• Bleeding and other pathological impurities in the feces;
• Violation of the stool up to intestinal obstruction;
• Signs of general intoxication;
• Pain syndrome.

The first symptoms depend on the location of the neoplasia. In addition to bleeding, which occurs in almost all patients, pain is possible as the first sign in the case of a low location of the cancer with a transition to the anal sphincter. In some cases, the disease occurs with stool disorders, more often in the form of constipation.

As the tumor begins to grow, constipation will not alternate with diarrhea, they begin to become stable. If a malignant tumor of the rectum begins to develop rapidly, then the patient has acute intestinal obstruction - a critical condition in which urgent surgical intervention is indispensable.

The condition of a patient suffering from rectal cancer depends on the presence or absence of metastases.

• If the tumor is located within the rectum, then the patient is only concerned about digestive disorders, pain in the intestine, impurities of pus, blood and mucus in the feces.
• If the tumor grows into neighboring organs, then there are symptoms characteristic of their defeat. With germination in the uterus and vagina - pain in the lower abdomen, violation of menstruation.
• With germination in the bladder - pain in the lower abdomen, impaired urination. With the spread of metastases to the liver - jaundice, pain under the ribs.
• With multiple metastases, the general condition of the patient is disturbed: weakness, fatigue, exhaustion, anemia, fever occur.

Among women

Cancer of the rectum in women can grow into the tissues of the uterus or vagina. A cancerous lesion of the uterus does not affect the overall clinical picture of the disease, but the germination of the tumor in the tissue of the posterior wall of the vagina can lead to the formation of a rectovaginal fistula. As a result, gases and feces begin to be released from the female vagina.

Cancer cells, driven by the movement of blood and lymph, spread even further throughout the body, leading to the formation of metastases that can occur in the lungs, in the liver, or in nearby lymph nodes.

Symptoms of rectal cancer in women are varied:

• the presence of blood in the stool;
• pain symptoms in the abdomen and in the anus;
• constipation, increased stool, diarrhea;
• mucous, purulent discharge in the anus;
• constant feeling of weakness or fatigue;
• , spontaneous discharge of feces;
• sensation of itching in the perineum;
• the presence of dysfunction in the genital organs;
• metabolism is disturbed, which causes a decrease in the overall development and growth of the patient.

In men

Cancer in men often grows into the wall of the bladder, also causing a rectovesical fistula, from which stool and gases are expelled. The bladder often becomes infected. Pathogenic flora enters the kidneys through the ureters, causing pyelonephritis.

Signs of rectal cancer in men:

• a sharp decrease in body weight;
• sensation of pain in the sacrum, genitals;
• impurities of blood in the consistency of feces;
• frequent trips as needed;
• chronic constipation.

Malignant formation in the absence of the necessary diagnostics is growing rapidly, affecting other systems and organs. It creates increased pressure inside the peritoneum, thereby exacerbating the problem. That is why it is important to identify the initial stage of the development of the disease in a timely manner and take all necessary actions.

Some of the symptoms of this disease are characteristic of a number of diseases of the gastrointestinal tract, the most common of which are:

• haemorrhoids;
• intestinal ulcer;
• violations of the digestive processes;
• prostatitis.

Very often, due to the similarity of symptoms, patients do not pay due attention to them in time, which is why the chances of recovery are rapidly decreasing.

Diagnostics

Only 19% of patients were diagnosed with cancer at stages 1-2. Only 1.5% of tumors are detected during preventive examinations. Most of the neoplasms of the intestine are in stage 3. Another 40-50% with newly diagnosed tumors of the colon develop distant metastases.

In the early detection of rectal cancer the leading place belongs not to the symptoms of the disease, which the patient himself notices, but to objective signs. Therefore, preventive medical examinations are a really effective method for diagnosing rectal cancer in the early stages!

The diagnosis is made by a proctologist, after examining the ball. With the help of his fingers, he is able to grope for a tumor if it is located near the anus. Otherwise, sigmoidoscopy is prescribed. This procedure allows you to take a fragment of the tumor for biopsy, which will help determine the nature of the formation.

When examining women at the same time research is underway vagina to assess the degree of involvement of the reproductive organs in the tumor process.

For more accurate diagnosis, other procedures are used:

• full proctological examination;
• biopsy followed by histological examination of the sample under a microscope;
• computed tomography;
• radiography of the abdominal cavity;
• irrigography to assess the condition of the large intestine;
• scintigraphy;
• laboratory blood tests for antigens and tumor markers (this method is used both for primary diagnosis and for monitoring the effectiveness of treatment);
• diagnostic laparoscopy.

Treatment Methods

In the treatment of rectal cancer, the priority is the surgical method, which consists in removing the organ affected by the tumor.

Is it possible to do without surgery? In fact, most likely not, since this is the main type of treatment. You must understand that chemotherapy and radiotherapy do not give 100% of the result and do not destroy all cancer cells - that is why it is necessary to remove the tumor with all damaged tissues in time.

Possible options for surgical treatment of rectal cancer:

• Organ-preserving variant (resection). Such an operation is possible only if the tumor is located in the middle and upper sections of the rectum.
• A complete removal of the rectum (resection with relegation to the anal canal of the colon) is carried out, followed by the formation of an "artificial" rectum from the healthy sections lying above.

Preoperative Therapy

Due to this stage, the likelihood of tumor progression is reduced, its growth slows down, and the prognosis for the patient is significantly improved. It is carried out by patients with any stage of a tumor of the rectum. The size of the dose and the need for chemotherapy drugs is determined by the oncologist, depending on the degree of cancer development.

Radiation treatment alone is usually used for mild tumor growth (grade 1 or 2). At 3 and 4 degrees, any chemotherapy drug (Ftorouracil, Leukovarin) is necessarily combined with irradiation of the patient.

The recovery process after surgery includes:

• Wearing a bandage (special compression belt) that reduces abdominal muscle tension and reduces intra-abdominal pressure.
• Active behavior - getting out of bed 5-7 times a day.
• Self-going to the toilet and procedures.
• Sparing nutrition - the use of fruits, vegetables and the restriction of indigestible and fatty foods.

Radiation therapy for rectal cancer is indicated during periods:

• before surgery - the area where the tumor is located is irradiated for 5 days. Upon completion of the course, an operation is performed in 3-5 days;
• after surgery - with confirmed metastases in regional LNs, after 20-30 days, a 5-day course of irradiation in the tumor zone and all LNs of the pelvic region begins.

Patient care during treatment

When diagnosed with rectal cancer, postoperative care is as follows:

• frequent change of linen: bed and underwear;
• in the prevention of bedsores: changing posture in bed and turning to the other side or back, using anti-decubitus or orthopedic mattresses;
• feeding the patient, using a special probe;
• carrying out hygiene procedures;
• providing special diapers and pads for urinary and fecal incontinence;
• colostomy care and colostomy replacement.

Therapeutic diet

Proper nutrition in rectal cancer should be given increased attention. The diet should be sufficiently nutritious and balanced in qualitative and quantitative terms, and not cause irritation of the intestines.

The diet after surgery for the first time should be as sparing as possible, not cause diarrhea and bloating. They start eating after resection with rice water, low-fat broth, berry jelly without fruits. After a few days allowed:

• Mucous soups (this is a strained decoction of cereals).
• Liquid, well-mashed porridge, boiled in water. Preference is given to non-coarse rice cereals, oatmeal, buckwheat.
• Cream (only in dishes up to 50 ml).
• Broths with semolina.
• Soft-boiled egg and protein omelet.
• A little later, mashed fish and meat are introduced.

In order not to miss the re-development of the disease, the patient should be regularly monitored by an oncologist. The following frequency of visits is currently recommended:

• The first 2 years after remission - at least once every 6 months (recommended once every 3 months);
• After 3-5 years - 1 time in 6-12 months;
• After 5 years - every year.

Prognosis of rectal cancer

No specialist will give an unambiguous answer to how long they live with rectal cancer, since the survival prognosis is made individually for each patient and consists of many indicators.

Here are the average values ​​for 5-year survival of patients after adequate treatment:

Factors affecting the prognosis for malignant neoplasms of the rectum:

• stage of the disease;
• cellular structure of the tumor;
• the degree of differentiation of tumor cells (undifferentiated are the least favorable - see above);
• the presence of metastases in the lymph nodes;
• type of treatment provided.

Rectal cancer is a malignant neoplasm that grows in the mucous layer of the final section of the large intestine. According to available statistics, pathology is diagnosed in men and women aged 40 and over equally. Most often, cancer cells are the result of chronic inflammatory processes (ulcers, colitis, proctitis), post-hemorrhoidal complications (anal fissures, fistulas, polyps).

Anatomical features

The final section of the digestive tract, the large intestine, consists of several segments: the cecum, colon, sigmoid and rectum. It is in the large intestine that food partially digested by the stomach enters, where it is further broken down and the formation of feces.

Thanks to the peristalsis of the intestinal walls, they move through the intestines and enter its final section, ending with the anus with a sphincter (a muscular ring that narrows the end of the rectum and allows you to control the exit of feces from the body) through which they exit the body. In terms of the frequency of diagnosing, rectal cancer is 65% among the most frequently detected neoplasms.

Causes of Cancer Development

There is no one specific reason that provokes the growth of cancer cells in the rectum. In medicine, a number of unfavorable conditions are distinguished, creating all the conditions for the degeneration of normal cells into tumor cells:

• Nutrition - according to statistics, rectal cancer is detected 1.5 times more often in those people whose diet contains a lot of meat products, including pork (fatty, hard to digest food). The absence in the menu of cereals, vegetables and fruits enriched with vegetable fiber, which support normal intestinal motility, also creates favorable conditions for pathogenic microorganisms.
• Hypovitaminosis (vitamin deficiency) - a lack of vitamins A, C, E leads to the fact that too many carcinogens enter the intestines (factors and chemicals, the effect of which on the human body increases the likelihood of healthy cells mutating into cancer cells).
• Excess weight - obesity adversely affects the normal functioning of the entire intestine as a whole. Excess weight disrupts blood circulation in the organ, its peristalsis, which leads to frequent constipation and, as a result, to favorable factors for the development of malignant formations.
• Bad habits (alcohol abuse, smoking) - nicotine and alcohol adversely affect blood vessels, impair blood circulation, irritate the intestinal mucosa, which contributes to the growth of cancer cells and the development of cancer of the rectum and other organs.
• Hereditary predisposition - genes are part of the chromosomes that are transmitted to the child at conception. And if in the course of life the parents had changes in oncogenes (cancer) responsible for the control of cell division, then already mutated genes are often transferred to the child. How they will behave in the body of an adult person and how they will contact the environment is unknown. But under the influence of adverse factors, they most often lead to the formation of malignant tumors.
• In rare cases, extremely unfavorable and harmful working conditions of a person can provoke cancer.

An important factor that creates prerequisites for the development of malignant formations in the rectum are precancerous pathologies:

• - outgrowths on the intestinal mucosa, having a benign character. Small growths are usually not dangerous. But with intensive growth of the polyp and its size over 2 cm, constant monitoring by a specialist is required;
• diffuse polyposis is a genetically transmitted disease. With it, multiple foci of polyps are formed in the thick and straight intestine. In some cases, from 100 or more;
• papillomavirus infection of the anus - viruses cause cell degeneration, change their properties, which can lead to the formation of cancerous foci.

Symptoms and clinical manifestations

The signs by which the presence of pathology can be detected depend on the size of the neoplasm, the stage of development, the location and nature of the growth of cancer cells:

• - in 90% of patients, this is the most common sign of cancer. Fecal masses, passing through the intestinal duct, injure the tumor located in the mucous tissue. With a small formation, the blood leaves the organ in a small amount (these can be blood clots mixed with feces or red streaks). Given that in the early stages of the disease, blood loss is very small, the development of anemia is excluded.
• The discharge of mucus or pus from the anus is a symptom of rectal cancer, characteristic of the last stages of an overgrown tumor. The secretion of mucus and pus occurs due to the complications that the formation causes: in the later stages, the tumor disintegrates and begins to actively spread metastases to neighboring and distant lymph nodes and organs, causing severe inflammation in the mucous tissue of the organ.
• Problems with the stool - failures can manifest themselves in different ways: frequent or diarrhea, painful urge to defecate, strong. Problems are caused by the inflammatory process in the mucous tissue and muscles of the intestinal walls.
• - a sign of the pathology of the last stage of rectal cancer. The overgrown cancer completely blocks the intestinal duct, causing chronic constipation (lack of stool for more than 3 days). Poisoning of the body with stuck feces begins: the patient experiences pain, nausea, and vomiting occurs.
• Severe pain - they can appear in the early stages of rectal cancer, if the neoplasm is located directly on the sphincter. The patient cannot sit on hard surfaces because the pain gets worse. In medicine, this symptom is called the "stool" syndrome. If cancer has struck the upper part of the intestine, then unbearable pain occurs only when it grows through the wall and when cancer cells damage neighboring organs.
• Severe changes in the general physiological state of a person - the patient complains of weakness, lack of strength, loses weight, appetite, quickly gets tired. The skin integuments change their color: they become pale, gray, sometimes earthy or cyanotic. At first, the signs manifest themselves very weakly, with an increase in the size of the tumor, the severity of the general poor health of a person also increases.

Diagnostics

If you suspect the formation of a cancerous tumor in the rectum, the specialist interviews the patient, digital examination and visual examination of the intestine, prescribes instrumental examinations and tests.

Patient Interview

During the interview, the doctor records the complaints of patients and the time of onset of failures in the body, finds out the diet, bad habits, and place of work. To diagnose and clarify the nature of the clinical picture of the development of the disease, it is very important to establish a possible genetic predisposition.

Finger examination

A digital examination of the rectum is a simple method to detect the presence of abnormal formations in the intestine. To the touch, the proctologist evaluates the elasticity of the intestinal walls and the presence of any abnormalities.

Finger examination does not allow 100% accuracy to confirm rectal cancer. But any deviations from the norm are immediately subjected to further diagnostics to confirm or refute the diagnosis.

Instrumental Research

To identify malignant neoplasms, the specialist prescribes a whole range of various diagnostic procedures:

• - the internal space of the intestine is examined using a sigmoidoscope (fiber-optic tube with a diode lamp at the end). The proctologist inserts a device into the rectum and pumps air into it to expand the lumen and visually inspect the walls. During the procedure, polyps, erosions, ulcers, blood clots, tumor formations, etc. can be detected.
• Irrigography - X-ray transillumination of the rectum using a polar substance (barium sulfate). Before the procedure, the patient's intestines must be clean. 1-2 days before the procedure, the patient should consume a sufficient amount of liquid (at least 1-2 liters per day). Heavy-to-digest foods should be completely excluded from the daily menu. Immediately before the procedure, the patient is given a cleansing enema. With the help of irrigography, various pathologies are revealed: ulcers, neoplasms, their size and extent.
• Computed tomography is used in rare cases when the results of ultrasound and x-rays contradict each other. With the help of computed tomography, a layered image of the organs of the pelvic region is obtained, which allows you to make a reliable diagnosis.
• A biopsy is a microscopic examination of a small piece of tissue. It is pinched off from the detected tumor in order to identify the nature of the pathology (malignant or benign). This is the most important test in diagnosing rectal cancer.

If a malignant tumor is detected during the examination by a proctologist, additional instrumental examinations are prescribed to detect metastases:

• X-ray of the abdominal organs - the examination is carried out without the use of a contrast agent. Using the procedure, the doctor assesses the condition of the intestines and neighboring organs.
• Fibrocolonoscopy - the distant sections of the intestine are viewed. This allows you to detect secondary foci of formations in regional organs: the sigmoid and colon.
• Radioisotope scanning of the liver - in rectal cancer, secondary cancer cells most often affect the liver, which is clearly visible on the pictures.
• Laparoscopy is a micro-surgery in which miniature cameras are inserted into the abdominal cavity through small openings in the abdomen. This allows you to assess the state of all organs in this area, identify metastases, take a sample of the material for further research.
• Intravenous urography - used to detect metastases in distant organs: kidneys, ureters, bladder. Pathologies are detected using a polar substance (urographine or omnipaque), which is administered intravenously.

Laboratory tests

To identify the stage and extent of the spread of a malignant formation, the patient is prescribed a set of laboratory procedures:

• Test for tumor markers (taking blood from a vein) - tumor markers - proteins secreted into the blood by cancer cells. Their content in the blood increases with the progression of pathology. With the help of the test, not only the presence of the tumor itself is detected, but also the appearance of metastases even at an early stage, but only in conjunction with other diagnostic methods.
• Cancer-embryonic antigen is a substance present in the blood of the fetus while it is in the womb. In adults, its content in the blood is absent. A high level of antigen is found only in the presence of cancers in the rectum.
• Cytological examination - microscopic examination of cellular elements in order to identify their nature (malignant or benign).

Tumor types

Rectal cancer is classified according to several indicators: the types of cells in the tissue, the direction of the focus of spread. All this directly affects further treatment and outcome of the disease.

Classification of tumors by cellular structure

Tumors of the rectum are divided into several types depending on their structural and functional structure:

• Adenocarcinoma is the most commonly diagnosed type of neoplasm in the rectum. This takes into account the differentiation of the tumor (the distance of pathogenic cells from normal healthy cells of neighboring organs). The lower the degree of differentiation, the more malignant the formation and the more unfavorable the outcome of the disease.
• Ring cell cancer - diagnosed in 3% of cases. Under a microscope, pathology cells look like rings with a stone, which led to their name. Cancer with the most unfavorable course. The tumor grows rapidly and metastasizes to distant organs. Most patients die within three years of diagnosis.
• Solid cancer is very rare. It develops from poorly differentiated glandular tissues of the intestine. Modified cells are arranged in the form of layers.
• Squamous cell carcinoma is a common complication that occurs after a papillomavirus infection. It is found mainly in the lower part of the rectum near the anus. Squamous cell tumors are characterized by rapid spread of metastases throughout the body.

Classification of tumors depending on the direction of growth

There are three forms:

• exophytic - a pathological formation develops mainly inside the rectum, gradually blocking its lumen;
• endophytic - a malignant tumor develops deep into the wall of the rectum, there is a gradual germination of the tumor through it;
• mixed - a form that is characterized by signs of an exophytic and endophytic tumor.

Stages of colorectal cancer

It is impossible to prescribe effective treatment without a clear understanding of the extent of the spread of the disease. Therefore, initially it is necessary to accurately determine the stage of the detected pathology. It depends on the size of the malignant formation and on the degree of damaged or not damaged organs.

• Stage 0 - epithelial cancer that develops in the inside of the rectum.
• Stage I - the neoplasm is localized in the mucous tissue of the organ and occupies no more than 1/3 of the intestinal lumen, there is no metastasis. If a tumor is detected at this stage, the prognosis is favorable, more than 80% of patients survive.
• Stage II - the size of the neoplasm does not exceed 5 cm. Lymph nodes are not affected or 1-2 are affected in neighboring organs. After diagnosis, about 60% of patients survive.
• Stage III - the tumor closes the intestinal duct by more than 50%, affects more than 3 lymph nodes in closely located organs. The survival rate is low - 20%.
• Stage IV is the stage with the most unfavorable prognosis. An overgrown tumor metastasizes to all neighboring organs (urethra, vagina, pelvic bones, uterus, etc.). Secondary foci of rectal cancer are also found in distant organs. Diagnosis - inoperable cancer, survival - 0%. At this stage, treatment and procedures are aimed at alleviating the patient's condition and eliminating pain.

Features of treatment

The main and only method of eliminating rectal cancer is surgery. The affected organ or part of it is removed. Radiation and chemotherapy are used as adjunctive therapy to rule out possible relapses of the disease.

Surgical treatment

Currently, there are several options for surgical intervention.

A tumor of the rectum is an oncological pathology that develops when the pathogenic cells lining the intestine multiply. In this case, the neoplasm can grow along the walls of the intestine or protrude through it. Let us consider in more detail the causes, symptoms and methods of treatment of this disease.

To date, there is no exact data on why a malignant tumor of the rectum develops. However, scientists identify several factors due to which a person has an increased risk of developing pathology. They are:

1. Wrong nutrition. This includes the frequent intake of too fatty and spicy foods, a lack of fiber in the diet, and the consumption of foods with carcinogenic additives.

All this will lead to the production of special bacteria in the intestines, which will negatively affect the rectum and eventually lead to a tumor.

Important! According to the results of studies, it was found that vegetarians almost do not get cancer of the rectum and other parts of the gastrointestinal tract. This is explained by the fact that their diet is rich in vitamins and fiber.

1. Frequent stress and nervous strain.
2. Binge eating.
3. Prolonged inflammation in the rectum.
4. The presence of polyps in the intestines, which were not cured in time.
5. Papillomavirus infection.
6. Anal sex.

Features of development and symptoms of the disease

A tumor of the rectum usually does not develop very quickly, so it is detected in an already quite neglected form. First, the cells of the neoplasm grow along the circumference of the intestine down or up. Only after that (if the pathology has not been identified) the cancer cells begin to disperse through the blood, affecting other organs.

The formation itself can be of two types: benign (polyps, villous tumor of the rectum) and malignant (pathology with cancer cells). Treatment depends on the type of disease.

The symptoms of this disease are:

1. Frequent pain and burning during bowel movements.
2. Chair disorder.
3. Constipation.
4. Diarrhea.
5. Bloody discharge during bowel movements.
6. Sudden weight loss.
7. Mucous discharge after stool.
8. Bloating.
9. Loss of appetite.
10. Frequent false urge to defecate.
11. Paleness of the skin.
12. Malaise.
13. Apathy.
14. Fast fatiguability.
15. Anemia.
16. Vomit.
17. Exacerbation of hemorrhoids.

In the early stages, a tumor of the rectum can be easily confused with paraproctitis or hemorrhoids, so you should be very careful in diagnosing.

Diagnostics

When the first symptoms of the disease appear, you should consult a proctologist as soon as possible. He will prescribe the following diagnostic procedures:

1. Finger examination of the rectum.
2. Abdominal ultrasound.
3. General analysis of blood and urine.
4. Fecal analysis.
5. Rectomanoscopy.
6. Biopsy of the rectum.
7. Irrigoscopy.
8. Colonoscopy.

Features of treatment

The most effective treatment for a rectal tumor is surgical removal. The operation is carried out based on the localization of the neoplasm, its size and the general condition of the patient.

If conditions allow, then part of the affected intestine is removed along with the tumor. This will be even more effective and reduce the risk of re-progression of the pathology.

Sometimes, along with the rectum, the anus of the patient will also be removed. In this case, a colostomy is formed in a person. This procedure is done when the formation is located close to the anus.

Important! During the operation itself, doctors should not touch the tumor, as this can provoke the movement of cancer cells in the body along with the blood.

If colon cancer has developed even before it spread to other organs, then there is no point in removing the intestine, but the tumor itself must be cut out in order to reduce the risk of possible complications.

Before the operation, the patient must prepare. To do this, he needs:

1. Do some cleansing enemas.
2. For several days before the operation, switch to a slag-free diet.
3. Take special laxatives (if prescribed by a doctor).

Additional treatment includes:

1. Radiation therapy can be administered both before and after surgery. It will help reduce pain and reduce the risk of developing a new tumor.
2. Conducting chemotherapy. It aims to reduce tumor growth. It can also be used in the preoperative and postoperative period.

Forecast and prevention

The prognosis after removal of a rectal tumor depends on the stage of the disease, the success of the operation and the general condition of the patient. If the patient follows all the instructions of the doctors, then he has every chance for a full recovery.

To reduce the risk of developing this pathology, you should adhere to the following tips:

1. Refuse to use such products:

• products with carcinogens and other artificial additives;
• spicy and fatty foods;
• fried foods;
• carbonated drinks with dyes;
• alcoholic drinks.

1. Treat inflammation and diseases of the rectum.
2. If the first unpleasant symptoms occur, you should immediately consult a doctor and do not delay the diagnosis.
3. Give up smoking.
4. Avoid stress and nervous strain.
5. Don't overeat.

Eat a balanced diet. At the same time, the basis of the diet should be foods rich in calcium and fiber (vegetables, fruits, dairy products).

Anton Palaznikov

Gastroenterologist, therapist

Work experience more than 7 years.

Professional skills: diagnosis and treatment of diseases of the gastrointestinal tract and biliary system.

One of the most common types of oncological lesions of the large intestine is a malignant tumor - almost a third of all cases. This tumor is located on the wall of the rectum in its various sections and arises from epithelial cells.

Its peculiarity is its relatively slow growth compared to other tumors of the gastrointestinal tract, as well as the limited location - in the first stages of development, it is located within the boundaries of the intestine.

Intestinal discomfort can be a symptom of cancer.

The main risk group for this disease is those who are over 50 years old, and in men this form of cancer is diagnosed one and a half times more often than in women. The insidiousness of the tumor is that the first stages are almost asymptomatic, or with minor manifestations that can be attributed to many others.

As the disease progresses, the manifestations become stronger, pains appear, indicating the development of the process. Cancer symptoms:

1. Intestinal discomfort - alternation and frequent stools.
2. The appearance of blood and mucus in the feces, in the last stages - bleeding.
3. Constantly elevated temperature.
4. Cramping pains in the abdomen, turning into continuous in the later stages of the disease.
5. Itching in the perineum, irritation of the skin by secretions.
6. Sexual dysfunction.
7. Manifestations of intoxication - headaches.
8. Exhaustion, weakness, anemia due to metabolic disorders.
9. Painful - the urge to defecate, not ending with the release of feces.

With the development of the disease, intestinal obstruction occurs, leading to inflammation of the peritoneum. Due to the absence or limitation of the act of defecation, bloating develops, it increases in size, intoxication develops, and a “pencil” or “ribbon” stool appears. Vomiting and lack of appetite accompany these complications.

Diagnosis of a malignant tumor of the rectum

Colonoscopy is one of the ways to diagnose the rectum.

With the first signs of trouble, you need to contact a doctor - a surgeon, an oncologist who will confirm or refute suspicions of rectal cancer. Modern medicine is able to detect this pathology at the earliest stages of development. Diagnosis is carried out according to a certain algorithm:

1. Collection of anamnesis and lifestyle, preliminary assessment of complaints.
2. Digital rectal examination.
3. Sigmoidoscopy (examination of the inner wall of the rectum and sigmoid colon).
4. General analysis of blood and urine, examination of feces for occult blood.
5. (colon endoscopy), irigoscopy (study using a contrast agent).
6. pelvic organs, ultrasound using an endorectal probe, endoscopic ultrasound.
7. Biopsy of the tumor, if found for histological and cytological examination.
8. Computer at the transition of the disease to the stage of metastases to assess the state of neighboring organs.

An informative method can be a blood test for the CA-19-9 oncomarker and for a cancer embryonic antigen. Their detection can occur in long-term smokers and in patients with chronic tumors and ulcerative colitis.

Treatment of malignant lesions in rectal cancer

Tomography - used to assess the condition of neighboring organs.

The main method of treatment is surgery in combination with chemotherapy and radiation therapy. This type of cancer responds well, so chemotherapy is carried out both before and after surgery. This helps to increase survival and reduce the number of relapses. Small tumors in the early stages are burned out with laser radiation.

Operations on the rectum are quite traumatic interventions and require careful preparation. If the tumor is small and located ten centimeters above the sphincter, then an anterior resection is performed, when the area of ​​the intestine with the tumor and regional lymph nodes are removed, and the remaining ends of the intestine are sutured. With this tactic of surgical intervention, the patient quickly recovers.

If the tumor is located below (6 cm from the anus), then a low resection is performed, when part of the intestine, after removal of the tumor, is removed through the outside, they wait for the intestine to grow together, and cut off the removed intestine. In this case, the intervention due to the removal of a large portion of the intestine is more traumatic, it is necessary to create a temporary path for defecation - a stoma.

In stages 2 and 3 of rectal cancer, a permanent colostomy is formed, and the rectum is excised. The constant wearing of a colostomy bag is very inconvenient, so they are trying with all their might to restore the natural process of defecation. At stage 4, the intestinal patency is restored and the nearest metastases are removed. If the process is accompanied by multiple metastases, then palliative treatment is carried out, aimed at maintaining the life of the patient, alleviating his condition.

Survival prognosis

This prognosis depends on the stage at which a malignant tumor of the rectum is diagnosed. If it is diagnosed at the first stage and produced successfully, then the five-year survival rate is 90%. At the stage of further development of the tumor, with the appearance of metastases in the lymph nodes, the five-year survival rate is 50%.

After surgery, 85% of patients may have tumor recurrence within 2 years. With timely detection of recurrence, reoperation is possible in 35% of patients. The remaining 65% can only receive supportive treatment (radiotherapy, chemotherapy), and have a poor survival prognosis.

For the timely detection of recurrence, patients undergo instrumental and digital examination of the intestine every three months, ultrasound of the liver and pelvic organs and a chest x-ray are performed every six months.

Details about the tumor of the rectum in the thematic video:

Prevention primary and secondary

Playing sports will have a great impact on the state of the body.

To prevent rectal cancer, you need to review your diet, enrich it with fiber from vegetables and fruits, do not overeat, stop smoking and lead an active lifestyle. Refusal of fatty foods, sports and physical education, feasible physical labor will have a great impact on health.

Persons at risk with intestinal pathologies and hereditary predisposition should regularly visit a doctor, give feces for occult blood annually, undergo an examination by a proctologist, colonoscopy, and sigmoidoscopy.

Early diagnosis of a malignant tumor of the rectum will allow you to identify the disease in the early stages, clarify in time, and carry out treatment. Persons at risk, over the age of 50, with intestinal pathologies, hereditary predisposition should be especially attentive to their health.

Rectal cancer- a malignant tumor that forms in the mucous membrane of the final section of the large intestine. Often among doctors the term "colorectal cancer" is used, which includes all tumors of the large intestine, including the rectum.

Among all tumors of the gastrointestinal tract, rectal cancer accounts for 45%.
5% of cancer patients suffer from this particular tumor.

In Russia, the prevalence of rectal cancer is constantly increasing. The highest frequency is noted in St. Petersburg and the Leningrad region, in Pskov. More than 50,000 new cases of this tumor are detected in our country every year. Between the ages of 30 and 50, the incidence of colorectal cancer has slightly decreased in recent years, and in older people it is constantly increasing.

World statistics

The death rate from colorectal cancer is on the rise. Every 10 years it increases by 15% - 20%. Often the disease is detected at a later stage, when many methods of treatment are ineffective.

Survival statistics for patients with rectal cancer:

• In developed countries, about 60% of patients survive within 5 years from the moment of detection of pathology.


• In developing countries, this figure is no more than 40%.

Anatomy of the rectum

In the mucous membrane of the rectum there are a large number of cells that secrete mucus. It acts as a lubricant during the passage of stool. The mucous membrane is collected in folds, having the form of vertical pillars and a semilunar shape.

In the lower part, the rectum is surrounded on the outside by a hemorrhoidal plexus, consisting of a large number of wide veins.

Causes of colorectal cancer

• Nutrition Features. Colon cancer is much more common in people who consume large amounts of meat, especially beef and pork. Meat food, getting into the intestines, stimulates the multiplication of bacteria that produce carcinogens. A decrease in plant fiber in the diet also increases the risk of developing pathology.
• Hypovitaminosis. Vitamins A, C and E inactivate carcinogens that enter the intestine. With their lack in food, the harmful effects on the wall of the rectum and the entire large intestine are intensified.
• Overweight. It has been proven that rectal cancer is most common among obese people.
• Sedentary lifestyle. With constant sedentary work, blood stagnation occurs in the veins of the pelvis and hemorrhoids. This leads to dysfunction of the rectal mucosa and increases the likelihood of developing malignant tumors.
• Heavy smoking. Statistical studies show that smokers have this type of malignant tumor more often than non-smokers. Apparently, this is due to the effect of nicotine on blood vessels.
• Alcohol abuse. Ethyl alcohol has an irritating effect on the intestinal wall, damages the mucous membrane, and promotes the formation of cancer cells.
• Occupational hazards. Colon cancer is common among workers exposed to indole, skatole and other harmful substances. Malignant tumors of the large intestine are common among workers in cement factories and sawmills.
• Heredity. A person whose relatives suffered from this disease has an increased risk. They are the higher, the closer the degree of relationship.

• polyps. These are benign formations of the mucous membrane, which are elevations. The risk of malignancy is especially high if the polyp is larger than 1 cm.


• Diffuse polyposis- a hereditary family disease in which a large number of polyps form in the rectum and colon.


• Papillomavirus infection in the anus papillomaviruses are capable of causing cell mutations leading to the development of malignant tumors.

To date, the mechanism of development of rectal cancer is not well understood.

Symptoms of colorectal cancer

• tumor size
• duration of the disease
• location of the tumor
• the nature of the growth of a malignant neoplasm

Diagnosis of rectal cancer

Patient Interview

• existing complaints and the time of their occurrence;


• the nature of nutrition, bad habits;


• history: has the patient ever been diagnosed with polyps or other precancerous diseases, has he already been treated for tumors of the rectum or other organs?


• family history: have relatives suffered from rectal cancer and other precancerous conditions?


• place of work: does the patient have to come into contact with harmful substances?

Finger examination and examination of the rectum in rectal mirrors

After a digital rectal examination, it is impossible to establish a diagnosis of a malignant tumor. But if any formation is detected, the doctor is obliged to prescribe a further examination to confirm or refute cancer.

A rectal speculum is an instrument that consists of two flaps and two handles. Inspection is also carried out in the knee-elbow position. The doctor inserts a mirror into the anus, while its flaps are in the closed position. By pressing the handles, the proctologist carefully pushes the valves apart, making the intestinal lumen accessible for inspection. After examination with a rectal speculum, it is more likely to assume the presence of rectal cancer, but the final diagnosis must be confirmed by other, more informative, methods.

Instrumental research methods

Research method	Description
Sigmoidoscopy	Endoscopy. Executed using sigmoidoscope- a device consisting of a tube with a lighting device and a device for pumping air. How is the research done? Before conducting sigmoidoscopy, the patient is asked to take one of two positions: knee-elbow: on all fours, leaning elbows and knees on the couch; on the left side with legs bent and pulled up to the stomach: the patient is asked to take a deep breath and then exhale, relaxing the right shoulder and neck, after which the proctoscope is inserted. The doctor inserts a proctoscope into the anus, pumps some air into the rectum to widen its lumen, and examines its mucous membrane. What can be found during recoromanoscopy? polyps and malignant neoplasms on the surface of the mucous membrane; erosion, ulcers and other defects; areas where bleeding is noted; blood, pus in the lumen of the rectum; during sigmoidoscopy, a small piece of the intestinal mucosa can be taken for examination under a microscope (biopsy - see below).
Irrigography – radiopaque examination of the rectum and colon	Irrigography- x-rays of the rectum, performed after a contrast agent (suspension of barium sulfate) has been introduced into it. Irrigoscopy- X-ray examination, in which the rectum filled with contrast is examined in real time on the screen. Preparation for the study: at the time of irrigoscopy, the intestines must be completely cleaned; 1 - 2 days before the study, a plentiful drink of water is prescribed; vegetables and fruits, milk, black bread are excluded from the patient's diet; On the eve of doing a cleansing enema. Irrigography: the doctor injects the patient into the rectum with a suspension of barium sulfate using an enema; pictures will be taken in different projections; after emptying the rectum, there is still a little contrast on its walls - you can take additional pictures and examine the relief. What is revealed during irrigography: volumetric formations on the wall of the rectum: the contrast flows around them, the so-called "filling defect" is formed; the size and extent of education; the presence of ulcerative defects on the wall; the nature of tumor growth: outward or inward, into the intestinal wall.
Ultrasound examination (ultrasound)	What helps to detect ultrasound in rectal cancer: spread of the tumor to neighboring organs; the presence of metastases in adjacent lymph nodes.
CT scan	Most often, computed tomography for rectal cancer is prescribed if, after ultrasound and x-rays, conflicting data are obtained. During computed tomography, images are obtained, which are layered sections of the pelvic region. The rectum and neighboring organs are clearly visible on them.
Additional instrumental research methods for detecting rectal cancer metastases
Survey radiography of the abdominal cavity.	X-rays of the abdomen are taken without the introduction of contrast. The study allows you to assess the condition of the intestine, to identify intestinal obstruction.
Fibrocolonoscopy	An examination in which a long, thin endoscope is inserted through the rectum into the overlying large intestine. Fibrocolonoscopy reveals the spread of a malignant tumor to the wall of the sigmoid and colon, the presence of polyps capable of malignant degeneration.
Radioisotope liver scan	Colon cancer often metastasizes to the liver. If a lesion is suspected, a radioisotope scan is performed. The patient is injected intravenously with isotopes that are captured and accumulated by tumor cells. Then the pictures are taken.
Laparoscopy	An endoscopic examination in which miniature video cameras are inserted into the abdominal cavity through punctures in the abdominal wall. The study is equivalent to surgery and is performed under general anesthesia. Laparoscopy makes it possible for all internal organs to assess their condition and the degree of metastases. The doctor has the opportunity to take material for examination under a microscope (biopsy).
Intravenous urography	X-ray contrast study, in which a solution of a contrast agent is injected intravenously. It is present for some time in the blood, and then excreted through the kidneys, ureters and bladder, staining them. On the pictures you can assess the condition of these organs, the presence of metastases in them.

Consultation with an oncologist on the treatment of rectal cancer

Laboratory research methods for rectal cancer

tumor markers

Tumor markers specific for colorectal cancer:

• SA 19-9- a substance that is secreted by tumor cells of the colon and rectum. It helps to identify not only the tumor itself, but also metastases at an early stage.


• Cancer embryonic antigen. This substance is produced in the digestive system of embryos and fetuses. In healthy adults, it is practically not detected in the blood. Its level increases with malignant tumors of the intestine.

Biopsy

The material obtained during the biopsy may be subject to histological and cytological examination.

Procedures during which material from the rectum and adjacent organs may be taken for biopsy:

• sigmoidoscopy;
• surgery for rectal cancer;

Histological examination

• Urgent. It is performed within 30 - 40 minutes. It is carried out if the result is needed quickly, especially in hospitals. The material is frozen, processed with special dyes, after which it can be studied under a microscope.


• Planned. Takes from 5 days. The tissue obtained during recoromanoscopy is treated with a special solution and paraffin, and stained. This is a more complex process than freezing, but it produces more accurate results.

Cytological examination

Materials for cytological research:

• a piece of rectal tissue obtained during a biopsy;
• pus, mucus from the lumen of the rectum;
• imprints of the mucous membrane of the rectum.

Types of colorectal cancer

Classification of malignant tumors of the rectum depending on the cellular structure

Types of tumors of the rectum depending on the histological structure:

• Adenocarcinoma. The most common type of malignant tumors of the rectum. Revealed in 75% - 80%. It is formed from glandular tissue, most often occurs in people over 50 years of age. When examined under a microscope, it is possible to reveal the degree of differentiation of the tumor tissue. There are highly differentiated, moderately differentiated, poorly differentiated and undifferentiated tumors. The lower the degree of differentiation, the more malignant the tumor, the worse the prognosis for the patient.


• Signet cell carcinoma. Occurs in 3% - 4% of cases. It got its name because of the characteristic appearance of tumor cells under a microscope: there is a lumen in the center of the cell, and a narrow rim with a cell nucleus on the periphery - it resembles a ring with a stone. This type of rectal cancer has an unfavorable course, many patients die within the first three years.


• Solid rectal cancer. Occurs rarely. It comes from glandular tissue. It consists of poorly differentiated cells, which no longer look like glandular cells and are arranged in the form of layers.


• sciros cancer (scir)- also a rare type of malignant tumor of the rectum. It has relatively few cells and a relatively large amount of intercellular substance.


• Squamous cell carcinoma. The third most common (after adenocarcinoma and ring cell cancer) malignant tumor of the rectum - is 2% - 5% of the total. This type of tumor is prone to early metastasis. Often its occurrence is associated with human papillomavirus infection. It occurs almost exclusively in the lower part of the rectum, in the region of the anal canal.


• Melanoma. A tumor of pigment cells - melanocytes. Located in the anal canal. prone to metastasis.

Classification of rectal cancer depending on the nature of growth

• Exophytic cancer. The tumor grows outward, into the lumen of the rectum.


• Endophytic cancer. The tumor grows inward, grows into the wall of the rectum.


• mixed form. It is characterized by both exophytic and endophytic growth.

Classification of rectal cancer according to the TNM system

Abbreviation decoding:

• T is the size of the tumor (tumor);
• N - metastases in nearby lymph nodes (nodus);
• M - distant metastases in various organs (metastasis).

The condition of a patient suffering from rectal cancer depends on the presence or absence of metastases.

• If the tumor is located within the rectum, then the patient is only concerned about digestive disorders, pain in the intestine, impurities of pus, blood and mucus in the feces.


• If the tumor grows into neighboring organs, then there are symptoms characteristic of their defeat. With germination in the uterus and vagina - pain in the lower abdomen, violation of menstruation. With germination in the bladder - pain in the lower abdomen, impaired urination. With the spread of metastases to the liver - jaundice, pain under the ribs.


• With multiple metastases, the general condition of the patient is disturbed: weakness, fatigue, exhaustion, anemia, fever occur.

Treatment of rectal cancer

Surgical treatment of rectal cancer

Operations on the rectum are among the most traumatic. Today, new techniques have been developed that allow maintaining a normal act of defecation and avoiding common postoperative complications.

Factors influencing the choice of surgical technique:

• the size and location of the tumor;
• the nature of the cellular structure of a malignant neoplasm;
• tumor classification according to the TNM system.

Radiation therapy for rectal cancer

• Preoperative period. Sessions are carried out daily for 5 days. The area where the tumor is located is irradiated directly. Surgical treatment is performed 3-5 days after the end of the course.


• Postoperative period. The course of radiation therapy is started 20-30 days after the operation, if metastases in the regional lymph nodes have been confirmed. The tumor area and all lymph nodes of the pelvic region are irradiated. Sessions are held daily 5 days a week.

• atrophy(reduction in size and dysfunction) of internal organs: bladder, uterus, ureters, vagina, prostate, etc.
• necrosis(death) of bones.

Chemotherapy for colorectal cancer

How to care for treated patients?

• who have recently undergone surgery for rectal cancer;
• emaciated, in serious condition;
• having a colostomy: the end of the intestine, brought to the skin of the anterior surface of the abdomen.

• frequent change of underwear and bed linen;
• it is necessary to ensure that crumbs and dirt do not accumulate on the sheet;
• prevention of bedsores: the patient must be periodically turned over, his position in bed should be changed, anti-decubitus mattresses can be used;
• treatment of bedsores with camphor alcohol;
• feeding the patient (if the patient cannot eat on his own, then a special probe is used);
• hygiene procedures: daily washing, brushing teeth, periodic washing of the body with a damp sponge;
• delivery of the vessel;
• for incontinence of feces and urine, special diapers and pads are used.

Colostomy patients wear a special colostomy bag. The main care is associated with its periodic replacement. This can be done by the patient or caregiver.

Replacement of the colostomy bag:

• carefully remove the used colostomy bag (most often adhesive ones are used - with a special sticker) from top to bottom, discard it;
• wipe the skin around the colostomy dry with a paper or gauze cloth;
• wash the colostomy and the skin around it with warm boiled water;
• dry the skin thoroughly with napkins;
• lubricate the cream with an ointment or paste prescribed by a doctor;
• remove the remnants of the cream from the skin with a napkin;
• glue a new colostomy bag onto the skin, following the manufacturer's instructions attached to it.

Diet for rectal cancer

• good nutrition, the inclusion in the diet of a sufficient amount of proteins, fats, carbohydrates, vitamins and minerals;
• restriction of fatty meat food;
• enrichment of the diet with vegetables and fruits;
• full breakfast;
• five meals a day in small portions;
• thorough chewing of food;
• exclusion from the diet of spicy, acidic, extractive foods.

Prognosis for rectal cancer

• stage of the disease;
• cellular structure of the tumor;
• the degree of differentiation of tumor cells (undifferentiated are the least favorable - see above);
• the presence of metastases in the lymph nodes;
• type of treatment provided.

Dependence of the number of patients who survived for 5 years on the stage of the tumor process:

• Stage I - 80%;
• Stage II - 75%;
• IIIA stage - 50%;
• IIIB stage - 40%.

Prevention of rectal cancer

• Proper nutrition. Restriction in the diet of meat and fatty foods.


• Sufficient physical activity, the fight against overweight.


• Timely treatment of diseases of the rectum: anal fissures, hemorrhoids, polyps, etc.


• Refusal of bad habits: alcohol, smoking.

• analysis of feces for occult blood;


• sigmoidoscopy;


• ultrasound procedure.