Cancer of the rectum (rectal cancer or colorectal cancer) is an abnormal growth of cells that form tumors in the rectum. The rectum is the lower section of the large intestine where bowel movement is held. If the cancer spreads to other parts of the body, it is still rectal cancer, and is called metastatic cancer.
There are different types and stages of rectal cancer that are diagnosed based on what kind of cancer cells are found, where the tumor started and where it has spread. Knowing your type and stage of rectal cancer you have helps your healthcare provider decide on the best treatment plan for you. It is important to diagnose and treat rectal cancer as soon as possible. The main goals of treatment are to kill the tumor cells, prevent a localized cancer from spreading, and prevent metastatic cancer from spreading more than it already has.
There are several factors that increase your risk of rectal cancer, including smoking, a personal or family history of colon cancer, or a personal history of breast cancer, ovarian, or endometrial cancer.
What can I expect in the hospital?
Several things may be done while you are in the hospital to monitor, test, and treat your condition. They include:
You will be checked often by the hospital staff.
Your fluid intake may be monitored closely by keeping track of everything you eat and drink and any IV fluids you receive.
Your fluid output may be monitored closely by keeping track of the amount of urine and bowel movements you produce. You may have a small tube (catheter) placed into your bladder through the urethra (the opening from the bladder to the outside of the body) to drain and measure urine from the bladder.
Testing may include:
Blood tests to check for infections or blood loss.
Tests of bowel movements to check for blood or infection.
Tests to look for abnormalities in your rectum, which may include:
Anoscopy: a small, lighted tube is put into your rectum to examine the anal area and look for abnormal areas or bleeding. A biopsy may be taken to help make a diagnosis. A biopsy is the removal of a small sample of tissue for testing.
Proctoscopy: A small, lighted tube is put into your anus and up into the rectum to look for abnormal areas. A biopsy may be taken to help make a diagnosis.
Sigmoidoscopy or colonoscopy: A test in which a thin, flexible tube and tiny camera is put into your rectum and up into the colon to look for abnormal tissue. A biopsy may be taken to help make a diagnosis.
Ultrasound scan: Sound waves are used to show pictures of the inside of the rectum
Tests to check if the cancer has spread to other parts of your body, including:
Blood tests to check for certain hormones, proteins, or chemicals that may be high if you have cancer.
Bone X-rays: Pictures of your bones to check for cancer
Bone scan: A series of detailed pictures that are taken after your healthcare provider injects a small amount of radioactive material into your blood. The scan shows any areas of bone where the radioactive material is being absorbed.
Chest X-ray: Pictures of the inside of your chest to check for cancer.
Computed tomography (CT) scan: A series of X-rays taken from different angles and arranged by a computer to show thin cross sections of the rectum and other areas where the cancer may have spread
Magnetic resonance imaging (MRI): A powerful magnetic field and radio waves are used to take pictures from different angles to show thin cross sections of the rectum and other areas where the cancer may have spread
Positron emission tomography (PET) scan: A series of detailed pictures that are taken after your healthcare provider injects a small amount of radioactive material into your blood. The scan shows areas where the radioactive material is being absorbed.
The treatment for rectal cancer depends on how far the cancer has advanced, your symptoms, how well you respond to treatment, your overall health, and any complications you may have.
Rectal cancer can be cured, depending on where the cancer is located, how large it was when you were diagnosed, and whether the cancer has spread. You may need to make lifestyle changes to stay as healthy as possible, manage other treatments you may need, or adjust to a colostomy if you have one.
You will have a small tube (IV catheter) inserted into a vein in your hand or arm. This will allow for medicine to be given directly into your blood and to give you fluids, if needed.
You may have a tube put through your nose down into your stomach, called a nasogastric or NG tube. The tube may be used to give fluids or medicine, or with suction to help relieve pressure from air or fluids in your stomach and intestine.
Treatments may include:
Chemotherapy (anticancer drugs), which uses medicine to kill cancer cells.
Radiation therapy, which uses high-energy X-rays to kill cancer cells.
You may need surgery to treat rectal cancer. Surgery may include:
Polypectomy: Surgery to remove the polyp or tumor and some tissue around it.
Local resection: Surgery to remove the section of rectum that contains the cancer. The ends of the intestine are then sewn back together.
Colostomy: Surgery to remove a large section of your colon, rectum, and anus. The healthy part of the remaining colon is attached to an opening in the wall of your abdomen. Bowel movements then pass through this opening instead of the rectum. They are collected in a bag outside your body.
Lymph node dissection: Surgery to remove lymph nodes in the pelvic area near the rectum to check if the cancer has already spread. It also allows the pathologist to determine the stage of the cancer accurately. This will allow your healthcare providers to determine if you need more treatment after you recover from surgery.
Your provider may also prescribe medicine to:
Treat or prevent an infection
Treat or prevent anemia, which means you have too few red blood cells to carry enough oxygen to your body. Anemia may be caused by your cancer, your treatment, or other problems.
Prevent side effects, such as nausea or constipation, from other treatments
Soften stool and reduce straining with a bowel movement
Reduce the acid in your stomach to help relieve acid indigestion
Help your immune system fight cancer
What can I do to help?
You will need to tell your healthcare team if you have new or worsening:
Bloating or pain in your belly
Blood or mucus in your bowel movement
Deep bone pain
Change in bowel habits, such as pain, mucus, diarrhea, constipation, or other intestinal problems
Nausea or vomiting
Redness, swelling, pain, warmth, or drainage from your surgical wound
Fever, chills, or muscle aches.
Ask questions about any medicine, treatment, or information that you do not understand.
How long will I be in the hospital?
How long you stay in the hospital depends on many factors. The average amount of time to stay in the hospital with rectal cancer is 6 to 9 days.
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Acute Care Advisor 2015.1 published by RelayHealth. Last modified: 2014-12-19 Last reviewed: 2014-10-10
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Niederhuber, J.e., Armitage, J.O., Doroshow, J. H., Kastan, M.B., and Tepper, T.E. (2014). Cancer of the Rectum. Abeloffâ€™s Clinical Oncology (Fifth Ed), Ch. 78, 1336-1359.e8. Philadelphia: Saunders.
US Department of Health & Human Services. (2012) National and regional estimates on hospital use for all patients from the HCUP nationwide inpatient sample. Agency for healthcare research and quality website. Retrieved 07/22/2014 from http://hcupnet.ahrq.gov/HCUPnet.jsp