Rectum Cancer: Symptoms, Diagnosis and Treatment

Posted On Aug 30, 2021

Dr. Karthik K S

Consultant - Surgical Oncology

KMC Hospitals–Mangalore

Cancer Care Hospital in Mangalore

The number of cancer cases is on a rise and it is projected to rise further in another two decades. Healthy lifestyle, regular exercise, and avoiding substance abuse form the pillars in the fight against Cancer. Also educating the common public, so that they are well aware of the circumstances is a must. Early diagnosis and treatment in the next level of the fight against cancer. Cancer diagnosed in its early stage can be treated better and the prognosis is good. Present-day cancers are treated according to international protocol. An Oncologist can guide the treatment according to the prevailing standards of treatment across the globe. A patient can avail treatment in comparison to developed countries being in India. When it comes to healthcare, India is no more underdeveloped. You reach a proper place and person and avail treatment of international standards.

Today, my topic of interest is Rectum. The rectum is that part of the bowel, about 15cm in length just before the feces exits (Anal Canal). A lot of discussions with respect to this organ are because of its complexity about sphincter mechanism and its effect on the surgery. The sphincter mechanism in the rectum is responsible for flatus and feces continence.

What is cancer? Abnormal growth of tissue, which is independent of the normal surrounding tissue. Cancer cells are immortal and hence they grow and dissipate more easily. They rob the normal metabolism and nutrition from the surrounding normal cells and ultimately invade and destroy the surrounding normal tissue.

The most important modality of treatment in solid tumors is surgery. What is also important is the selection and timing of the surgery. Also, the appropriate planning of neoadjuvant and adjuvant treatment is necessary.

There is something unique in the rectum, the sphincter mechanism. The flatus and stool continence is a very important function. The sphincter is shown and depicted in the picture. The surgery aims to keep the sphincter mechanism intact. But it is also important to achieve a “cure”. For that, we have to achieve oncological clearance. There are situations where the sphincter cannot be preserved: when the sphincter is involved, and when the tumor is very low. It is always a priority to try and preserve the sphincter. However, when the sphincter cannot be preserved permanent stoma becomes inevitable.

Neoadjuvant treatment is a very important discussion in rectal cancer. Neoadjuvant radiation decreases the chances of local recurrence. Without neoadjuvant radiation, the chances of local recurrence can be as high as 30 percent. Also, neoadjuvant radiation improves the chances of saving the sphincter. Neoadjuvant radiation can be given as a long course (over 6 weeks) or a short(over 1 week) course based on patient and disease profile. Whenever possible, short-course treatment can reduce the treatment duration by up to 3 months. Locally advanced cancers would usually need adjuvant treatment.

The stoma can be temporary or permanent. A permanent stoma is planned where preserving the sphincter is not possible. However, the temporary sphincter is used to rest the surgical anastomotic site. Anastomotic leak in the absence of stoma sometimes can lead to sepsis and endanger life. A temporary stoma is usually reversed after the completion of adjuvant treatment. We see a lot of stigma towards the stoma in our practice. These stomas are usually done as life-saving measures and are mostly inevitable. These can be well hidden within the dress without much discomfort.

Manipal Hospital is the Cancer Care Hospital in Mangalore where you can consult the best cancer doctor in Mangalore for Rectum Cancer Treatment in Mangalore.

from different specialties routinely remove tumors from different organs in the same operation (synchronous treatment).

Rectum-like, most of the cancers can be better treated in earlier stages. It is important to identify the disease in its early stage. Any bleeding during passing of stool, altered bowel habits (irregular constipation or loose stool), Tenesmus (Pain and feeling of incomplete evacuation) has to be thoroughly evaluated. We often find patients to have delayed diagnosis because of misdiagnosis with piles-related issues. A simple colonoscopy before starting a piles treatment would help to diagnose the disease early. 

Cancer is not a death sentence. The cure lies in diagnosis early and treating appropriately. A healthy lifestyle with regular exercise and a balanced healthy diet is an important preventive modality. As a society, we should work towards removing the stigma towards cancer. We have to support the affected in all means we can. Science has advanced and we have to believe in science. We have to treat and get treated scientifically according to the prevailing international guidelines.

When to See a Doctor

Make an appointment with Surgical Oncologist at Manipal, the best cancer hospital in Mangalore if you have any persistent symptoms that worry you.


Dr. Karthik K S

Surgical Oncology

Manipal Hospital, Mangalore


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