Rectal Cancer Treatment in Bangladesh

Rectal/Rectum Cancer (রেকটাম ক্যান্সার)

What is rectum cancer?

Rectum is part of digestive system between last part of colon and anus. It helps pass waste material out of the body. The colon (large bowel) is the first part of the large intestine and is about 5 feet long. Together, the rectum and anal canal make up the last part of the large intestine and are 6-8 inches (15 cm) long. The anal canal ends at the anus (the opening of the large intestine to the outside of the body). Cancer is a malignant tumour. Rectal cancer often develops slowly over several years. It typically starts as a small abnormal growth on the inner lining of the rectum. This is called a polyp. Some polyps can eventually grow into cancer. Rectal cancer is often contained within the rectum. But if left untreated, it can spread to other organs, most often the liver and lungs. Cancer tends to spread all over the body. It causes various sufferings to us even death, if untreated.

Signs and Symptoms

Check with your doctor if you have any of the following sign and symptoms

• Blood (either red or dark) in the stool.

• A change in bowel habits for more than two weeks

o Diarrhea.

o Constipation.

o Feeling that the bowel does not empty completely.

o Stools that are narrower or have a different shape than usual.

• General abdominal discomfort (frequent gas pains, bloating, fullness, or cramps).

• Weight loss for no known reason.

• Rectal cancer often does not cause symptoms in the early stages. That’s why we recommend that you get regular screenings for colorectal cancer. Cancer of colon and rectum together is called colorectal cancer. In Bangladesh colorectal cancer begins more than 10 years earlier than western countries. That’s why we recommend colorectal cancer screening starting at the age of 40 years in case of average risk people. Those who have first degree relative with colorectal cancer should be screened at more earlier age.

Tests to detect (find) and diagnose rectal cancer.

Tests used to diagnose rectal cancer include the following:

• Physical exam and history:

• Digital rectal exam (DRE):

• Colonoscopy:

• Biopsy: taking small part of cancer from body

• histopathological examination (examination of the biopsy under microscope) Staging:

Determining How far the cancer has spreaded. There are four stages of rectal cancer.

• Stage I: The tumor has spread beyond the inner lining but remains within the rectum wall and has not spread to the lymph nodes (small organs that are part of the immune system).

• Stage II: The cancer extends through the thick outer muscle layer of the rectum but has not spread to the lymph nodes.

• Stage III: The cancer has spread outside the rectum to one or more lymph nodes.

• Stage IV: The cancer has spread to other parts of the body, such as the liver or lungs.

• Staging is done by mainly by pelvic MRI; and CT scan of whole abdomen and chest.

• Pelvic MRI: to determine spread of cancer around the rectum

• CT scan of whole abdomen and chest with IV and oral contrast: To determine the spread of cancer to distant parts like liver, lungs etc.

• Endorectal USG: helps to stage early rectal cancer especially to see whether rectal wall muscle has involved or not.

Treatment:

A multidisciplinary approach that includes surgery, medical oncology, and radiation oncology is required for optimal treatment of patients with rectal cancer. Determination of the optimal treatment plan for a patient with rectal cancer involves a complex decision-making process. The number of lymph nodes removed (12 or more; minimum, 10) at the time of surgery impacts staging accuracy and prognosis. Factors influencing sphincter and organ preservation in patients with rectal cancer can be described as follows

• Surgeon training

• Surgeon volume

• Use of neoadjuvant chemoradiotherapy

If you are diagnosed with rectal cancer, your doctors will discuss treatment options with you.

We understand how important quality of life is. We always try to preserve your ability to use the bathroom normally as well as your sexual health. There are several ways to treat rectal cancer depending on the stage and location of the disease. These methods are often used in combination, including:

• Surgery to remove the cancer. Early-stage rectal cancer can often be treated with a minimally invasive procedure, which uses a smaller incision (cut) than traditional surgery. This includes robot-assisted surgery. With some procedures, doctors use special tools so that they can avoid an incision. For more advanced cancer, surgery may still be appropriate, usually with chemotherapy or radiation before, during, or after surgery.

• Chemotherapy with drugs that shrink or kill cancer cells. This can be done before, during, or after surgery.

• Radiation using high-energy rays or radioactive seeds to shrink or kill cancer cells. These therapies use sophisticated, highly precise imaging tools to deliver powerful doses of radiation directly to a tumor while avoiding damage to normal cells.

• Watch-and-wait therapy (nonoperative management): rectal cancer treatments with a combination of chemotherapy and radiation for people with stage II and III cancer that spare them from surgery.

• Targeted therapy that attacks genetic weaknesses in cancer cells. This treatment spares normal cells.

• Immunotherapy. This helps unleash your body’s own immune system to fight cancer.

Rectal/ rectum Cancer specialist in Dhaka, Bangladesh.

We have special expertise in minimally invasive techniques that help people preserve their ability to use the bathroom normally as well as their sexual health and quality of life after surgery for rectal cancer. We are here to help you every step of the way.

Am I at risk for getting rectal cancer?

Colorectal cancer is the third most common cancer diagnosed in both men and women worldwide.

Your risk of rectal cancer depends on many factors. You can control some of them but others you can’t, including:

• age – the older you are, the more likely you are to develop rectal cancer. In western countries rectum cancer usually occurs after 50 but we are getting so many patients of rectal cancer at the age of 20s or 30s.

• diet, exercise, and tobacco and alcohol use

• a personal history of polyps and inflammatory bowel diseases, including ulcerative colitis and Crohn’s colitis

• a family history of colorectal and related cancers and inherited disorders, including Lynch syndrome and familial adenomatous polyposis

• genetics— about 5 to 10 percent of colorectal cancer is due to genetic causes passed from parents to children.

How will rectal cancer treatment affect my quality of life?

After the shock of a rectal cancer diagnosis, you may have many questions about how treatment will affect you, including your ability to use the bathroom normally as well as your sexual health. Preserving these functions is one of our key goals. Your care team will focus on your quality of life from the very beginning of treatment. We will tailor a personalized plan for you. Because we care for many people with rectal cancer.

Learn more about a colonoscopy and other screening tests for colorectal cancer

1.https://www.cancer.gov/types/colorectal/patient/rectal-treatment-pdq#:~:text=Rectal%20cancer%20is%20a%20disease,used%20to%20diagnose%20rectal%20cancer.

2.https://www.mayoclinic.org/diseases-conditions/rectal-cancer/symptoms-causes/syc-20352884

3.https://fascrs.org/patients/diseases-and-conditions/a-z/rectal-cancer

4.https://www.mskcc.org/cancer-care/types/rectal

5.https://www.emedicinehealth.com/rectal_cancer/article_em.htm

6.https://www.cancercenter.com/cancer-types/colorectal-cancer/types/rectal-cancer

7.https://en.wikipedia.org/wiki/Colorectal_cancer

Appointment

For treatment and care of rectal cancer by Colorectal Surgeon Dr Tariq Akhtar Khan please call 01736-369536 and take an appointment.

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