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Diagnosis rectal cancer

Rectal cancer: An evidence-based update for primary care providers

Suspected signs and symptoms of rectal cancer include rectal bleeding during defecation and abdominal abnormalities that might be caused by other diseases such as an anal fistula (an infection near the anus due to chronic constipation), diverticulitis (inflammation or infection of small pouches called diverticula that develop along the walls of the intestines) or an angiodysplasia defined as an abnormality with the blood vessels in the lining of the intestine.

Potential risk factors for developing rectal cancer might involve genetics or family history of cancer, age over 45, being obese or overweight and unhealthy lifestyle habits e.g. regular eating of high-fat foods or red meat, fermented or processed foods as well as alcohol drinking and smoking.

If signs and symptoms present, especially in a combination with risk factors, diagnostic tests must be performed by highly experienced specialists. Early diagnosis plays a major role to increase the chances of successful treatments. Diagnostic tests and procedures involve:

  • Medical history taking and full physical examination.
  • Laboratory tests.
  • Barium swallow to view and access the abnormalities of the intestine and rectum.
  • Computed tomography (CT)-colonoscopy uses special X-ray to examine the large intestine and rectum.
  • Colonoscopy: Using a scope to examine the inside of the colon and rectum. A long, flexible and slender tube attached to a video camera and monitor is inserted through the anus to view the entire colon and rectum.
  • Blood test to determine carcinoembryonic antigen (CEA), tumor marker used for disease prognosis and follow-up after receiving treatment.
  • Biopsy: If any suspicious areas are found during colonoscopy, the specialists pass surgical tools through the tube to take tissue samples (biopsy) for analysis and remove polyps.

After receiving all investigational results including cancer staging, customized treatments are collectively planned by multidisciplinary team consisting of colorectal surgeons,

diagnostic radiologists, radiation oncologists, medical oncologists and pathologists. The ultimate aim is to provide the treatment with the best possible outcomes while taking into consideration of patient’s physical and mental aspects.

Treatments

Treatment options include non-surgical treatments (e.g. medications, injections or sclerotherapy and rubber band ligation) and surgical treatments.

In case that rectal cancer is strongly suspected, colonoscopy will be used for confirmatory diagnosis. Normally, the rectum regulates the defecation process.

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