Rectal Cancer can be differentiated into five stages, which are:

• ● Stage 0: When only the inner layer is affected.
• ● Stage 1: When cancer cells have metastasised past the rectum wall’s innermost layer but haven’t reached the lymph nodes yet.
• ● Stage 2: When cancer cells have passed through the rectum wall’s outer muscle layer but not affected the lymph nodes.
• ● Stage 3: When cancer cells have damaged the rectum muscles’ outermost layer and have spread to one or more lymph nodes.
• ● Stage 4: When cancer cells have invaded other organs.

There is a range of factors, which can raise the possibility of Rectal Cancer. These are:

• ● Age: Rectal Cancer is most common after 50, but these days, even younger individuals are diagnosed with it.
• ● Family history: A history of this type of cancer in your family can be a significant cause.
• ● Radiation therapy: If you have had radiation treatment around your abdominal area, it can put you at risk.
• ● Other health conditions: Inflammatory bowel disorder, ovarian cancer, obesity and type 2 diabetes are a few of the health issues that can augment the level of risk.
• ● Lifestyle factors: Lack of exercise, smoking, excessive alcohol, an imbalanced diet that lacks vegetables, and too much red meat are other contributing factors.

The notable signs and symptoms of Rectal Cancer that you must be wary about include:

• ● Changes in bowel habits, like constipation, diarrhoea, or more frequent bowel movements
• ● Abdominal pain and cramps
• ● Narrow stool
• ● Bright red blood in the stool
• ● Mucus in the stool
• ● A feeling of incomplete bowel movements
• ● Fatigue or weakness
• ● Sudden weight loss
• ● Anaemia

Evaluation plays an extremely critical role in the treatment of cancer. Once it is confirmed that you have Rectal Cancer, the next step is to determine to what extent it has spread. A few tests that help to do this are:

• ● Blood tests to check organ function: A chemistry panel test helps determine the level of chemicals in your blood. Abnormal levels of these chemicals may indicate issues with other organs.
• ● Complete blood count (CBC): CBC tests can show if your red blood cell count is low because a tumour can be causing blood loss.
• ● CT Scan: This imaging test can show if rectal cancer has spread to other organs like lungs or liver.
• MRI of the pelvis: An MRI provides your doctor with a detailed view of the organs, muscles, and tissues surrounding the tumour.

Based on how aggressively the cancer has spread, there are different ways to deal with Rectal Cancer.

1. Removing small cancerous lumps from inside the rectum: When rectal cancer has not spread extensively, it can be removed with a colonoscope’s help (a long tube with a camera is inserted into the anus) and other specialised instruments.

These surgical instruments are inserted into the anus to remove the cancerous tissues and some of the surrounding healthy tissues.

Polypectomy and transanal local excision is done this way. But, if your lab analysis shows that the cancer cells have spread into your lymph nodes, then you might be advised of an additional procedure.

2. Removing whole or part of the rectum: Rectal Cancer, which is usually localised at a safe distance from the anal canal, but is big in size, can be removed with a low anterior resection. In this, a portion, or the whole rectum, along with the nearby tissues and lymph nodes, is taken out. However, the anus is safe.

Additionally, this surgery is planned according to the location of the cancer. If the lower portion of the rectum is affected, then the whole rectum is removed. After this, the colon is shaped into a pouch and connected to the anus (coloanal anastomosis).

If the rectum’s upper portion is damaged, then a portion of it is removed, and the colon is attached to the remaining part of the rectum (colorectal anastomosis).

3. Removing the anus and the rectum: When the rectal cancer cells have grown too close to the anus, it becomes challenging to remove them without hampering the muscles, which control the bowel movements.

In such a situation, a surgery called an abdominoperineal resection (APR) is carried out where your rectum, anus, part of the colon, lymph nodes, and surrounding tissues are cut off.

4. Chemotherapy: In this, drugs are used to destroy the cancer cells and can be implemented in three ways:

• ● Post-surgery, chemotherapy can help destroy any remnant cancer cells.
• ● Before surgery, chemotherapy is combined with radiation therapy, and this method can shrink the tumour for easy removal.
• ● It can also help provide you relief from cancer symptoms if it has spread to the other parts of your body.

5. Radiation Therapy: Powerful energy sources like x-rays and protons are employed to eliminate the cancer cells. If you have rectal cancer, then your physician may combine radiation therapy with chemotherapy. It is highly effective in shrinking cancer cells.
6. Immunotherapy: The cancer cells produce a protein that keeps them hidden from your immune system, and hence your body is unable to fight. Immunotherapy is a drug treatment, which fortifies your immune system.
7. Targeted Drug Therapy: This mode of treatment focuses on some particular abnormalities of cancer cells and blocks them accordingly. Targeted drug therapy can be fruitful for people with advanced Rectal Cancer.
8. Palliative Care: There are palliative care specialists who provide you with care and support to withstand the symptoms of this severe disease. These specialists work in coordination with your doctors and your family to enhance the quality of your life.

The result of Rectal Cancer treatment largely depends on which stage it has been detected in and the mode of treatment. It also varies from patient to patient. Thanks to the advances in cancer cure, the survival rate has increased with each passing year. The five-year survival rate is more than 90 percent if detected in stage 1.

Regular testing or check-up is one of the most effective ways to keep Rectal Cancer at bay. This type of test is called “colorectal screening.” It can take almost 10-15 years for polyps to grow into colorectal cancer. With regular colorectal screening, these polyps can be found and removed at the right time.

Increase the intake of fruits, vegetables, whole grains containing vitamins, minerals, and antioxidants. Also, avoid smoking, ensure moderate alcohol consumption, avoid gaining weight, and include daily exercise in your routine.

Yes, Rectal Cancer symptoms can be quite cumbersome, and the side effects of the treatment may also impact your quality of life. There are therapies and support centres that can help you cope with stress.

You must avoid the intake of sugary desserts, carbonated drinks and food items with high levels of saturated fat like lamb, pork and beef.

There is no doubt that a disease like cancer can be very overwhelming. A second opinion can be very reassuring for you as a patient.