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Rectal cancer

Apr 29, 2020

The rectum is the final part of the large intestine, which performs the function of fecal accumulation and is responsible for the act of defecation. When mutations occur, normal rectal cells can turn into tumor cells. During the rapid growth of tumor cells, a malignant tumor is formed. The close location of the tumor to the anal opening complicates the treatment of patients, requiring an individual approach, in order to preserve the natural course of the intestine and avoid the formation of a permanent intestinal stoma. 

WHAT IS THE STAGE OF RECTAL CANCER?

In order to determine how far the tumor process has gone and to determine the treatment tactics, it is necessary to establish the stage of rectal cancer. 

Stage I-the tumor is located inside the lumen of the intestine and is located within the mucosal layer alone. At this stage of the disease, a large operation is not required, but it is possible to remove the tumor through the lumen of the intestine. 
Stage II-the tumor has grown to the adipose tissue surrounding the rectum. However, the lymph nodes and other organs are not affected by tumor cells.  
Stage III-the tumor sprouts all layers of the intestinal wall, there are lymph nodes affected by tumor cells, located along the vessels that supply blood to the rectum with the tumor. However, there is no damage to other organs
Stage IV-tumor cells spread through the blood, lymphatic vessels, or through contact throughout the body and began to grow in various organs (liver, lungs, etc.).

HOW IS RECTAL CANCER DIAGNOSED?

Already at the initial examination and conversation, you can suspect a malignant tumor of the rectum in the patient on the basis of complaints about:

  • discharge of blood and mucus from the rectum;
  • pain in the rectum;
  • violation of the stool in the form of constipation or diarrhea;
  • false urge to defecate

and the detection of a tumor during a finger examination of the rectum.

After the examination, it is necessary to conduct a comprehensive examination, which includes: colonoscopy with biopsy, computed tomography of the thoracic and abdominal cavities, magnetic resonance imaging of the pelvis with intravenous contrast, blood tests, determination of cancer markers, examination of the cardiovascular and pulmonary systems.  

Colonoscopy is a procedure that allows you to see a tumor in the lumen of the intestine and take a piece of this tumor for examination under a microscope. 

MRI of the pelvis with intravenous contrast is necessary to determine the stage of the tumor, as well as damage to neighboring organs, major vessels or other anatomical formations of the pelvis.

Computed tomography of the thoracic and abdominal organs with intravenous contrast can reveal distant metastases. 

In all cases of rectal cancer, it is recommended to analyze the tumor for the presence of disorders in the microsatellite instability system . In metastatic rectal cancer, it is advisable to conduct an analysis for mutation of the RAS and BRAF familygenes . These studies allow you to choose individual medications, taking into account the characteristics of the tumor. 

Surgical treatment of rectal cancer is currently the only radical treatment. Rectal resection is an operation to remove a part of the rectum with a tumor. If the lymph nodes are affected by tumor cells, they are resorted to their removal (lymphadenectomy or lymphodissection). 

Surgeons of the Moscow Clinical Scientific and Practical Center named after A. S. Loginov possess technologies of interfacial, embryonic surgery, i.e. removal of the affected fragment of the rectum with the preservation of small nerves of the small pelvis. This approach of gentle surgery allows you to avoid local recurrence of the disease and preserve the natural course of the intestine, without resorting to performing crippling operations. 

At the Loginov Moscow Research Center, operations for rectal cancer are performed using minimally invasive laparoscopic and robotic technologies and modern crosslinking devices, which allows sphincter-preserving operations to be performed even with rectal tumors located very close to the edge of the anus. 

If the patient's malignant tumor is located close to the anus or has a large size, such patients are given preoperative chemoradiotherapy. This treatment allows you to reduce the size of the tumor and then perform a radical surgical treatment. 

The tactics of treatment of patients with rectal cancer at the Loginov Moscow State Medical Center are determined by an interdisciplinary team of doctors consisting of colorectal surgeons, oncologists-chemotherapists and specialists in radiation therapy.

Only a personalized approach to treatment in a specialized clinic allows you to achieve good results even in patients with advanced stages of rectal cancer. 

Do not delay your visit to the specialists of our center. This will help to diagnose the disease in a timely manner and choose the right treatment tactics. Doctors of the Department of Coloproctology of the Moscow State Medical Center named after A. S. Loginov are always ready to help you.

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