Can rectal cancer be cured?

Written by Liu Liang
Oncology
Updated on September 07, 2024
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If rectal cancer is detected in its early stages, such as stage I or II, curative surgery can be performed. Postoperative decisions regarding the necessity of adjuvant radiotherapy or chemotherapy are based on the postoperative pathological staging. Early-stage rectal cancer patients can achieve a cure through surgical treatment combined with some postoperative adjuvant therapies. After curative surgery, the overall five-year survival rate is approximately 50%. However, this rate can vary and is associated with several factors such as postoperative pathology, whether there is lymph node metastasis, the presence of vascular tumor thrombi, and nerve invasion, among other high-risk factors for recurrence, showing certain individual differences. Yet, early-stage rectal cancer patients can achieve a cure through these methods.

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Written by Gong Chun
Oncology
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Is a severely blocked anus a symptom of rectal cancer?

Is anal blockage a manifestation of rectal cancer? The answer could be yes, but it could also be due to hemorrhoids, or other diseases. The main common symptoms of rectal cancer include changes in bowel habits and the characteristics of the stool. There may be frequent bowel movements, diarrhea, or constipation, or alternating constipation and diarrhea, a sensation of anal heaviness, or associated with vague abdominal pain. Symptoms of abdominal pain, intestinal obstruction, and abdominal masses might also appear. When the tumor grows to a certain extent, an abdominal mass can be palpated, which might cause some compressive symptoms, possibly leading to anal blockage as one of the symptoms.

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Oncology
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Stage II colorectal cancer

Rectal cancer staging is based on the TNM system. "T" refers to the primary tumor, "N" indicates whether there are lymph node metastases, and "M" indicates the presence of distant metastases. Staging is determined according to these factors. Stage II generally refers to patients with T3, N0, M0, or T4, N0, M0. What does this mean? T3 indicates that the tumor has penetrated the base layer reaching the subserosal layer, or has invaded the tissues adjacent to parts of the colon or rectum that are not covered by peritoneum, which is described as T3. T4 means that the tumor has invaded through the entire bowel wall, perforated the visceral peritoneum, and involved other organs or structures, which is called T4. N0, M0 means there are no lymph node metastases and no distant metastases, such as to the liver or lungs. Such patients are clinically staged as stage II rectal cancer.

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Written by Liu Liang
Oncology
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Does stage II rectal cancer require chemotherapy?

Whether a stage II colorectal cancer patient needs adjuvant chemotherapy after surgery depends on the specific circumstances. For example, stage IIA patients are classified as T3, N0, M0. The necessity of adjuvant chemotherapy for these patients should be determined based on the pathological report. If the report indicates the presence of vascular invasion, neural invasion, poor differentiation, or if microsatellite stability testing shows poor prognostic factors, then such patients should undergo postoperative adjuvant chemotherapy. If none of these conditions are present in a stage IIA patient, then postoperative adjuvant chemotherapy may not be necessary. Generally, stage IIB patients, whose tumors have penetrated the full thickness of the intestinal wall, are recommended to undergo postoperative adjuvant chemotherapy. Therefore, the specific conditions of the patient need to be considered.

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Written by Deng Heng
Colorectal Surgery
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Early symptoms of rectal cancer

The early symptoms of rectal cancer generally include five main signs: The first early symptom is bloody stool, which is the earliest and most common symptom of rectal cancer. The second symptom is mucous bloody stool. Large cauliflower-like tumor masses generally secrete a large amount of mucus, which can cause mucous bloody stool. The third is a change in bowel habits. What does a change in bowel habits mean? It means that sometimes there can be diarrhea, sometimes constipation, or an alternation of constipation and diarrhea, indicating a change in bowel habits. There can even be changes in the shape of the stool, which is the third symptom. The fourth symptom is a feeling of heaviness or fullness in the perineum or anus. The fifth symptom can cause abdominal pain. It can cause pain in the lower abdomen, a sensation of a foreign body in the intestine, and even bloating. For instance, constipation can lead to difficulty in passing stool, which in turn can cause bloating and abdominal pain. These are primarily the five early symptoms.

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Written by Yan Chun
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How to distinguish between anal fissure and rectal cancer causing rectal bleeding

In clinical practice, to differentiate between rectal bleeding caused by anal fissures and that caused by rectal cancer, we can consider the following aspects. Firstly, rectal bleeding caused by anal fissures is generally accompanied by pain in the anal area, and the bleeding is especially severe after defecation, with blood attached to the surface of the stool. In contrast, rectal bleeding caused by rectal cancer rarely accompanies pain in the anal area, and the blood is generally mixed with the stool. Secondly, rectal bleeding from anal fissures is usually due to hard stools, and improving the condition of hard stools, along with providing local anti-inflammatory treatment, usually relieves the symptoms of bleeding. However, in the case of rectal cancer, besides hard stools, patients may also experience an increase in the frequency of defecation and signs of diarrhea, and typical anti-inflammatory treatments are not notably effective.