What tests are used to check for rectal cancer?

Written by Liu Liang
Oncology
Updated on September 25, 2024
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When clinical symptoms such as diarrhea or constipation, changes in bowel habits, bloody stools, and abdominal pain occur, we should be vigilant about the possibility of rectal cancer. The examination for rectal cancer can start with a digital rectal exam, especially for low-lying rectal cancer, which is closer to the anus; these tumors can be detected through this method. Then, a colonoscopy should be performed to take a biopsy to confirm the diagnosis, which is the gold standard for confirmation. Additionally, blood tests for tumor markers can be conducted. Generally, carcinoembryonic antigen (CEA) and CA199 levels may be elevated, but this is not absolute as their specificity and sensitivity are not very high. An enhanced CT scan of the abdomen can also be done. In such scans, we can see thickening of the intestinal wall where the tumor is located, and the enhancement can show the intensified thickening of the intestinal wall. Combining all these methods can confirm the diagnosis of rectal cancer.

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What are the late-stage symptoms of rectal cancer?

The late-stage symptoms of rectal cancer patients in clinical practice mainly include the following types. The first type is abdominal symptoms caused locally by rectal cancer. For example: bloody stools, pass stools with mucous and pus, anal pain, bloating, abdominal pain, and other manifestations. The second category of symptoms is those from metastases in various locations. For example, bone metastases cause bone pain and limb movement disorders. Lung metastases cause chest tightness, shortness of breath after activity, chest pain, breathing difficulties, coughing and coughing up blood, etc. Brain metastases cause headaches, dizziness, and seizures. The third category of symptoms is mainly systemic symptoms caused by rectal cancer lesions, such as: weight loss, fatigue, and high fever.

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Written by Liu Liang
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How long can one live after rectal cancer surgery?

The specific life expectancy after radical resection for rectal cancer varies among individuals and is dependent on various factors including the patient's general and physical condition, pathological staging post-surgery, and whether there are high-risk factors for recurrence such as lymph node metastasis, vascular tumor thrombus, and nerve invasion. The overall five-year survival rate post-surgery is approximately 50%. If the disease is confined to the submucosa and lacks high-risk factors such as vascular tumor thrombus, nerve invasion, or lymph node metastasis, the five-year survival rate after radical surgery can reach up to 90%. However, if post-surgery pathology reveals lymph node metastasis, vascular tumor thrombus, and nerve invasion, among other high-risk factors, the patient's five-year survival rate will decrease. Thus, survival rates are closely related to many factors.

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Written by Si Li Li
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How to rule out the possibility of rectal cancer

Common symptoms of rectal cancer include abdominal pain, changes in stool characteristics, and rectal bleeding. These symptoms could suggest the possibility of rectal cancer. An initial examination can be conducted via a digital rectal exam to preliminarily exclude rectal cancer. If a mass is felt during the digital rectal exam, a high suspicion of rectal cancer should be maintained. Additionally, a colonoscopy can be performed for a definitive diagnosis. If a mass on the rectal mucosa is observed during the colonoscopy, a biopsy can be conducted for histopathological examination to determine the nature of the mass. Generally, if the surface of the mass is uneven, brittle, and bleeds easily, the likelihood of malignancy is high while a smooth surface suggests a greater possibility of benignity.

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Written by Liu Liang
Oncology
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What are the symptoms of rectal cancer?

Symptoms of rectal cancer include changes in bowel habits, such as a feeling of heaviness around the anus, a constant need to defecate, or diarrhea. Some patients may experience constipation, or alternating episodes of diarrhea and constipation. Another common symptom is a change in the shape of the stool, with the stool becoming narrower. Additionally, abdominal pain and rectal bleeding are also common symptoms. Some patients with rectal cancer may exhibit clinical signs of intestinal obstruction, which includes constipation, inability to pass stool or gas, which means no flatulence. This is accompanied by nausea and vomiting. Other common symptoms include significant abdominal pain and bloating.

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Is chemotherapy effective for late-stage rectal cancer?

Late-stage rectal cancer is primarily due to the metastasis and proliferation of cancer cells. At this stage, surgery alone cannot completely eliminate cancer cells, so chemotherapy is necessary. Chemotherapy has certain effects clinically, especially in patients who are sensitive to chemotherapy drugs, where the effects are more pronounced. This can control the spread of cancer cells in multiple locations and can, to some extent, improve patient survival rates. For patients, it is important to maintain good health, enhance their immune system, consume foods rich in high-quality proteins, and engage in appropriate exercise. Moreover, maintaining a positive mindset is beneficial for extending life. Additionally, patients can integrate traditional Chinese medicine and acupuncture as complementary therapies, which can also potentially improve postoperative survival rates.