Is rectal cancer without metastasis curable?

Written by Gong Chun

Oncology

Updated on March 08, 2025

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Can rectal cancer without metastases be treated successfully? If rectal cancer has not metastasized, its prognosis and outcome are relatively much better compared to cases where there are metastases and recurrences. If surgery is performed for rectal cancer and there is no recurrence or metastasis afterwards, then the five-year survival rate is naturally higher. However, if rectal cancer is initially treated surgically and cleaned thoroughly but then quickly recurs, with liver metastases, lung metastases, etc., then the five-year survival rate would be much lower. Therefore, if rectal cancer has not metastasized, the treatment and prognosis are much better. Thus, if there is no liver or lung metastasis in rectal cancer, the treatment is relatively easier.

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Which is more serious, anal canal cancer or rectal cancer?

Rectal cancer and anal canal cancer both belong to the category of malignant tumors of the digestive system, with anal canal cancer generally considered a type of rectal cancer, primarily occurring at the anal canal close to the anus. Comparatively, anal canal cancer is somewhat more serious than rectal cancer. Clinically, the closer the tumor is to the anus, the potentially higher the malignancy, meaning more severe. However, subsequent treatment outcomes also need to be considered. Both anal canal cancer and rectal cancer can be considered for curative surgery. If the cancer is very close to the anus and an anus-preserving surgery is not feasible, further colostomy surgery may be required.

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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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Is anal pain and rectal bleeding indicative of rectal cancer?

Pain in the anal area, accompanied by blood in the stool, does not necessarily indicate rectal cancer. There are many causes of pain and bloody stools, which require identification and diagnosis through the color of the bloody stools, digital rectal examination, and colonoscopy. Common causes of bright red bloody stools or pain are mainly due to hemorrhoids and anal fissures. During the onset of rectal cancer, early stages generally do not involve pain in the anal area. It is mainly characterized by changes in bowel habits, or dark red blood in the stool in the middle to late stages. The tumor may grow larger, causing difficulty in defecation, and may even induce systemic symptoms such as weight loss, anemia, and intestinal obstruction.

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Oncology

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What are the early symptoms of rectal cancer in women?

The early symptoms of female rectal cancer are primarily localized to the rectum. Most patients exhibit symptoms such as bloody stools, recurrent constipation, or alternating occurrences of diarrhea and constipation. Some patients may experience a change in stool characteristics, an increase in the frequency of daily bowel movements, and narrower stools. Additionally, some early-stage patients may exhibit symptoms similar to bacterial dysentery, such as the discharge of mucus and bloody pus in stools, and a feeling of incomplete evacuation after a bowel movement. Some female rectal cancer patients may mistake bloody stools for hemorrhoids and consequently avoid seeking medical attention. Early symptoms are not distinctive, and many patients may overlook them, leading to a delay in the early detection of rectal cancer.

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Symptoms of rectal cancer recurrence

The symptoms of rectal cancer recurrence can include changes in bowel habits and stool characteristics, possibly presenting as rectal bleeding, increased frequency of bowel movements, a sensation of heaviness in the anus, and changes in stool shape, such as narrowing. The second symptom may be abdominal pain, particularly persistent and subtle pain. The third symptom involves palpable abdominal lumps or masses, especially with right-sided colon cancer. The fourth symptom is intestinal obstruction, which can occur if the bowel is blocked due to the recurrence of rectal cancer, leading to symptoms of intestinal obstruction. The fifth symptom, if the recurrent rectal cancer has metastasized, may lead to symptoms at the respective metastatic sites.