Can a colonoscopy detect rectal cancer?

Written by Wang Hui Jie
Gastroenterology
Updated on March 14, 2025
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Colonoscopy can detect colon and rectal cancer. It is the most important and primary method for examining colonic mucosal lesions. The large intestine includes the cecum, colon, and rectum. Colonoscopy allows direct visual inspection of lesions, including the size and color of the lesions, and whether there are ulcers and erosion, the nature of any attachments, etc. It also allows for direct biopsy. Firstly, it can assess the texture of the lesion, such as whether it is soft, hard, or brittle. Moreover, the biopsied sample can be analyzed histologically to determine the benign or malignant nature, depth of infiltration, etc. Different pathological characteristics have different prognoses and treatment methods, suitable for early cancers treatable under endoscopy, or those that can be removed during the process of the colonoscopy.

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Hemorrhoids bleeding and rectal cancer bleeding

Hemorrhoids or colorectal cancer can both cause local bleeding in the anal area, but there are clear differences between hemorrhoidal bleeding and colorectal cancer bleeding in clinical practice. Hemorrhoidal bleeding is mostly bright red and does not mix with the stool; it is separate bleeding. It may manifest as blood on the finger, or as dripping or spurting blood. Colorectal cancer bleeding, on the other hand, is generally dark red and mixes with the stool, sometimes accompanied by pus and blood. Bleeding from colorectal cancer mainly occurs in the late stages of the disease, usually caused by local mucosal ulceration or tumor rupture. During hemorrhoidal bleeding, an anal scope examination can reveal clear bleeding points above and below the dentate line, while bleeding from colorectal cancer requires examination with an electronic colonoscope to observe the local tumor area, which may show mucosal damage or ulcers.

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Written by Deng Heng
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Can you eat edamame after rectal cancer surgery?

Patients with rectal cancer can eat edamame after surgery. However, they should pay attention to the following dietary advice post-surgery: First, eat less or avoid animal fats, which means limiting the intake of saturated fatty acids. Second, even the consumption of vegetable oils should be limited. Third, do not eat fried foods. Fourth, during cooking, oils should not be overheated. Fifth, eat plenty of fresh vegetables and fruits.

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Written by Cui Fang Bo
Oncology
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Can the anus be preserved if the rectal cancer is 3 cm away from the anus?

When rectal cancer is 3cm from the anus, it generally isn't possible to preserve the anus. Currently, the commonly used surgical methods for rectal cancer are the Dixon and Miles techniques. Generally, the threshold is 5cm from the anus; when the tumor is within 5cm of the anus, it often necessitates a Miles procedure, which does not preserve the anus. When the tumor is more than 5cm from the anus, an anus-preserving Dixon procedure can be performed. However, in considering the radical resection of rectal cancer, preserving the anus should not be the primary choice; instead, the main goal should be curative.

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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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What causes rectal cancer?

The occurrence of rectal cancer is a process involving multiple factors and multiple steps, and it is the result of the interaction between environmental factors and genetic factors of the body. To date, its causes are not completely understood, but there are some factors that are considered high-risk. First, dietary factors are generally believed to be high in animal protein, high fat, and low fiber, which are significant factors in the high incidence of rectal cancer. Second, lifestyle factors such as prolonged sitting, smoking, drinking, being overweight, and obesity may increase the incidence of rectal cancer. Third, having a history of medical surgeries. Fourth, environmental factors, such as asbestos workers. Fifth, genetic factors.