What are the differences between colon cancer and rectal cancer?

Written by Cui Fang Bo
Oncology
Updated on January 02, 2025
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The fundamental difference between colon cancer and rectal cancer lies in their locations of occurrence. Both are collectively referred to as colorectal cancer, which is one of the more prevalent malignancies of the digestive system in China. Colon cancer originates from the mucosa of the colon, while rectal cancer originates from the mucosa of the rectum, with different points of origin. In terms of treatment, there are significant differences between colon and rectal cancer. In surgical treatment, both cancers typically require surgery as the first choice. However, patients with colon cancer can preserve their anus, whereas some patients with low rectal cancer might face situations where anus preservation is not possible. In internal medicine, the chemotherapy drugs used for colon and rectal cancer are quite similar. In terms of radiation therapy, there are notable differences; radiation treatment is generally not included for colon cancer but is an important treatment method for rectal cancer.

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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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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.

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Could having blood in the stool for five years be rectal cancer?

If there has been blood in the stool for five years, whether it's colorectal cancer or not, this can only be confirmed through a colonoscopy. Furthermore, pathological tissue analysis and biopsy are necessary to make a definitive diagnosis. Pathological examination is the gold standard for diagnosing cancer. If cancerous changes are present, surgical treatment should be undertaken promptly to prevent the spread of cancer cells. If there are no malignant changes, symptomatic treatment measures can be adopted. Conditions such as chronic colitis, ulcerative colitis, or hemorrhoids could also cause blood in the stool.

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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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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.