How to differentiate rectal cancer from hemorrhoids

Written by Yu Xu Chao
Colorectal Surgery
Updated on October 24, 2024
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Rectal cancer is a malignant lesion, with clinical symptoms mainly causing an increase in the frequency of bowel movements, changes in stool characteristics such as grooved stools or stools with mucus and pus and blood. Severe patients may experience abdominal pain, weight loss, anemia, and other accompanying symptoms. Generally, low-lying rectal cancer can be seen during a digital rectal examination or with an anoscope. If the cancer is located higher up, an electronic colonoscopy is needed to see the cauliflower-like mass. Hemorrhoids, on the other hand, are benign lesions often caused by improper diet or poor bowel habits, leading to pathological hypertrophy and descent of the anal cushions. They are mostly characterized by intermittent painless rectal bleeding with bright red blood, along with a feeling of heaviness and a foreign body sensation in the anus.

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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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The difference between rectal cancer and colon cancer lies in the location of the cancer. Rectal cancer occurs in the rectum, which is the final part of the large intestine, while colon cancer occurs in other parts of the colon.

Rectal cancer and colon cancer are collectively referred to as colorectal cancer, named according to the different locations where the tumors occur. Rectal cancer occurs in the rectum. Colon cancer includes tumors in the transverse colon, descending colon, ascending colon, and sigmoid colon, and tumors in these areas are called colon cancer. Both are known as colorectal cancer, and they exhibit similar clinical manifestations, including rectal bleeding, abdominal pain, and changes in bowel habits, such as constipation, diarrhea, alternating constipation and diarrhea, and changes in stool shape, such as narrowing of the stool. They are merely named differently based on the location of the tumors and are collectively referred to as colorectal cancer.

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What are the differences between colon cancer and rectal cancer?

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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Early symptoms of rectal cancer

The early symptoms of rectal cancer generally include the following aspects: many patients experience changes in their bowel habits, such as prolonged diarrhea, prolonged constipation, or alternating occurrences of diarrhea and constipation. Some patients also experience changes in the characteristics of their stools, with stools becoming thinner and more watery due to increased bowel movements. Additionally, some patients may excrete stools mixed with mucus, pus, and blood, or stools that contain blood, and may experience a feeling of urgency followed by a sensation of incomplete evacuation. Some patients also feel itching or a dull pain in the anal area. Moreover, the early symptoms of rectal cancer are not very prominent, and many patients can easily confuse them with benign rectal diseases such as hemorrhoids and anal fissures. This confusion leads many patients not to seek medical attention, and by the time symptoms like significant pain and lumps appear, the disease is typically in its intermediate or advanced stages.

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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.