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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Written by Si Li Li
Gastroenterology
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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 Deng Heng
Colorectal Surgery
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Early symptoms of rectal cancer

The early symptoms of rectal cancer generally include five main signs: The first early symptom is bloody stool, which is the earliest and most common symptom of rectal cancer. The second symptom is mucous bloody stool. Large cauliflower-like tumor masses generally secrete a large amount of mucus, which can cause mucous bloody stool. The third is a change in bowel habits. What does a change in bowel habits mean? It means that sometimes there can be diarrhea, sometimes constipation, or an alternation of constipation and diarrhea, indicating a change in bowel habits. There can even be changes in the shape of the stool, which is the third symptom. The fourth symptom is a feeling of heaviness or fullness in the perineum or anus. The fifth symptom can cause abdominal pain. It can cause pain in the lower abdomen, a sensation of a foreign body in the intestine, and even bloating. For instance, constipation can lead to difficulty in passing stool, which in turn can cause bloating and abdominal pain. These are primarily the five early symptoms.

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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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Written by Liu Liang
Oncology
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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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Written by Chen Tian Jing
Colorectal Surgery
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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.