Rectal cancer treatment

It is the second most deadly cancer.
Rectal cancer develops from the cells that line the inner wall of the rectum. Most often, it comes from a benign tumor, called an adenomatous polyp, which evolves slowly and eventually becomes cancerous.
Rectal cancer is 90% non-hereditary. Only familial adenomatous polyposis and HNPCC (Lynch syndrome) have a higher risk of colorectal cancer. It often appears from the age of 50 and doubles every decade.
His diagnosis is often made around the age of 70.
60 to 80% of cancers develop from an adenoma. The risk of an adenoma becoming cancerous depends on its size, location and degree of dysplasia.
SYMPTOMS:
• Transit disorder
• Abdominal pain that does not give way to treatment
• Rectorragy (anal emission of red blood outside the stool)
• Weight loss, tiredness
• Abdominal or anal mass on clinical examination
• Iron deficiency anemia without a cause found.
• No symptoms and discovered during an annual screening.

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ITS DIAGNOSIS:
Total colonoscopy:
Key examination under general anesthesia. It is a long flexible tube composed of an endoscope (camera) and pliers that are inserted by the anal route. At the same time, biopsy samples are taken and sent to pathology to confirm the diagnosis and type of cancer. The exam lasts about 20 minutes, then you stay in the recovery room between 1 and 2 hours.
A preparation based on laxatives and a strict residue-free diet is essential within 5 days of this examination.
Biology:
A standard biological assessment and specific tumour markers: ACE (carcinoembryonic antigen). Other markers can be made: alpha foeto-protein CA19-9.
Imaging:

SURGERY:
It is essential. A prior appointment with the surgeon will allow you to answer all your questions and doubts.
It is performed under general anesthesia with the agreement of the anesthesiologist.
The surgeon will remove the rectal area where the tumour, fat, blood vessels and lymph nodes around it are located to reduce the risk of local recurrence. This operation is done by laparotomy (open abdomen, by a vertical incision of about twenty centimetres on the abdomen, starting from the top of the navel that he goes around, until the bottom of the abdomen), laparoscopy (a few incision points are made and a flexible tube with camera, forceps, scalpel to resect is inserted), or by transanal route (it goes through the anus, there are no incisions).
There are different types of surgery depending on the distance from the tumor to the anus.
A distinction is made between tumours of the upper rectum (10 to 15 centimetres from the anus), tumours of the middle rectum (5 to 10 centimetres from the anus) and those of the lower rectum (less than 5 centimetres from the anus).
Tumors of the upper rectum:
The surgeon removes the sigmoid colon and the upper third of the rectum. A suture is then made between the colon and the remaining rectum. No exit pocket is necessary.
The tumors of the middle third:
The surgeon removes the entire rectum. It creates a colonic reservoir to replace the rectum. An ostomy pouch (transitional artificial anus) connected to the skin is placed for 6 to 8 weeks to optimize healing and limit the risk of infection. An intervention is secondarily programmed to allow a natural elimination of stool and close the stoma.
The tumors of the lower rectum:
The surgeon removes the rectum, sphincter and anus. A stoma called a permanent colostomy is placed, and if other pelvic organs such as the bladder or uterus are affected, the surgeon also removes them and the surrounding lymph nodes.
Cancer with metastasis:
If there are metastases of the liver or lungs that are removable, the surgeon removes them during the procedure. If the metastases are too severe, chemotherapy is used. If the treatment works, secondary resection surgery is proposed. Otherwise, chemotherapy is continued with or without changing the drugs introduced.

THE CONSEQUENCES OF THE INTERVENTION:
After the operation, an anti-pain treatment is adjusted by the anaesthetist in the recovery room. The hospitalization lasts on average 6 days during which your vitals, ostomy pouch, pain and resumption of feeding are checked.
The most serious but rare complication (10 to 15%) is anastomotic fistula. Pain, transit problems and fever are the signs of it. An abdominal CT is performed to confirm the diagnosis. Depending on the degree of complication, antibiotic therapy or a repeat procedure will be indicated.
Other complications are: haematomas, infections, transit disorders.
Strict dietary rules are established by the nutritionist to avoid these inconveniences
RADIOTHERAPY:
Radiation therapy involves exposing cancer cells to radiation that prevents their multiplication and causes their destruction.
It is used preoperatively to reduce the size of the tumor.
It is used in the postoperative period to destroy the surrounding lymph nodes and eliminate all potentially unremoved cells.

About Rectal cancer treatment

FOLLOW-UP:
It is essential to avoid any risk of recurrence. It lasts for minimum 5 years.
Follow-up is based on consultations with the surgeon, blood tests and imaging.
On average, the follow-up is as follows:
Follow-up is adapted on a case-by-case basis.
Some complex diseases such as cancer can lead some patients to seek a second medical opinion. Almost 50% of patients using the second medical opinion have seen their treatment options evolve. Seeking a second medical opinion is perfectly legitimate when faced with a serious illness.
Click here to find out more about the second MEDICAIM medical opinion
MEDICAIM takes care of the follow-up on a case-by-case basis. www.medicaim.com
MEDICAIM is looking for the best specialists for you and we will offer you several renowned doctors.
MEDICAIM organizes your entire stay for you: post-operative nursing care, biological follow-up, therapeutic, nutritional and psychological support.
Any additional questions? Ask your MEDICAIM doctor about it: careteam@medicaim.com