Rectal cancer is a malignant neoplasm,
developing from the tissues of the intestine (its internal
epithelium). ATозникшая опухоль может поразить не только стенку
guts, but also grow and block the digestive tract,
germinate in the lymph nodes, liver and other organs.
How does cancer appear in the rectum in men and women that
prescribed as a diagnosis and treatment of this disease –
What is rectal cancer?
Colorectal cancer is a disease that develops as a result of
tumor degeneration of mucosal epithelial cells,
lining any of the sections of the rectum and possessing characteristic
signs of cellular polymorphism and malignancy.
Life expectancy for rectal cancer depends on many
characteristics: structure, type of growth and location of the tumor. But
The most important factor is the early diagnosis of the disease, which
increases chances for a further full life tenfold!
In the initial stages, unfortunately, there are no very bright signs.
the presence of a tumor in the body. The neoplasm itself is pretty fast.
develops and has a malignant nature. AT определенной фазе
begins to metastasize to the nearest lymph nodes and organs.
If we consider in more detail the anatomical structure of the rectum,
then there are three main areas:
- Anal part. It is here that the sphincters are located, with the help
which is defecation. This is the end portion of the intestine and
its length is about 3 cm.
- Ampular part. This site removes the excess
fluids from feces and their further formation before
excretion from the body. Ее длина составляет чуть меньше one0
- Nadampular The initial section of the rectum length of about 5
cm, which closes the peritoneum.
If we talk about the most frequently affected areas of the tumor, then
here the most “popular” is precisely the ampullary direct
guts. It is in this part that cancer cells are formed in 80% of cases.
- ATысокодифференцированная — опухоль довольно медленно растет и
- Poorly differentiated – fast-growing malignant tissue
- Medium differentiated – Has a moderate growth rate and
Another type of classification of rectal cancer based on
localization of malignant neoplasms, subdivides them into
- анального отдела (встречаются в one0% случаев);
- ректосигмоидного отдела (30%);
- нижне-, средне- и верхнеампулярного (60%) отделов прямой
ATыделяют следующие формы роста опухоли прямой кишки:
- in the lumen of the intestine (there is a tumor component in the lumen of the intestine
– endophytic, from the Latin “endo” -in);
- in the direction of fatty tissue and organs of the small pelvis (as such
there is no external component of the tumor, it forms a single mass with
surrounding tissues – exophytic, from the Latin “exo” –
The alleged causes of the disease:
- Proctitis is an inflammation of the sigmoid colon and its mucous membrane.
It has a specific nature (helminthic invasions, gonorrheal,
syphilitic, tubercular, etc.), or is a consequence
acute diseases that were not treated.
- Chronic fissures and ulcers in the anal
- Genetic predisposition.
- Lack of physical activity.
- Overeating and obesity.
Опухоли кишечника за последнее время вышли на 3-е место у
мужчин и на four-е место у женщин по частоте встречаемости, на
5-ом месте находится рак прямой guts. Peak incidence
приходится на возрастной период 70-7four года и составляет 67,one%.
Cancer is an insidious disease, its symptoms may not appear
for a long time until the neoplasm reaches significant
At first, the disease does not manifest itself externally, whereas
cancer cells are formed and spread in the body. When answering
Asked how to recognize intestinal cancer at an early stage, doctors do not
give a definite answer. The disease is detected by chance – with
passing a scheduled medical examination or treating another diagnosis. With
time inflammation makes some adjustments to the usual life
When the patient’s pathology progresses, the first signs of cancer
rectum may be as follows:
- painful defecation;
- change in the consistency of feces during defecation;
- the presence of mucus and blood in the stool;
Note that at an early stage of the disease, symptoms may be confused.
with hemorrhoids and other similar diseases. However distinctive
feature of the disease should be noted the appearance of the anus
blood, which, unlike hemorrhoids, occurs before a bowel movement, and
not after it. Also as a result of the development of a tumor, in feces
masses are often observed mucus and pus.
Classification рака прямой кишки в зависимости от стадии
tumor process based on the following characteristics of the disease:
- Size of primary tumor;
- The prevalence of the tumor in relation intestinal wall and
- Involvement of adjacent organs in the tumor process;
- The presence of metastases in the lymph nodes;
- The presence of metastases in distant organs.
Rectal cancer is accompanied by metastases – screenings from
main lesion, identical in structure and capable
to grow, disrupting the functions of organs that have fallen.
Stages of colorectal cancer take into account the characteristics of the
neoplasms, its size, ingrowth into the surrounding tissue, and
nature of metastasis. So, domestic
онкологи выделяют четыре клинических стадии течения
- one стадия, когда опухоль не более двух сантиметров,
grows no deeper submucous layer and does not metastasize.
- At stage 2, the tumor to 5 cm, does not go beyond the boundaries
organ, but may manifest metastases in the local lymph nodes.
- 3 стадия сопровождается прорастанием всех слоев кишечной
walls and the appearance of metastases in local lymph nodes.
- При four стадии рака прямой кишки страдает весь организм.
The spread of metastases is accompanied by a lack of
organ in which the new tumor growth began. At defeat
vital organs (heart, lungs, brain and so
further) develops syndrome of multiple organ failure, which
is the main cause of death of cancer patients.
Symptoms of rectal cancer in adults
Most often in the development of the disease is observed following
regularity Initially adenomatous is formed in the rectum.
polyp. This tumor does not pose a direct threat to life.
and is not malignant. However, over time in a polyp
there are changes. The neoplasm becomes malignant and
turns into a cancer that spreads through
body in the form of metastases.
The symptoms of colorectal cancer are determined by the stage and level
location of education. These include:
- Various dyspeptic disorders;
- Bleeding and other pathological impurities in the feces;
- Violation of the stool up to intestinal obstruction;
- Signs of general intoxication;
- Pain syndrome.
The first symptoms depend on the location.
neoplasia. Помимо кровотечения, возникающего почти у всех
больных, возможна боль как первый признак в случае
low location of the cancer with the transition to the anal sphincter. AT
in some cases, the disease occurs with impaired stool, more often – in
As the tumor grows, constipation will not
alternating with diarrhea, they begin to acquire steady
character AT случае, если злокачественная опухоль прямой кишки
begins to develop rapidly, then the patient has an acute
intestinal obstruction is a critical condition in which no
do without urgent surgical intervention.
The condition of a patient suffering from rectal cancer depends on
the presence or absence of metastases.
- If the tumor is located within the rectum, then the patient
disturb only digestive disorders, pain in the intestine, admixture of pus,
blood and mucus in feces.
- If the tumor grows into neighboring organs, then there are
symptoms characteristic of their defeat. When germinating in the uterus and
vagina – pain in the lower abdomen, violation of menstruation.
- With germination in the bladder – pain in the lower abdomen,
violation of urination. When spreading liver metastases –
jaundice, pain under the rib.
- With multiple metastases, the general condition is disturbed.
patient: there is weakness, fatigue, exhaustion,
Cancer of the rectum in women can grow into tissue
uterus or vagina. Cancer of the uterus does not affect
the overall clinical picture of the disease, but the germination of the tumor in
the tissue of the posterior vaginal wall can lead to the formation of
rectovaginal fistula. ATследствие этого из женского влагалища
start to release gases and feces.
Cancer cells by blood and lymph movement
spread even further through the body, which leads to
metastases that may occur in the lungs, in
parts of the liver or in closely located lymph nodes.
Symptoms of colorectal cancer in women are diverse:
- the presence of blood in the feces;
- pain symptoms in the abdomen and anal area
- constipation, increased stools, diarrhea;
- mucous, purulent discharge in the anus;
- constant feeling of weakness or fatigue;
- flatulence, spontaneous discharge of feces;
- sensation of itching in the perineum;
- the presence of dysfunction in the genitals;
- disturbed metabolism, which causes a decrease in overall development and
growth of the patient.
Cancer in men often grows into the bladder wall, causing
also a rektovesikalny fistula, from which a chair is pulled out and
gases. The bladder is often infected. Pathogenic flora
penetrates the kidneys through the ureters, causing pyelonephritis.
Signs of colorectal cancer in men:
- sharp weight loss;
- feeling pain in the sacrum, genitals;
- blood impurities in stool consistency;
- frequent trips of need;
- chronic constipation.
Malignant education in the absence of necessary
Diagnosis is growing rapidly, affecting other systems and organs. It
creates increased pressure inside the peritoneum, thereby aggravating
the problem. ATот почему важно выявить своевременно начальный этап
development of the disease and take all necessary actions.
Some symptoms of this disease are characteristic of a number of
diseases of the gastrointestinal tract, the most common of
which are considered:
- intestinal ulcer;
- disorders of the digestive processes;
Very often, due to the similarity of symptoms, patients do not pay in time.
due attention to them, because of what the chances of recovery
Лишь у one9% больных рак диагностирован на one-2 стадиях.
Только one,5 % опухолей выявляют при профилактических осмотрах.
Most of the tumors of the intestine falls on stage 3.
Еще у four0- 50% с впервые диагностированными опухолями толстой кишки
distant metastases develop.
AT раннем выявлении рака прямой кишки ведущее место принадлежит
not the symptoms of the disease that the patient himself notices, but the objective
featured. Therefore, preventive medical examinations are
really effective method for diagnosing rectal cancer on
The diagnosis is made by the proctologist, after the study.
ballroom Using fingers, he can feel a tumor if
located near the anus. AT противном случае
appointed rectoromanoscopy. This procedure allows
take a fragment of a tumor for biopsy research that will help
determine the nature of education.
In the study of women at the same time research
vagina to assess the degree of involvement of reproductive organs
in the tumor process.
For a more accurate diagnosis using other procedures:
- full proctological examination;
- biopsy followed by histological examination
sample under a microscope;
- computed tomography;
- radiography of the abdominal cavity;
- irrigology to assess the state of the thick
- laboratory blood tests for antigens and tumor markers
(this method is used both for the primary diagnosis and for
control the effectiveness of the treatment);
- diagnostic laparoscopy.
AT лечение рака прямой кишки приоритетным является хирургический
method which is to remove the tumor
Is it possible to do without surgery? In fact, most likely
No, as this is the main type of treatment. ATы должны понять, что
химиотерапия и радиотерапия не дает one00 % результата и не
destroys all cancer cells – that’s why you need time
remove the tumor with all damaged tissues.
ATозможные варианты оперативного лечения рака прямой кишки:
- The organ preservation variant (resection). Such an operation is possible
only if the tumor is located in the middle and upper
sections of the rectum.
- Complete removal of the rectum is performed (resection with reduction
into the anal canal of the colon) followed by the formation
�”Artificial” rectum from lying above the healthy departments.
This stage reduces the likelihood of progression.
tumor growth slows down and the prognosis for
the patient. It is performed in patients with any stage of a rectal tumor.
Dose size and need for chemotherapy drugs
Determined by an oncologist, depending on the degree of development
Only radiation treatment is usually used when
незначительном росте опухоли (one или 2 степень). При 3 и four степенях
sure to combine any chemotherapy (fluorouracil,
Leucovarin) with patient irradiation.
ATосстановительный процесс после операции включает:
- Wearing a bandage (special compression belt) that
reduces abdominal muscle tension and reduces
- Active behavior – getting out of bed 5-7 times a day.
- Independent circulation in the toilet and procedures.
- Gentle food – eating fruits, vegetables and limiting
difficult and fatty foods.
Radiation therapy for cancer of the rectum is shown during periods:
- before the operation – the zone is irradiated for 5 days, where
the tumor is located. At the end of the course in 3-5 days they spend
- after surgery – with confirmed metastases in regional LU
after 20-30 days begins a 5-day course of radiation in the tumor zone
and all lu of the pelvic area.
Patient care during treatment
In the diagnosis of rectal cancer postoperative care is
in the following:
- frequent change of linen: bed and underwear;
- in the prevention of bedsores: changing posture in bed and
turning on the other side or back, using
anti-decubitus or orthopedic mattresses;
- feeding the patient, using a special probe;
- hygiene procedures;
- provision of special diapers and pads when
incontinence of urine and feces;
- colostomy care and in the replacement of the colostomy bag.
Proper nutrition for rectal cancer must be given
increased attention. The diet should be quite nutritious and
balanced in qualitative and quantitative terms, and not
cause intestinal irritation.
The diet after the operation at the beginning should be as much as possible.
gentle, do not cause diarrhea and flatulence. Begin reception
food after resection with rice broth, low-fat broth, berry
jelly without fruit. A few days allowed:
- Mucous soups (this is strained croup broth).
- Liquid, well-grated porridge, boiled in water. Preference
It is not given to coarse rice, oatmeal, buckwheat.
- Cream (only in dishes up to 50 ml).
- Broths with semolina.
- Soft-boiled egg and protein omelette.
- A little later, mashed fish and meat is introduced.
In order not to miss the re-development of the disease, the patient should
regularly observe with an oncologist. Currently,
The following frequency of visits is recommended:
- The first 2 years after remission – no less than one time in 6 months
(recommended one time in 3 months);
- After 3-5 years – one time in 6-one2 months;
- After 5 years – every year.
Prognosis of rectal cancer
No specialist will give a definite answer on how much
live with rectal cancer because the prognosis for survival
It is made individually for each patient and consists of
sets of indicators.
We present the average values for 5-year survival of patients.
after adequate treatment:
|Stage of rectal cancer||5 year survival rate|
|one||More than 90%|
|four||Не более one5%|
Factors affecting the prognosis of malignant
malformations of the rectum:
- stage of the disease;
- cell structure of the tumor;
- the degree of differentiation of tumor cells (undifferentiated
least favorable – see above);
- the presence of lymph node metastases;
- type of treatment.