Rectal cancer questions and answers
1. What is rectal cancer? refers to cancer located above the dentate line to the junction of the sigmoid colon and rectum. Generally speaking, it is cancer that occurs in the rectum. The rectum refers to the last part of the large intestine about 15 cm long that connects to the anus.
2. Which age group is susceptible to rectal cancer?
Rectal cancer tends to occur in middle-aged and elderly people over 40 years old, and the incidence rate of men and women is basically equal. It is worth noting that the incidence of rectal cancer among young Chinese has gradually increased in recent years. The young people we are talking about here are those under 30.
3. Is rectal cancer a genetic disease?
Rectal cancer is not a genetic disease, but it has a genetic predisposition, that is, the risk of rectal cancer among the immediate relatives of people with rectal cancer is significantly higher, which is about 2-3 times that of ordinary people.
4. Is rectal polyp cancer?
Rectal polyps are not cancers, they are benign lesions, but they can be malignant. If they are benign lesions, we call them rectal polyps, such as rectal adenomas. If they are malignant lesions, we just call them rectal cancer. Benign rectal polyps can be transformed into cancer, that is, cancerous changes of polyps. Rectal polyps, especially adenomatous polyps, are currently recognized precancerous lesions, and a considerable part of rectal cancer is transformed from these precancerous lesions.
5. What are the symptoms of early rectal cancer?
1. Hematochezia: Hematochezia is the most common symptom of rectal cancer and one of the earliest symptoms of rectal cancer. Initially, blood in the stool is mostly painless, intermittent, a small amount of blood in the stool or blood on the surface of the stool. The blood in the stool can be bright red or dark red. The patient has no abnormal feelings and is not easy to attract attention. It is precisely because of these characteristics that early blood in the stool is caused by rectal cancer. Symptoms are often ignored by patients, and it is not easy to cause vigilance and attention;
2. Changes in bowel habits: increased stool frequency without obvious reasons, changes in original stool characteristics, such as thinning, thinning, and flat stools;
3. Feeling of falling stool and incomplete discharge.
6. Is rectal cancer with symptoms of blood in the stool?
Hematochezia is not a unique symptom of rectal cancer. There are many causes of blood in the stool. The most common hematochezia disease is benign lesions of the anus and rectum, such as hemorrhoids and anal fissures. Rectal cancer is a minority compared with these common diseases, but blood in the stool can not be simply attributed to diseases such as hemorrhoids and anal fissures, causing misdiagnosis and delaying treatment. The correct way is to go to the hospital to find a professional doctor for examination.
7. How to distinguish hemorrhoid bleeding and rectal cancer bleeding?
1. Bleeding characteristics: bleeding from hemorrhoids is fresh blood, while bleeding from rectal cancer is mostly dark red or mucus in the blood;
2. Bleeding frequency: bleeding from hemorrhoids is usually continuous for multiple days, while bleeding from rectal cancer is mostly intermittent bleeding;
3. Bleeding volume: bleeding from hemorrhoids can be dripping or even jet-like bleeding, and the amount is large, while the amount of bleeding from rectal cancer is generally less, mostly without jet-like bleeding.
8. What is the most commonly used examination method to diagnose rectal cancer?
The most common and simplest method of examination is digital rectal examination. Since nearly 75% of human rectal cancers are low rectal cancer, most rectal cancers can be found during digital rectal examination. Digital rectal examination does not require any auxiliary equipment. There is no need for bowel preparation, which is simple and easy.
9. In addition to digital rectal examination, what other methods can diagnose rectal cancer?
1. Colonoscopy: You can directly see the general shape of the lesion, and you can take a biopsy for further pathological examination to determine the nature of the lesion. Colonoscopy is the most accurate method for rectal cancer and is called the "golden" standard";
2. CT and MR examination: Although it is not possible to visually see the shape of the tumor like colonoscopy, it is possible to understand the size of the tumor and the infiltration and spread of rectal cancer in the pelvic cavity, whether it invades the uterus, bladder and pelvic wall, for guidance Surgery is of great significance and is a routine checkup method before surgery;
3. Tumor markers: the most commonly used is carcinoembryonic antigen, but it has no specificity and is only for clinical reference;
To summarize: no method is perfect, each has its advantages and limitations. Carcinoembryonic antigen is inaccurate and is for reference only; CT and MR look at the whole picture, but cannot be biopsy qualitative; enteroscopy is intuitive and pathologically qualitative, but it is impossible to observe the invasion and metastasis of extraintestinal tumors.
10. How to detect rectal cancer early?
1. Middle-aged and elderly people over the age of 40 should pay special attention to the condition of stool, blood in the stool, changes in defecation habits and shape, and timely examination to detect early rectal cancer;
2. People with a family history of rectal cancer have a significantly higher risk of rectal cancer than normal people. Therefore, it is recommended to have a colonoscopy every 2-3 years to deal with problems in time; 3. People with rectal polyps and other precancerous lesions Once the diagnosis is clear, the patients should be surgically removed to reduce the chance of cancer.
11. What are the surgical treatments for rectal cancer?
The main surgical methods for rectal cancer are as follows: 1. Local resection; 2. Combined abdominal and perineal resection (without retaining anus, permanent colostomy); 3. Transabdominal rectal cancer resection (with retaining anus); 4. Transabdominal rectal cancer resection, proximal colostomy, and distal sealing (reserving anus, colostomy);
The specific procedure should be determined by the clinician based on the patient's condition.
12. Does permanent colostomy seriously affect life?
The reasons for rejecting or fearing a stoma are mostly that the stoma is too dirty, affects the absorption of nutrients in the intestines, and is afraid of others' jokes. In fact, this is a misunderstanding of a colostomy because:
1. Now there are a series of stoma products with reliable quality and very convenient to use. After the application of the ostomy bag, the stool will not pollute the surroundings, there is no peculiar smell, and it is very hygienic;
2. Removal of the rectum and part of the sigmoid colon will not have any effect on the absorption of nutrients;
3. Patients with colostomy can live and work normally after physical recovery. As time goes by, their stools will resume their regularity. Even if the number of stools is a little more, due to the protection of the ostomy bag, there will be no stool problems. The embarrassment of spilling contaminated clothing on its own.
According to our many years of clinical observation, the colostomy has little effect on the work and life of the patients. The patients can adjust themselves psychologically for a period of time after the operation, and quickly return to normal life.