Taking Charge of Your Health

[MUSIC] The most common sign and symptom of rectal cancer
is rectal bleeding. And it’s usually
painless bleeding. And it can be either blood that
appears on the toilet paper or in the toilet itself
after a bowel movement. Other signs can be pain, depending on where the tumor is,
diarrhea or constipation. The scary thing about
rectal cancer is, commonly, there are no signs or symptoms. And people can have this tumor
growing in them for a while and not even know it. That’s why it’s very important
to adhere to the screening guidelines that have been
established, to either prevent colon and rectal cancer
by removing precancerous lesions when they occur in individuals,
or detect cancers early. So that everybody’s chance
of survival is better. [MUSIC] Screening for rectal cancer is
generally that people should undergo a regular physical
exam with a digital exam, digital rectal exam, looking for blood in the stool whilst
the digital exam is done. When people get to the age of
50, if they don’t have any history of colon or rectal
cancer in their family, and if they don’t have any history
of other colonic diseases, like inflammatory bowel disease, they should undergo
a screening colonoscopy. If they’re not going
to have a colonoscopy, they can have a sigmoidoscopy,
which is looking at less of the colon in conjunction with
radiology tests to look for either precancerous or
cancerous conditions. Now if people have
a history of colon and rectal cancer in their family,
then generally we recommend the screening start ten years
earlier at the age of 40. And if the family member that
has colon or rectal cancer in your family has had that cancer
very early, then we could potentially recommend screening
even earlier than that. So, screening is very
important because often times these cancers develop from
precancerous lesions. And if they’re
detected early and removed then you won’t
develop the cancer. [MUSIC] So people should consider
genetic testing if they are what I would
consider a young person. And young we would define as
someone under the age of 40, or people who have a significant
family history of rectal cancer. Those people are individuals
who have direct relatives, either a mother, father, sister,
or brother with rectal cancer. If people have many relatives
in their family that have rectal cancer, so uncles, aunts,
cousins, those also are people who I think should consider
some sort of testing. Nowadays, almost all colorectal
cancers undergo some form of genetic testing. Those tests that are done
are looking at specific gene defects that we then
use to define how we treat the cancers after surgery
with chemotherapy. So there are some defects that
we have that will respond very well to chemotherapeutic agents. And so by defining those
defects in all individuals, we know whether or not they
should get certain drugs. [MUSIC] There actually are quite a few
minimally invasive treatment options now for rectal cancer. There is the, what we call
the laparoscopic approach, which uses a camera and instruments
that are placed through small incisions to free the cancer
up from its attachments. Free the rectum up
from its attachments. Remove the portion of colon and
rectum that has the cancer and put everything back together. That can be done in
conjunction with new technology that allows us to
operate through the anus freeing up the rectum in
difficult places. That’s something called
a tamis or a TEM procedure. Or it can be done with
the robot, which currently is also used to mobilize and remove
the portions of the colon and the rectum, and
put things back together. Technology is advancing
at a very rapid pace. And so, every two or
three years, we have a new piece of equipment
that makes it easier for us to do this without
making large incisions. And I think there are multiple
options for treating these patients with rectal cancer
with smaller incisions. Now, smaller incisions
are helpful, and we think that people
recover quicker with them. But they don’t necessarily
reduce the complexity, or the difficulty
of the operation. So that’s something
to keep in mind. [MUSIC] I think the advances for treating recurrent rectal
cancers are, again, multi-factorial and involve
multiple different teams. One of the advances is we just
have better techniques of operating, of maintaining
patients’ vital signs in the operating room so that
we can do bigger procedures. If the cancer hasn’t spread
to other places we can still perform large
resections in the pelvis and maintain patients’
quality of life and indeed have low mortality
rates with these procedures. A second advancement is in
the use of intraoperative radiation therapy, which over the last 25 years
has really also gone through tremendous improvement, and has
sort of revolutionized the care. We have the capability here. And there are certain centers
in the United States to deliver the radiation to the patient
during the operation, when the abdomen is open,
thereby reducing the risk of radiation side effects
to other structures. Finally, the way we
reconstruct either the rectum, colon, or other structures
such as the bladder, have advanced people’s quality
of life after these procedures. So all of those things together
have improved the likelihood of being able to remove
recurrent rectal cancer, and have also improved
people’s survival and quality of life
after the procedure. [MUSIC] Well, for rectal cancer, there
have been dramatic improvements over the last 10 to 15 years
in how we manage these tumors. And those improvements include
advances in chemotherapy and radiation therapy. And indeed nowadays
many rectal cancers, before we even think
about doing surgery, are treated with chemotherapy
and radiation therapy together. There are different forms
of radiation therapy and there are different
chemotherapeutic agents. It’s really very important
to have a team that looks at the entire picture with respect
to the patient and the cancer to determine what is the best
therapy prior to surgery. What surgery should be done. And then, how to care for the patient after
the surgery is completed. We feel that that
multidisciplinary approach really provides the highest
quality care that you can achieve. [MUSIC]

17 thoughts on “Rectal Cancer | Q&A

  1. what if you have these symptoms and are not over 50? I have had rectal bleeding for 8 months at every bowel, and they're not hemorrhoids. lately, I have pain during a bowel.

  2. I’m 40 and had a colonoscopy because of rectal bleeding and family history. Just diagnosed with a cancerous tumor in the rectum. Now action plan for treatment. And lots of faith.

  3. hi , my mother is suffering from rectum cancer and had surgery 3 years ago now she feels a severe pain in rectum kindly suggest some medicine to relieve her pain. presently she is under going 5th line of chemo therapy.

  4. I ate some really spicy food after 3 or 4 months of bleedings stopped (happened cuz i was addicted to eating spicy foods) and whenever nature calls it really really hurts

  5. Update: Never too young. After six months of treatment my Oncologist told me I was basically cured. Stage 1. I did chemo radiation and 2 surgeries, low anterior resection davinci robot and ileostomy reversal. I had to wear an ileostomy temporary for 7 weeks that was awful My poor skin burned so bad I cried every day. Go to the doctor if you have symptoms and are watching this video like I did. Run don’t walk. It saved my life .

  6. Hi im having a problem becuase when im defecating theres a blood dripping and after i wash it theres no blood anymore because when im washing my butt im also sticking my finger inside to wash the inside also. And after that the second time i defecated theres no blood anymore. And the next day when i defecated there is blood again and it goes away again what is this mean? I dont have stomach pain or anything just that blood dripping and the blood is not in the stool.

  7. What do you mean rectal bleeding after bowel movement? As in right after your done with a bowel movement, blood comes out by it self?

  8. I hadda PICC line for a Month (Flouracil 5) plus
    a month of Radio therapy, plus 16 weeks of weekly I.v. chemo 6 months
    after, I had stage III

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