Metastasis to the rectum

Colon cancer is a malignant tumor that affects the rectum.

At present, scientists have not yet established the exact cause of malignant tumors in the rectum. But they have managed to identify the main risk factors leading to the disease:

1. Nutrition. The presence of large amounts of meat, animal fats, and a lack of plant fiber increases the risk of malignant tumors. High-calorie food moves through the gastrointestinal tract rather slowly, while substances that provoke malignant tumors act on the intestinal walls for a long time. By the way, among adherents of vegetarian cuisine, the percentage of detection of malignant tumors in the rectum is very small.
2. Working with asbestos. Scientists have now managed to prove the ability of asbestos to provoke cancerous tumors. Asbestos has a carcinogenic effect and the risk of disease increases if the concentration of asbestos dust in the air is higher than the permissible level. However, the problem of asbestos has long been outside the production framework. Materials containing asbestos have a fairly wide application - in almost all industries (construction, interior decoration, transport, etc.). Therefore, not only workers directly involved in the production and processing of asbestos are exposed to asbestos, but also workers in other industries, as well as part of the population.
3. Chronic inflammation and polyps in the intestines.
4. Papilloma infection, anal sex. It has been noted by scientists that passive homosexuals with papillomavirus infection are at risk of the disease.

The growth of a malignant tumor in the intestine occurs at a relatively slow pace. First of all, the tumor grows around the circumference of the intestine for a long time. On average, it is believed that the tumor reaches the full circumference of the rectum in about 1.5 - 2 years. Then the malignant tumor begins to affect the walls of the intestine, growing into the pelvic bones and adjacent organs. Metastases in the rectum are carried throughout the body by the circulatory and lymphatic systems. For rectal cancer, the source of metastasis is very often organs and tissues adjacent to the tumor.

Most often, like most other oncological diseases, a cancerous tumor in the rectum is discovered completely by accident.

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Metastases in rectal cancer

Rectal metastases are seedings originating from the primary formation, completely identical to its structure and capable of further growth, while completely disrupting the functioning of those organs they have entered. The appearance of metastases in the body is associated with the natural growth of a malignant tumor: actively growing tissue does not receive adequate nutrition for all elements, cancer cells lose contact with each other, break away from the tumor and end up in the human circulatory system. With the blood flow, tumor cells begin to spread throughout the body. When they enter the liver, lungs, bones, brain, the cells settle and begin to grow, thus forming metastases. Sometimes metastases can grow up to 10 cm in size, which will inevitably lead to the death of the patient from dysfunction of the affected organ.

Metastases in the rectum mainly affect the lymph nodes that are located nearby, for example, the groin area. Metastasis in organs more distant from the original lesion most often occurs in the liver. This occurs due to the peculiarities of the blood flow: the outflow of blood with pieces of cancer cells begins from the upper sections of the rectum and then goes to the liver (the main filter of the entire body), where they settle and begin to progress. Next in terms of the frequency of metastases are the lungs. The outflow of blood from the lower intestine goes further along the central vein, which is directed directly to the heart and lungs. Metastasis is also possible in bones, serous lining of the peritoneum, brain and other organs. Single metastases detected are removed surgically, which increases the patient's chances of recovery. If the tumor has given multiple metastases, only chemotherapy is possible, which gives only a supportive effect.

Other malignant tumors can form in the intestines:

• melanomas (highly malignant formation of pigment cells)
• sarcomas (formations from lymphatic, blood or muscle tissue).

Symptoms of metastases in the rectum

Symptoms of rectal cancer are divided into:

1. Non-specific – these include a slight increase in temperature (up to 37 C0), weakness, perverted taste, smell, low appetite, significant weight loss.
2. Characteristic. First of all, it is worth noting the release of impurities of a pathological nature during defecation. The presence of mucus in the feces may indicate a tumor in the rectum, since the mucous glands are the basis for the development of a large number of tumors. The discharge can be purely mucous or with blood or purulent impurities. Bleeding occurs periodically (bright scarlet discharge indicates a tumor that is concentrated in the lower part of the rectum, a darker color during bleeding, with black coagulated clots, indicates the possible progression of a cancerous tumor in the upper part), sometimes there is a release of small pieces of the tumor.

Patients suffering from enlarged hemorrhoidal nodes do not rush to see a specialist when bleeding occurs, as they attribute bleeding to the manifestation of hemorrhoids. The nature of the bleeding can still be distinguished: with hemorrhoids, bloody discharge is formed at the end of defecation and is concentrated mainly on top of the feces, and with malignant tumors in the intestine, the feces are bloody, since when moving through the intestines, the tumor is injured by feces.

Pain in the sacrum, coccyx, lumbar region, and perineum is felt as a result of the damage of cancer cells to the rectal lining, where many nerve endings are concentrated; pain also occurs due to the onset of inflammation in the organs and tissues surrounding the cancerous tumor.

The shape of the feces changes - they become ribbon-like. The person feels painful and frequent urges to defecate, but after visiting the toilet, there is a feeling of a foreign body, which is provoked, in fact, by the tumor.

One of the symptoms of malignant tumors in the intestine is constipation (with the growth of cancer cells in the upper section). Constipation can be periodic (1-2 days) and long-term (more than a week). Patients feel aching pain in the lower abdomen, bloating, a feeling of heaviness. But this symptom is often ignored by elderly people, since reduced activity of the digestive system, as well as intestinal atony (impaired bowel movements) are considered age-related.

Formations in the anus and the outlet section of the rectum are often determined by the patient himself. Such tumors are characterized by gas incontinence, as well as feces, because the muscles that narrow the anus are affected. Urinary incontinence is also possible if the muscular base in the small pelvis is affected.

Symptoms at later stages of cancer development, when metastases in the rectum already affect a considerable number of nearby tissues and organs, are as follows:

• quite severe, almost constant pain, concentrated mainly in the lower abdomen;
• the appearance of feces during urination. Women note this type of discharge from the vagina (occurs if cancer cells have affected the bladder, vagina, as a result of which a fistula appears between the intestine and the bladder). In this case, chronic cystitis begins to progress, as well as a disease of the genital organs in women. Often, inflammation from the pelvic organs rises along the ureters and affects the kidneys.
• When defecating, patients with cancerous tumors in the rectum notice the presence of urine (occurs when the bladder is affected).

Diagnosis of metastases in the rectum

If there is a suspicion of a neoplasm of any nature in the rectum, first of all, the following types of examinations are prescribed:

• digital examination method. An experienced doctor can detect a tumor in the rectum located at a distance of up to 15 cm from the anus. The digital method allows you to determine the location of the tumor (on the back, front or side wall), at what stage of development is the obstruction of the intestinal lumen, the size of the cancerous tumor, to what extent the nearby organs are involved in the cancer process. The doctor conducts such an examination if the patient complains of a violation of the defecation process, impurities in the feces, pain in the rectum. The digital method of examining the rectum is carried out in the following way: the patient lies on his left side, bends his legs at the knees and pulls them up to the stomach (or gets into the knee-elbow position). The doctor, with his index finger inserted into the patient's anus, examines the internal relief of the rectum.
• Rectomanoscopy. The examination is performed using a special device that allows examining the rectum at a depth of up to 50 cm. During this examination, the doctor can visually examine the intestinal mucosa, as well as take small pieces of tissue that cause suspicion for additional examination. This examination is quite painful, but absolutely necessary to identify a malignant tumor or metastases in the rectum.
• irrigoscopy. An "old-fashioned" but very effective method for detecting malignant tumors in the rectum. For the examination, the patient is given an enema, which includes a contrast fluid, and after emptying, a series of X-rays of the intestine are taken. Sometimes it is necessary to additionally introduce air into the intestine - i.e. to do double contrast. This diagnostic method is prescribed to detect malignant tumors that may be located in other parts of the intestine or if there is a suspicion of two or more cancerous tumors, it is also prescribed to weakened or elderly people who, for certain reasons, cannot undergo endoscopy. With the advent of fibrocolonoscopy, this method has become less relevant.
• fibrocolonoscopy. An endoscopic type of examination, during which the doctor can examine the intestinal mucosa from the inside. Today, this method is recognized as the most effective and efficient. It makes it possible to determine the exact location of a cancerous tumor, take small pieces of tissue for more thorough examination under a microscope, and also cut out existing benign polyps.
• intravenous urography. The examination is prescribed by a doctor if metastasis of the bladder and ureter is not excluded.
• ultrasound examination of the pelvis and abdominal cavity (ultrasound). It is prescribed to detect nearby organs and lymph nodes affected by metastases, as well as to detect metastasis in more distant organs.
• computed tomography. It is an excellent way to detect the growth of a malignant tumor into neighboring tissues and organs, metastasis of lymph nodes, and the extent of a malignant tumor.
• laparoscopy. A surgical type of diagnostics, in which the abdominal wall is punctured, where a camera is inserted, through which various sections and organs in the peritoneum are examined. Laparoscopy is prescribed if there is a suspicion of an advanced process and metastasis to other organs.
• tumor markers. A modern blood test for proteins that are produced only by malignant tumors and are completely absent in the blood of a healthy person. Considering that they have a fairly low diagnostic value, tumor markers are used quite rarely.

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Treatment of metastases in the rectum

Treatment of metastases in the rectum occurs primarily by surgery, when the organ affected by cancer cells is removed. Other methods of treatment, unfortunately, give only a supportive, not long-term result.

The following types of tumor removal operations are available:

1. Organ-preserving surgery or rectal resection is performed if the tumor is detected in the middle or upper part of the intestine. Removal occurs as low as possible, with the simultaneous formation of a sealed intestinal tube in the depths of the pelvis.
2. Resection with lowering of the colon into the anal canal - during this surgical operation the rectum is completely removed, and then an "artificial" one is formed, while the anal opening is preserved.

All other types of surgical interventions are similar in one thing - the output of a colostomy (artificial anus) to the abdomen.

3. Colostomy with complete removal of the affected rectum, adjacent tissue and lymph nodes are also removed.
4. Hartmann's operation - colostomy, complete closure of the intestinal outlet (sewn up tightly) and tumor removal. The operation is performed on weakened people, in old age, with complications (intestinal obstruction).
5. Colostomy without direct removal of the cancerous tumor. The operation is performed exclusively to prolong the life of patients at stage 4 of the disease and with any complications.
6. A combination of several types of surgical interventions, such as removal of the rectum, as well as organs involved in the cancer process - the liver, vagina, bladder (completely or partially).

Successful results in the treatment of cancer tumors are achieved with the help of radiation therapy. Radiation (radiation) irradiation is carried out with a special device in small doses every day for one month. This type of irradiation is destructive for cancer cells. Radiation therapy can be carried out before surgical treatment, to reduce the size of the cancer tumor and transfer it from the state of "intractable" to "removable". Radiation therapy is also prescribed after an operation has already been performed for existing metastases, to prevent relapse. Irradiation can be external or internal (insertion of the sensor directly into the rectum), there is also an option that combines both types of irradiation. Internal radiation therapy acts on nearby organs and tissues less destructively, damaging them less. For elderly people who have contraindications to surgical intervention (heart pathology), radiation therapy is prescribed as an independent treatment. Without a doubt, radiation therapy is inferior to surgery, but despite this, it gives good results in treatment.

Sometimes, in cases of very severe pain and inflammation, when it is impossible to remove the tumor with surgery, radiation is used in small doses to alleviate severe symptoms of the disease.

Metastases in the rectum, as well as in adjacent lymph nodes in large quantities, require mandatory chemotherapy. It is also used if there are numerous metastases in other organs that cannot be removed surgically. Chemotherapy is the intravenous administration of various synthetic toxic substances that have a destructive effect on cancer cells. Sometimes chemotherapy is prescribed in the form of tablets, they are absorbed by the body much better and have fewer side effects. Such treatment is carried out in courses of four or more times. Chemotherapy reduces the size of metastases, relieves severe symptoms, prolongs the life of the patient.

In the early stages of the disease, you can use traditional medicine, which is not only quite effective, but also successfully helps to get rid of unpleasant sensations. First of all, you need to pay attention to the diet recommended for people with cancerous lesions of the rectum. It is important to refuse to eat fried (especially potatoes), sweets, red meat - all this provokes the growth of cancer cells. To prevent the cancer from growing and metastasizing in the rectum, it is necessary to include in the diet foods that are a kind of protectors from any kind of tumors (benign or malignant) in the human body. These products include raw beets, broccoli, various vegetable juices, as well as those with a high calcium content (cottage cheese, cheese, legumes, spinach, parsley). A salad of plantain, dandelion, onions, garlic with kefir dressing has a good effect on the body.

The root of the poisonous hemlock (cicuta) has long been used to treat cancer. To prepare the tincture, pour the hemlock root with vodka in a ratio of 1:50, leave it in a dark place for a week, then strain and the tincture is ready for use. It is better to use the tincture in courses, alternating with celandine tincture. Drink the tincture, starting with one drop per 1/4 glass of water, every day, adding one drop for 10 days, then removing one drop for 10 days. Take 2 times a day (if the form of cancer is advanced - 3 times a day). Then take a week's break and repeat the course from the beginning. To prepare the celandine tincture, grind fresh grass in a meat grinder (or chop in a blender), squeeze out the juice and let it stand in a dark place in a tightly closed jar for 2 days. Next, pour the juice without sediment into another container (preferably glass). This tincture can be stored for several years. You need to take celandine tincture according to the same scheme as hemlock tincture. In addition to drinking, you can use the tincture as an enema. This is a good remedy that affects the tumor locally. Microclysters from celandine help relieve swelling, inflammation, stop bleeding, and strengthen the walls of blood vessels.

Useful for bowel cancer is eating beets and cabbage. You can make freshly squeezed juice from them and drink it, preferably on an empty stomach, 3 times a day. To improve the taste, you can add a little honey to the drink.

It is recommended to eat as many stalks of ordinary white cabbage as possible.

To prevent cancer, traditional medicine recommends taking 2 tablespoons of olive oil daily.

Prognosis for rectal metastases

By the time a tumor is detected, approximately 25% of patients already have metastasis to distant organs, i.e. every third patient. Only 19% of patients are diagnosed with a malignant tumor at early stages (first, second). In 1.5% of cases, a malignant tumor in the rectum is detected during a routine examination. Most malignant tumors are at stage 3 at the time of detection.

No more than 60% of patients with rectal cancer live for about 5 years.

Economically developed countries (USA, Japan, Canada) occupy first place in the number of people with rectal cancer. Recently, cases of colon cancer have become more frequent in Russia. In terms of the number of people with bowel cancer, men are in 3rd place, women in 4th place, and in terms of frequency, this type of cancer ranks 5th.

Approximately 67% of those affected are elderly (70-74 years old), however, recently there have been frequent cases of the disease being detected at a younger age (30-35 years old).

The survival rate for advanced disease directly depends on the stage at which the tumor was detected:

• At the first stage: the growth of the cancerous tumor occurs within the intestinal mucosa, it occupies no more than 1/3 of the space, there are no metastases in the rectum, at this stage of the disease the survival rate is 80%.
• At the second stage, the tumor diameter reaches 5 cm and grows to more than 1/3 of the intestine, metastases appear in the lymph nodes located near the tumor. Survival in this case is no more than 60%.
• At the third stage, the tumor grows, it occupies more than half of the intestine, and metastasis of the lymph nodes occurs.
• At the fourth stage, the tumor begins to grow into nearby organs, affecting the vagina, uterus, pelvic bones, bladder, and urethra.

When detecting malignant tumors in the rectum at stages three and four, doctors give disappointing prognoses. Survival in these cases is no more than 10-20%. With stage 4 rectal cancer, there has not been a single case where the patient has crossed the five-year threshold of life. A tumor detected at an early stage increases the chances of survival by 15 times.

Metastases in the rectum indicate the progression of cancer in the human body. Metastasis begins at the second stage of the disease, mainly neighboring organs and lymph nodes are affected by single cancer cells. Unfortunately, rectal cancer, like any other type of cancer, is almost asymptomatic in the early stages of development and reveals itself only when obvious disruption in the functioning of the affected organs begins.