Metastases in the rectum

Cancer of the intestine is a malignant formation that affects the rectum.

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

1. Food. The presence of large quantities of meat, animal fats, a shortage of plant-derived fiber increases the risk of malignant tumors. High-calorie food moves along the gastrointestinal tract rather slowly, while substances provoking malignant tumors for a long time act on the walls of the intestine. By the way, among adherents of vegetarian cuisine is a very small percentage of the detection of malignant formations in the rectum.
2. Work with asbestos. Now scientists have been able to prove the ability of asbestos to provoke cancerous tumors. Asbestos has a carcinogenic effect and the risk of the disease increases if the air concentration of asbestos dust is higher than the allowable rate. However, the problem of asbestos has long been outside the production framework. Materials with asbestos content have quite a wide application - almost in all industries (construction, interior decoration of premises, transport, etc.) Therefore, exposure to asbestos affects not only workers directly related to the production and processing of asbestos, but also workers in other industries , as well as part of the population.
3. Chronic inflammation and polyps in the intestine.
4. Infection of the papilloma, anal sex. It was noted by scientists that passive homosexuals with papillomovirus infection are at risk of the disease.

The growth of malignant formation in the intestine occurs at a relatively slow rate. First of all, the tumor grows around the gut for a long time. On average, it is believed that the full girth of the rectum the tumor reaches about 1.5 - 2 years. Then the malignant formation begins to hit the walls of the intestine, germinating in the pelvic bones and adjacent organs. Metastases spread in the rectum through the body with the help of the circulatory and lymphatic systems. For cancer of the rectum, very often the source of metastasis is the organs and tissues adjacent to the tumor.

More often than not, as with most other cancers, a cancerous tumor in the rectum is revealed quite by accident.

[1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12]

Metastases for colorectal cancer

Metastases in the rectum are screenings, originating from the basic formation, completely identical to its structure and having the ability to further growth, while completely disrupting the work of those organs that fell into it. The appearance of metastases in the body is associated with the natural growth of a malignant tumor: actively growing tissue does not receive proper nutrition for all elements, cancer cells lose contact with each other, detach from the tumor and find themselves in the circulatory system of man. With blood flow, tumor cells begin to spread throughout the body. When you get into the liver, lungs, bones, brain cells settle and begin to expand, so the metastases are formed. Sometimes metastases in size can grow up to 10 cm, which will invariably lead to the death of the patient from a violation of the function of the affected organ.

Metastases in the rectum, mainly affect the lymph nodes, which are located next to, for example, the inguinal zone. Metastasis in organs more distant from the initial lesion focuses most often in the liver. This is due to the peculiarities of the blood flow: the outflow of blood with pieces of cancer cells begins from the upper parts in the rectum and then follows into the liver (into the main filter of the whole organism), where they settle down and begin to progress. Further on the frequency of appearance of metastases are the lungs. The outflow of blood from the lower part of the intestine follows further along the central vein, which is directed straight to the heart and lungs. Metastasis is also possible in bones, serous peritoneum, brain and other organs. Identified single metastases are removed surgically, which increases the patient's chances of recovery. If the tumor has given multiple metastases, only chemotherapy is possible here, which gives only a supporting effect.

Other malignancies can form in the intestine:

• melanoma (high-malignant formation of pigment cells)
• sarcoma (formation of lymphatic, blood or muscle tissue).

Symptoms of metastases in the rectum

Symptoms of cancer of the rectum are divided into:

1. Nonspecific - 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 allocation of impurities, which are pathological in feces. The presence of mucus in the stool can indicate a tumor in the rectum, as the mucous glands form the basis for the development of a large number of tumors. Excretions can be purely mucous or with blood or purulent impurities. Periodically, bleeding occurs (a bright scarlet color indicates a tumor that is concentrated in the lower part of the rectum, a darker color with bleeding, with black coagulated clots, suggests a possible progression of the cancerous tumor in the upper section), and sometimes small pieces of the tumor appear.

Patients suffering from hemorrhoidal enlarged knots, with bleeding, do not rush to consult a specialist, since they refer hemorrhage to the manifestation of hemorrhoids. The nature of bleeding can still be distinguished: with hemorrhoids, bloody discharge is formed at the end of the bowel movement and is concentrated mainly on the top of the stool, and in malignant formations the intestinal feces are bloody, as when moving along the intestine the tumor is traumatized by the calves.

Soreness of the sacrum, coccyx, lumbar region, perineum are felt due to the defeat of the cancerous shell of the rectum, where a lot of nerve endings are concentrated, and pain arises because of the inflammation in the organs and tissues that surround the cancer tumor.

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

One of the symptoms of malignant tumors in the intestine is constipation (with the growth of cancer cells in the upper section). There are constipation periodic (in 1-2 days) and long (more than a week). Patients feel aching pain in the lower abdomen, swelling, a feeling of heaviness. But this symptom is often ignored by the elderly, since the reduced active activity of the digestive system, as well as intestinal atony (violation of the emptying process) is considered the age norm.

Formations in the anus and exit areas in the rectum are determined quite often by the patient himself. For such tumors, incontinence of gases, as well as feces, is characteristic, because muscle damage occurs, which narrows the anus. It is also possible to urinate if the muscular base is injured in the small pelvis.

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

• a fairly strong, almost non-stopping pain, concentrated mainly in the lower abdomen;
• the appearance of feces during urination. Women note a release of this kind from the vagina (occurs if the cancer cells hit the bladder, the vagina, resulting in a fistula between the intestine and the bladder). In this case, the progression of chronic cystitis begins, as well as the disease of the genital organs in women. Often the inflammation of the pelvic organs along the ureters rises and affects the kidneys.
• when bowel movements are eliminated, patients with cancer tumors in the rectum will notice the presence of urine (happens when the bladder is affected).

Diagnosis of metastases in the rectum

If there is a suspicion of a neoplasm of any kind in the rectum, first of all, such types of examinations are appointed:

• finger method of research. An experienced doctor can detect a tumor in the rectum located at a distance of up to 15 cm from the anus. The finger method allows to determine the location of the tumor (on the posterior, anterior or lateral wall), at what stage of development is the overlap of the intestinal lumen, the size of the cancer tumor, as far as the organs adjacent to the cancer process are involved. Such a survey the doctor conducts, if the patient complains of a violation of the process of defecation, impurities in the stool, tenderness in the rectum. The finger method of examination of the rectum occurs in this way: the patient lies on the left side, bends the legs in the knees and pulls them to the stomach (or becomes in the knee-elbow position). The doctor conducts an examination of the internal relief in the rectum with the index finger inserted into the patient's anus.
• sigmoidoscopy. The study is carried out by a special apparatus, which allows to examine the rectum at a depth of up to 50 cm. In this study, the doctor can visually inspect the intestinal mucosa, and also take on additional research small pieces of tissue that cause suspicion. Such a survey is rather painful, but absolutely necessary to reveal malignant formation or metastases in the rectum.
• Irrigoscopy. "Dedovskiy", but very effective way of detecting malignant formation in the rectum. For the study, the patient is given an enema containing a contrast fluid, and after emptying, a series of X-ray pictures of the intestine are performed. Sometimes there is a need to additionally introduce air into the intestine - i.e. Make a double contrast. This diagnostic method is used to detect malignant tumors that may be in other parts of the intestine or if there are suspicions of two or more cancerous tumors, it is also prescribed to the weakened or to elderly people who, for certain reasons, can not undergo endoscopy. With the advent of fibrocolonoscopy, this method became less relevant.
• fibrocolonoscopy. Endoscopic examination, in which the doctor can examine the intestinal mucosa from the inside. Today, this method is recognized as the most effective and effective. It makes it possible to determine the exact location of a cancerous tumor, take small pieces of tissue for more thorough research under a microscope, and also cut out available benign polyps.
• intravenous urography. The study is appointed by the doctor, if the metastasis of the bladder, ureter is not excluded.
• ultrasound examination of the pelvis and abdominal cavity (ultrasound). It is used to detect metastases of closely located organs and lymph nodes, as well as to detect metastasis in more distant organs.
• CT scan. It is an excellent way to identify the germination of malignant formation in neighboring tissues and organs, metastasis of lymph nodes, the extent of malignant formation.
• laparoscopy. Surgical type of diagnosis, in which the peritoneal wall is pierced, where a camera is inserted through which various departments and organs are examined in the peritoneum. Laparoscopy is prescribed if there is a suspicion of running the process and metastasizing other organs.
• oncomarkers. Modern analysis of blood on proteins, which are produced only by malignant formations and completely absent in the blood of a healthy person. Given that they have a fairly low diagnostic value, oncomarkers are used quite rarely.

[13], [14], [15], [16], [17], [18], [19], [20], [21], [22]

Treatment of metastases in the rectum

Treatment of metastases in the rectum occurs, first of all, surgically, when the organ is removed, which is affected by cancer cells. Other methods of treatment, unfortunately, give only a supportive, not lasting result.

Operations to remove the tumor are as follows:

1. An organ-preserving operation or rectal resection is performed if the tumor is detected in the middle or upper part of the intestine. Removal occurs as much as possible below, with the simultaneous formation in the interior of the pelvis of an airtight intestinal tube.
2. Resection with reduction of the colon to the anal canal - with such a surgical operation the rectum is completely removed, and then an "artificial" one is formed, while the anal opening remains.

All other types of surgical intervention are similar in one - the withdrawal to the abdomen of the colostomy (artificial anus).

3. Withdrawal of colostomy with complete removal of the affected rectum, adjacent adipose, lymph nodes are also removed.
4. The operation of Hartmann - the withdrawal of colostomy, complete overlapping of the excretory part of the intestine (sewed tight) and removal of the tumor. The operation is performed in weakened people, in old age, with complications (intestinal obstruction).
5. Conclusion of colostomy without direct removal of a cancerous tumor. The operation is carried out solely to prolong the life of patients at the 4th stage of the disease and with any complications.
6. Combination of several types of surgical interventions, for example 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) exposure is carried out by a special device in small doses every day for one month. This kind of irradiation is detrimental to cancer cells. Radiation therapy can be performed prior to surgical treatment, to reduce the size of a cancerous tumor and transfer it from the state of "undelete" to "removed." Also, radiation therapy is prescribed after an operation already performed with existing metastases to prevent relapse. Irradiation can be external or internal (entering the sensor directly into the rectum), there is also an option combining both types of irradiation. Internal radiotherapy acts on a number of located organs and tissues is not so destructive, less damaging them. Elderly people who have contraindications to surgical intervention (cardiac pathology) radiotherapy is appointed as an independent treatment. No doubt, radiation therapy is inferior to surgery, but despite this, it gives good results in treatment.

Sometimes, with very severe pain and inflammation, when a tumor can not be removed by surgery, irradiation in small doses is used to alleviate the severe symptoms of the disease.

Metastases in the rectum, as well as in adjoining lymph nodes in large numbers, require the mandatory chemotherapy. It is also used if there are numerous metastases in other organs that can not be removed by surgery. Chemotherapy - the introduction of intravenous various synthetic toxic substances that act destructively on cancer cells. Sometimes chemotherapy is given in the form of tablets, they are absorbed by the body much better and have fewer side effects. Such treatment is carried out by courses from 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 alternative medicine, which not only are quite effective, but also successfully help to get rid of unpleasant sensations. First of all, you need to pay attention to the diet shown to people with cancerous lesions of the rectum. It is important not to eat fried (especially potatoes), sweet, red meat - all this provokes the growth of cancer cells. To ensure that the cancer does not expand and does not give metastases in the rectum, it is necessary to include foods in the diet that are specific protectors against any kind of tumors (benign or malignant) in the human body. These products include raw beets, broccoli cabbage, various vegetable juices, and also high in calcium (cottage cheese, cheese, legumes, spinach, parsley). A salad of plantain, dandelion, onion, garlic and kefir dressing is a good influence on the body.

As a treatment for cancerous formations for a long time using the root of the poisonous (cicuta) milestone. To make the tincture, pour the root of the milestone with vodka in the ratio 1:50, insist for a week in a dark place, then strain and the tincture is ready for use. Apply tincture better courses, alternating with celandine tincture. Drink the tincture, starting with one drop per 1/4 cup water, every day, adding one drop for 10 days, then removing one drop - 10 days. Take 2 times a day (if the form of cancer is started - 3 times a day). Then a week break is made and the course is repeated again. To prepare celandine tincture, it is necessary to grind fresh grass on a meat grinder (or grind it in a blender), squeeze the juice and let stand in a dark place in a tightly closed jar for 2 days. Next, you should pour the juice without sludge into another container (preferably glass). This tincture can be stored for several years. Take tincture of celandine should be the same as the tincture of the milestone. In addition to drinking, you can use the tincture as an enema. This is a good remedy affecting the tumor locally. Microclysters from celandine help to remove puffiness, inflammation, stop bleeding, strengthen the walls of blood vessels.

Useful for cancers of the intestine is the use of beets, cabbage. Of these, you can prepare freshly squeezed juice and drink, 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 that there are as many kocherzyzhek from ordinary white cabbage.

For the prevention of cancer, alternative medicine recommends taking 2 tbsp. Spoons of olive oil daily.

Prognosis for metastases in the rectum

At the time of detection of the tumor, approximately 25% of patients already have metastasis of distant organs, i.e. Every third patient. Only 19% of patients with cancer diagnosed in the early stages (first, second). In 1.5% of cases, malignant formation in the rectum is detected in the medical examination. Most malignant tumors at the time of detection are in the 3rd stage.

No more than 60% of patients with cancer in the rectum live about 5 years.

Economically developed countries (USA, Japan, Canada) rank first in the number of cases of cancer of the rectum. Since recent times, cases of colon cancer have increased in Russia. By the number of people with bowel cancer, men are on the 3rd place, women on the 4th, this type of cancer is the 5th most frequently.

Approximately 67% of elderly patients (70-74 years old), but recently cases of detection of the disease at a younger age (30-35 years) are not uncommon.

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

• In the first stage: the growth of a cancerous tumor takes place 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%.
• In the second stage, the diameter of the tumor reaches 5 cm and grows more than 1/3 of the intestine, metastases appear in the lymph nodes located next to the tumor. Survival in this case is not more than 60%.
• In the third stage, the tumor grows, it takes more than half of the intestine, metastasis of the lymph nodes occurs.
• In the fourth stage, the tumor begins to germinate in the nearby organs, the vagina, the uterus, the pelvic bones, the bladder, the urethra are affected.

When detecting malignant formations in the rectum at the third and fourth stages, doctors do not give comforting predictions. Survival in these cases is no more than 10-20%. With the 4th stage of rectal cancer, there was not a single case where the patient crossed the five-year life line. The tumor, revealed at an early stage, increases the chances of life 15 times.

Metastases in the rectum testify to the progression of cancer in the human body. Metastasis begins at the second stage of the disease, mainly by single cancer cells, neighboring organs and lymph nodes are affected. Unfortunately, cancer of the rectum, like any other type of cancer, in the early stages of development proceeds almost asymptomatically and reveals itself only when there is a clear violation in the work of the affected organs.