Surgical and drug treatment for rectal cancer

Before prescribing treatment for rectal cancer, the doctor must take into account such characteristics as the stage of the tumor, its exact location and volume, the depth of penetration into surrounding tissues, the presence of metastases, as well as the general condition of the patient. There are many methods of treating the disease. The doctor's task is to choose the optimal therapeutic regimen that is most suitable for a particular patient.

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Medicines for the treatment of rectal cancer

Medicines (chemotherapy) are prescribed for tumors very, very often, but the main method of cancer treatment is still surgery. Chemotherapy can be used to slow tumor growth, to prevent and remove metastases, as a preparation for surgery or after it, to increase the effectiveness of treatment.

Currently, the following drugs are used, depending on the purposes for which chemotherapy is used:

• Erbitux is administered intravenously once a week. It can be prescribed independently or in combination with Irinotecan. Possible side effects include allergies and skin rashes.
• Avastin – administered intravenously once a day for 20 days. Blocks blood flow to malignant cell structures. Usually prescribed in combination with 5-fluorouracil or Irinotecan, especially in the presence of metastases. Side effects include increased blood pressure, nosebleeds, and increased risk of thrombosis.
• Irinotecan is administered intravenously once a day for 10 days, sometimes in combination with 5-fluorouracil. Side effects include fatigue, diarrhea, decreased hemoglobin levels, and increased susceptibility to infectious diseases.
• Oxaliplatin (Eloxatin) – administered intravenously once/15-20 days. In the presence of metastases, it is combined with 5-fluorouracil. The most common side effects are fatigue, dyspeptic disorders, infection, paresis and paresthesia, and a feeling of cold in the body.
• Capecitabine is an oral drug with effects and side effects similar to 5-fluorouracil.
• 5-fluorouracil is an intravenous drug, usually combined with radiation therapy. Like all chemotherapy drugs, it has a number of side effects: increased fatigue, diarrhea, ulcerative stomatitis, peeling and redness of the feet and palms.

The effectiveness of chemotherapy as an independent type of treatment is quite low. However, in combination with other therapeutic interventions, the chances of success increase significantly.

Radiation therapy for the treatment of rectal cancer

Radiation therapy is the effect of high-energy X-rays, which are photon beams or directed beams of other elementary particles. Directed high-dose beams, superior in effect to conventional beams used for X-ray examination, have a destructive capacity for malignant cancer cells. This leads to damage to the cell's DNA and its destruction.

Before starting irradiation, it is necessary to think about how to protect healthy tissues closest to the tumor. To do this, the doctor carefully thinks through the treatment plan. It consists of determining the location of the patient's body so that the radiation flow is directed strictly in the right direction. This will make irradiation more effective, and the load on nearby tissues - minimal. When thinking through such a plan, specific corrective marks are applied to the patient's skin.

In order to protect healthy tissues, among other things, reflective lead plates are used for patients. To clarify the size of the neoplasm and the correspondence of the diameter of the beam to them, a computer or magnetic resonance tomography is performed.

What do radiation sessions provide:

• reduce the size of the neoplasm (to simplify the surgical intervention);
• destroy malignant cells that may remain after surgery to reduce the risk of disease recurrence.

Sessions are held every day for a month and a half. Each procedure lasts only a couple of minutes and does not cause discomfort to the patient.

Side effects of radiation may include:

• skin irritation;
• diarrhea;
• weakness.

After completion of therapy, all side effects usually disappear.

Traditional treatment for rectal cancer

Rectal cancer is a very serious disease, which would be unwise to treat with folk remedies alone. Folk medicine recipes can only be used as a supplement to traditional treatment, after consultation and approval from a doctor.

An enema for rectal cancer can be used to facilitate the passage of feces. As a rule, in hospitals, an enema is given immediately before diagnostic tests or surgery. But in folk medicine, enemas are often used to introduce herbal infusions and saline solutions into the rectum, which is an element of cancer treatment. In practice, it is not recommended to administer enemas to neoplasms of significant sizes, to decomposing tumors and to metastases. If the neoplasm is small, then it is not prohibited to administer an enema - however, this should be done carefully and cautiously. If after an enema the patient's condition worsens or pain occurs, then it is better to abandon this method of treatment. In the absence of unpleasant sensations, the use of an enema is quite acceptable.

Most often, herbal infusions are used as microclysters for rectal cancer. The following infusions are recommended:

• celandine herb, sage, birch and poplar buds, field horsetail herb;
• celandine herb, horsetail herb, chamomile flowers, wormwood, poplar buds;
• chamomile flowers, hemlock, celandine herb, calendula, flax, immortelle;
• elecampane, rose hips, nettle leaves.

To prepare the infusion, take 10 g of each ingredient, mix (1 tbsp of the mixture per 250 ml of water), brew and leave for 2.5 hours. After straining, add 1 tbsp of sea buckthorn oil. Use as an enema before bedtime. When using, the infusion should not be hot, but have a temperature of +35 °C. Duration of treatment is 10-14 days. Then, after a week's break, the course can be repeated.

Treatment of rectal cancer with soda is quite risky and is not welcomed by representatives of official medicine. However, such a method exists, and we will tell you about it for informational purposes.

The mechanism of action of soda is as follows: the alkaline solution blocks the development of cancer cells, for which an acidic environment is favorable. As a result, the neoplasm stops growing and dissolves over time (at least, this is what the adherents of folk medicine claim). In order for the therapeutic effect of baking soda to manifest itself, it is used in the form of solutions for oral administration, for enemas and even for injection directly into the tumor. Internal use of soda solution is immediately questioned, because any alkali is neutralized by the acidic contents of the stomach, which can only lead to damage to the stomach walls. As for the enema use of soda solution, this is a rather controversial issue, to which a clear answer has not yet been given.

Herbal treatment is the most well-known method of influencing a cancerous tumor. There are many recipes for using herbs, but they are all effective in different ways. The most popular methods of treatment are:

• mix 10 g of aloe leaf (not younger than 4 years), elecampane rhizome, birch mushroom, pour 500 ml of red wine and leave in the dark for 7-8 days, stirring occasionally. Use 50 ml three times a day after meals;
• Mix 30 g of freshly squeezed juice from the lower leaves of aloe with 20 g of natural liquid honey. Separately, pour 20 g of St. John's wort into 1500 ml of water and boil for 5 minutes, then strain and mix with 100 ml of wine. Mix the resulting mixture with aloe and honey. Dry red wine is used. The medicine should be stored in a dark bottle in a cool place, you can put it in the refrigerator. Take 2 teaspoons three times a day after meals;
• Mix 2 tablespoons of buckthorn and 1 tablespoon of chamomile flowers. Pour 1 tablespoon of the mixture into a glass of boiling water and leave for half an hour. Filter and drink the infusion at once. This medicine should be done daily.

Celandine for rectal cancer helps eliminate spasms, pain, and also restore tissue damaged by cancer.

To prepare the medicine, you need to dig up the plant during the flowering period (around May) together with the rhizome, wash it and dry it in the shade for 2 hours. After that, grind the celandine through a meat grinder and squeeze out the resulting juice. Let it stand in the refrigerator for 3 days, filter it and pour medical alcohol over the juice (1 liter of juice - 0.25-0.3 liters of alcohol). Store the remedy for up to 5 years. Take 1 tablespoon 1 hour before meals with a small amount of water, about 4 times a day.

Before you start using folk remedies, do not forget to consult a doctor - this will help you avoid adverse effects after the end of treatment.

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Suppositories for rectal cancer

To relieve the symptoms of cancer, suppositories with analgesics are often used to eliminate pain. The most common suppositories are based on non-steroidal anti-inflammatory drugs or local anesthetics.

Nonsteroidal anti-inflammatory suppositories:

• Ketonal;
• Flexen;
• Arthrosilene;
• Voltaren;
• Artrum;
• Diclofenac, etc.

Anesthetic suppositories:

• Novocaine suppositories;
• Anesthesol.

Suppositories for pain relief from cancer are prescribed for administration every 5 hours into the rectum, preferably after bowel movement.

Glycerin suppositories are not recommended for rectal cancer. Such suppositories effectively eliminate constipation, but irritate the already damaged intestinal mucosa. The use of glycerin can lead to a worsening of the disease and the appearance of bleeding from the cancerous tumor.

Vitamins for rectal cancer

Oncology patients can and should take vitamins, because such biological components actively participate in the restoration of the body and support its immunity. In addition, vitamins reduce the side effects of radiation and chemotherapy, and help reduce the manifestations of intoxication. However, patients should take into account that the choice and use of vitamin preparations should be agreed with the doctor, since some vitamin substances can, on the contrary, stimulate tumor growth.

• Vitamin A has an anti-cancer effect due to its antioxidant action, the ability to improve connections between cells and normalize the cell cycle. Retinol is usually administered intramuscularly for several months. The main thing is not to exceed the dosage, otherwise the intoxication of the body can only worsen.
• B vitamins are responsible for the metabolism in the body. Despite the importance and value of these vitamins, they should be taken with caution in case of tumors, as they can significantly stimulate the growth and restoration of cells, including cancer cells.
• Ascorbic acid significantly reduces the risk of developing tumors and can be used as a preventative measure. In the presence of cancer, vitamin C smooths out the side effects of taking cytostatics or hormones, increasing immunity and promoting the formation of free radicals.
• Vitamin D ensures the integrity of vascular walls, activates immunity, and restores calcium metabolism.
• Vitamin E is used to prevent possible relapses of malignant tumors - it is often used during the rehabilitation period, especially after a course of treatment with cytostatic drugs.

Vitamins are essential for restoring and maintaining the body during difficult times for health. It is not always possible to obtain all the necessary substances from food, so in many cases doctors prescribe complex vitamin preparations to strengthen the body's internal reserves.

Homeopathy

Homeopathy as a medical direction was formed more than two hundred years ago. And today in our country at least 1500 different homeopathic preparations are allowed for use. Moreover, over the past 20 years such preparations have been recognized, including by representatives of academic medicine, due to the large number of studies conducted and positive results from the means used.

As for oncology, homeopathic medicines are used mainly for the prevention of malignant diseases, not for treatment. If the patient's condition is such that surgery, chemotherapy and radiation are required, then such a course of treatment should be carried out without fail. Homeopathic remedies can be used to reduce side effects, to improve the patient's well-being, and also to prepare a cancer patient for surgery or during the rehabilitation period.

If you still want to try one or another homeopathic drug for cancer treatment, then assess the situation soberly, consult with your doctor and make an informed decision.

Surgical treatment of rectal cancer

Surgical treatment of the tumor is the main option for combating the disease. As practice has shown, any other type of treatment has only a temporary, restraining effect.

Currently, surgeons practice such types of surgical interventions as radical and organ-preserving operations for rectal cancer. That is, if possible, the doctor will try to preserve part of the rectum to be able to continue to maintain the function of removing feces from the anus. With a radical operation, the function of the anal sphincter is lost, and in its place another, artificial opening is created, called a colostomy.

The following types of operations for rectal cancer are known:

• resection - removal of the damaged section of the intestine with the formation of a special tubular section with a lower location in the pelvis. Resection is performed when the tumor is localized in the upper or middle section of the rectum;
• resection with lowering of part of the colon to the anal canal area - is an operation to remove the affected intestine with displacement of the upper intestinal sections in its place, which allows to form a semblance of the rectum and preserve the natural anal sphincter. Such an operation is performed when the upper intestinal sections are in a normal state;
• removal of the area of the rectum affected by the tumor, along with the adjacent areas of tissue and lymph nodes. The sphincter is not preserved, and a colostomy is created in the abdominal area;
• surgical intervention using the Hartmann method - removal of only the neoplasm and colostomy. Prescribed for weak and elderly patients;
• colostomy (the neoplasm is not removed) – prescribed for advanced malignant processes in order to prolong the patient’s viability.

In addition, operations can be performed in combination with each other. For example, surgical removal of the rectum can be performed simultaneously with the removal of metastases or growths that have grown into nearby organs.

There is also such a thing as inoperable rectal cancer - a tumor that cannot be removed due to the neglect of the process, or due to the unsatisfactory general condition of the patient, which does not allow the doctor to perform the operation. In this case, symptomatic treatment is carried out to maintain the patient's life. In the presence of intestinal obstruction, minimal intervention is prescribed to remove a colostomal opening, without resection of the neoplasm.

Rehabilitation

The rehabilitation period for patients who have undergone surgery consists of:

• wearing a support belt to reduce the load on the abdominal muscles (this promotes rapid healing of damaged tissue);
• in maintaining physical activity in the postoperative period (it is recommended to get up after a few days, walk along the corridor, etc.);
• in following a special gentle diet to improve bowel function.

Restoring normal bowel function is an important stage of rehabilitation. At first, the patient may suffer from bowel movement disorders, diarrhea - do not worry, this is quite normal. Over time, the changed intestine will adapt to its condition, and bowel movements will normalize.

Important: prevent constipation to avoid irritation of the intestines by feces and their decomposition products.

If the patient had a colostomy during the operation, it is necessary to explain to the patient the need to wear a special device for collecting feces, due to the absence of an anal sphincter.

Caring for a patient with rectal cancer

At home, the colostomy opening can be cared for by the patient himself or his relatives. After defecation, the opening is treated according to the following scheme:

• remove residual fecal matter;
• wash the hole and the area around it with warm water;
• blot the hole with a soft cloth;
• apply an antiseptic ointment to the skin, removing any excess with a napkin;
• apply a cotton pad lubricated with petroleum jelly to the cleaned hole;
• cover with a piece of gauze on top;
• secured with bandaging or a bandage belt.

Such actions are taken at the stage of colostomy healing. After the fistula has healed, the doctor will give recommendations regarding the use of a colostomy bag.

To replace the ostomy bag, you must:

• remove the contaminated ostomy bag and discard it without stretching or injuring the skin;
• wipe the skin around the hole with a napkin and wash with warm water;
• dry the hole, lubricate it with antiseptic cream (which the doctor recommended);
• Stick a new ostomy bag onto the hole according to the instructions provided.

With normal care, patients can easily return to their normal lifestyle, getting used to slightly new living conditions.

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Diet for rectal cancer

A patient diagnosed with rectal cancer should make changes to their diet and lifestyle. The diet should consist of foods rich in vitamins and nutrients.

After surgery, nutrients from the digestive system are not absorbed well enough, so it is important to eat high-quality and easily digestible food. The basis of the diet should be fermented milk and plant products, as well as cereals and seafood.

Preferred food:

• fruits – dried fruits, citrus fruits, kiwi, apples, avocado;
• berries – strawberries, wild strawberries, raspberries, and also watermelon;
• vegetable crops – cabbage, zucchini, eggplant, tomato, bell pepper, pumpkin;
• nuts, seeds;
• seafood – fish, seaweed;
• cereals – buckwheat, oatmeal;
• greens, onions, garlic;
• vegetable oils;
• fermented milk products – fresh kefir, yogurt, cottage cheese.

It is recommended to chew food well, eating small portions, but relatively often (5-6 times a day). It is advisable to prepare dishes immediately before eating them.

When it comes to drinks, preference should be given to green tea and herbal infusions.

Avoid foods that are difficult to digest, such as fatty meats, lard, fried foods, whole milk, hard and processed cheeses, baked goods, white rice. Sweets, sodas, and processed foods are not recommended.

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Prognosis: how long do people live after surgery?

Approximately 25% of patients with malignant lesions of the rectum already had distant metastases at the time of diagnosis. And only in 20% the tumor was detected at the early stages of development. Therefore, most cases of the disease are detected at the third stage.

Statistical survival during the first five years after treatment can be 50-60%. This depends on the scale of the tumor process, the presence and number of metastases, the stage of the disease, and the general condition of the patient.

• If the neoplasm does not leave the borders of the mucosa, does not affect more than a third of the rectum, and does not have metastases, then the patient survives in 80% of cases.
• If the tumor affects more than a third of the size of the intestine (but not more than 5 cm), and also has regional metastases in the nearest lymph nodes, then the patient's chances of survival are estimated at 60%.
• If the tumor is large, has distant metastases, or grows into nearby organs, the prognosis is less favorable. The five-year survival rate of such patients is no more than 10-20%.

The fourth stage of the tumor process leaves no chance for any patient to live more than five years.

Treatment of rectal cancer is carried out only after all diagnostic measures have been carried out. The doctor must evaluate all medical options so that the outcome of the disease is as favorable as possible. The most suitable treatment regimens are necessarily discussed with the patient, and all procedures are carried out only with his consent (or with the consent of relatives).

Prevention

The key to effective cancer treatment is early diagnosis. For the vast majority of patients, a late diagnosis can mean an extremely unfavorable prognosis. If cancer is detected in a timely manner, this significantly increases the patient's chance of surviving and leading a full life.

For early diagnosis, the following preventive measures are carried out:

• screening of families at increased risk of cancer;
• regular preventive examinations for people over 50 years of age;
• preventive monitoring of patients who have already been treated for cancer or intestinal polyposis.

People who frequently suffer from inflammatory processes in the intestines (for example, ulcerative colitis) are recommended to undergo control diagnostics once every 1-2 years, since in such situations there is also a high risk of developing cancer.

In addition to periodic digital rectal examination, the following studies are recommended:

• fecal occult blood test;
• X-ray or endoscopic examination;
• biopsy of existing polyps.

An important part of prevention is also proper nutrition. If there is obesity, the risk of developing a cancerous tumor increases.

To reduce the risk, it is recommended:

• significantly reduce your consumption of red meat (or eliminate it altogether);
• consume enough calcium (for example, from fermented milk products);
• drink only high-quality ground coffee (not instant);
• consume sufficient amounts of plant fiber;
• consume enough folic acid (for example, from greens);
• limit sweets and sugar;
• increase your intake of foods rich in vitamins A, C, D and selenium.

Giving up bad habits and leading an active lifestyle can also reduce the risk.