Rectal cancer: general information

In order to clearly understand what constitutes rectal cancer, it is necessary to have information about the anatomy, physiology and mechanism of development of such a disease. This article contains the main points that characterize this malignant pathology.

Code for ICD 10 (on the international list of diseases):

• C 00-D 48 - Various neoplasms within the body.
• C 00-C 97 - malignant neoplasm.
• C 15-C 26 - tumors with malignant course, localized in the digestive system.
• C 20 - malignant neoplasm in the rectum (lymphoma, cancer, etc.).

To begin with, understand what the rectum is - the final part of the large intestine, so to speak, the transition from the colon to the anus. Why is this site selected in a separate category? The main function of the rectum is the retention and storage of the formed fecal masses, which are already ready for defecation.

The gut consists of three layers:

• mucous layer - covers the cavity of the rectum, serves to isolate a special mucus, which provides easy movement of feces;
• the muscular layer is a median tissue consisting of muscle fibers that hold the shape of the bowel and, contracting, progressively move the stool outwards;
• the peritoneum layer is a damping fatty tissue that literally envelops the rectum.

Also, describing cancer of the rectum, necessarily pay attention to the lymph nodes, which are sufficiently present around this organ. Lymph nodes inhibit not only pathogenic microorganisms (bacteria and viruses), but also cancer cells.

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Rectal cancer statistics

According to statistical data, malignant neoplasms are considered to be leading in terms of the number of deaths in world medicine. Every year from this disease, 7 to 8 million people die. Of these, the third place is allocated to cancer of the rectum.

The most cases of cancer are registered in developed regions and large cities. To be more precise, more than one million patients diagnosed with rectal cancer each year are found out: more than half of the deaths occur. The disease mainly occurs in people after 40 years of age. The average age of the disease is 55-65 years. However, young patients from 20 to 25 years old are also no exception. It's not a secret that the cancer is getting younger every year, and the incidence is rising. And the further forecast of the World Health Organization is not optimistic: in the future, scientists predict an increase in mortality from cancer.

After surgery for the removal of cancer in the rectum, the so-called "five-year survival" is approximately 35-75%. This large range is explained by the fact that the degree of survival of patients can directly depend on the type of oncology, the location of the tumor relative to the intestine, the quality and volume of surgical intervention, and the literacy and experience of the operating surgeon.

If the patient has regional metastases, this sign lowers the expected survival rate by 30-40%.

Even considering that the methods of cancer treatment are constantly being improved, the effectiveness of therapy is still relatively unchanged. It's all about relapses that occur in operated patients in about 10-40% of cases.

Undoubtedly, in different countries and regions, patient survival may differ significantly. Therefore, you should not blindly trust statistics. The average coefficient is based on the vast majority of reported cases, but the degree of risk to any particular patient may be quite different. It can not be wrong to tell a cancer patient about how much he has to live. This question is not so much statistical data as the level of care rendered to the patient, the quality of medical examination, as well as the general state of human health.

Causes of colorectal cancer

The causes of the formation of malignant disease of the rectum are currently under study. So far, there are only assumptions and hypotheses that a cancerous tumor can appear as a result of some chronic pathologies, for example, as a result of cracks in the anal opening, ulcerative inflammation of the intestine or proctitis.

In the appearance of a cancerous tumor, hereditary-genetic factor is of great importance. That is, in any person the risk of developing bowel oncology may be higher if in his family someone was ill with diffuse polyposis or with malignant diseases of the intestines. Diffuse polyposis is a disease characterized by the appearance of a large number of polyps (benign formations) in the lumen of the large intestine or rectum. Such multiple polyps can be transmitted genetically from a senior member of the family to a younger one, besides, they carry a great danger of cancer degeneration.

The emergence of a cancer is also promoted by individual principles of nutrition. Among the alimentary risk factors are the following:

• insufficient intake of vegetables, as well as cereals, cereals, various cereals;
• excessive consumption of animal fats, meat food.

Defecation disorders, such as constipation (especially chronic) lead to stagnant stool starting to decompose in the intestines, causing irritation of the mucosa by the products of decay.

Also, its negative contribution to the appearance of cancer is made by such factors as overweight, inactivity, overeating. It is established that bad habits are involved in the development of malignant diseases of the rectum. So, smoking and alcohol are irritating not only on the stomach, but also on the entire intestinal mucosa, which can cause inflammatory reactions and even oncology.

We can not discount the harmful professional activity - work related to toxic and radiation waste, chemicals, etc.

In addition, rectal cancer is not a rare occurrence among patients with human papillomavirus, as well as among homosexuals who practice anal sex.

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Pathogenesis

Inflammatory reaction in the tissues of the rectum, mechanical damage to the mucosa provokes stimulation of regenerative processes. But with prolonged and frequent inflammatory and tissue integrity disorders, recovery processes can be disrupted. So there are, for example, polyps. With a genetic predisposition to polyposis, intestinal mucosa from birth have a tendency to pathological proliferation of polyps. The development of these small tumors is slow and often unnoticeable.

Over time, polyps can malignantly degenerate, tumor cells change structure and cancer occurs.

Cancerous tumor exists and grows for a long time without leaving the rectum. Only after years the tumor can germinate into nearby tissues and organs. For example, sprouting and spreading of cancer in the posterior vaginal wall, prostate, bladder, urethra is often observed. As with any oncopathology, sooner or later metastasis begins - the separation of tumor cells and their spread throughout the body. First of all, the lymphatic and circulatory system is affected, through which malignant cells are transferred to the liver, lungs, brain, kidneys and other organs.

The growth of rectal cancer is a fairly long process, if compared with any other tumor location. So, cancer cells slowly develop in the tissues of the intestine, not penetrating into their depth. Malignant process can be hidden behind local inflammation: degenerated cells are convenient to develop inside an inflammatory infiltrate, where whole cancer colonies can form.

Often because of the slow and latent growth, the symptoms of rectal cancer are detected at fairly late stages of development, when the tumor already has significant enough dimensions and distant metastases. And even then, patients do not always seek medical help, mistakenly accepting the right signs of malignancy for anal fissures or manifestations of hemorrhoids.

Indeed, the diagnosis of this disease is difficult due to many reasons. First, as we have already said, the early stages of the disease often do not manifest themselves in any way. Secondly, patients are often embarrassed to seek help, believing that the symptoms are not so serious. And this, in spite of the fact that in our country it is recommended that all people over the age of 40 periodically examine the intestines for malignant diseases.

Treatment of rectal cancer is mainly surgical. The amount and type of surgical intervention, as well as additional methods of treatment are chosen depending on the location of the tumor, the degree of its germination in the tissues and the nearest organs, the presence of metastases, the condition of the patient,

Unfortunately, rectal cancer is not a rare and serious enough pathology, which requires long and complex treatment. Therefore, in order to avoid the disease or, at least, to start treatment on time, it is important to follow all recommended prevention methods.