Rectal cancer is a type of cancer that develops in the rectum, the final section of your digestive system. As food travels through your body, it passes from the stomach into the small intestine, then the colon, and finally into the rectum, where it’s prepared for elimination as stool. When cancerous cells form in the rectum, they can cause various symptoms, including changes in bowel habits, blood in the stool, unexplained weight loss, fatigue, and anemia.
Rectal cancer is often grouped with colon cancer under the term “colorectal cancer” because of their many similarities. According to the American Cancer Society, approximately 46,220 individuals in the United States will be diagnosed with rectal cancer in 2024. While overall colorectal cancer rates have decreased since 2011, there’s been a concerning rise in cases among adults under 50 since the mid-1990s, making awareness of early warning signs critical.
Early Symptoms
Rectal cancer often begins with the development of small growths called polyps on the inner lining of the rectum. While many polyps are benign, some can become cancerous if left untreated. In the early stages of rectal cancer, you might not experience any noticeable symptoms. However, as the tumor grows, certain symptoms may start to appear.
Blood in Stool
One of the earliest and most common signs of rectal cancer is the presence of blood in the stool. Sometimes, the bleeding may not be visible to the naked eye (occult blood) and can only be detected through specialized tests. Visible blood might appear as bright red on toilet paper or in the toilet bowl, indicating bleeding in the rectum or lower colon. Although rectal bleeding can also result from conditions like hemorrhoids, bleeding due to rectal cancer typically persists or worsens over time and may be accompanied by other symptoms like pain or changes in bowel habits.
Painful Bowel Movements
Pain during bowel movements is another potential symptom of rectal cancer. This pain might manifest as sharp, burning, or general discomfort. If you notice new or worsening pain during bowel movements, it’s essential to consult with a healthcare provider, as it could be a sign of rectal cancer or another digestive disorder.
Changes in Bowel Habits
A tumor in the rectum can disrupt normal bowel function, leading to changes such as constipation, diarrhea, or a noticeable narrowing of the stool (often described as “pencil-thin”). You might also feel an urgent need to have a bowel movement, even if the rectum is not fully ready to pass stool.
Incomplete Bowel Emptying
After a bowel movement, you might feel as though you haven’t completely emptied your bowels. This sensation, known as tenesmus, can occur when a tumor takes up space in the rectum, making it difficult to pass stool.
Progressive Symptoms
As rectal cancer progresses, additional symptoms may develop. These symptoms often become more pronounced as the cancer grows or spreads to other parts of the body.
Unexplained Weight Loss
Unexpected weight loss can occur as cancer cells consume more of your body’s energy, particularly glucose. This increased energy demand can lead your body to break down fat and muscle for fuel. Additionally, the cancer and the body’s response to it can alter how your body processes food and nutrients, further contributing to weight loss. The tumor itself can also affect your appetite and digestion, making you feel full quickly or reducing your desire to eat.
Anemia
Rectal cancer can cause chronic blood loss, even if you don’t see visible blood. Over time, this can lead to anemia, a condition characterized by a deficiency of healthy red blood cells, resulting in symptoms like weakness, dizziness, and shortness of breath.
Fatigue
Fatigue is a common symptom in people with rectal cancer. The cancer can drain your body’s energy, interfere with nutrient absorption, and cause anemia, all of which contribute to feelings of extreme tiredness.
Abdominal Pain or Cramping
As the tumor grows, it can press against surrounding organs and tissues, leading to persistent abdominal pain, cramping, bloating, or a sensation of fullness.
Urinary Symptoms
In some cases, a large tumor may press against the bladder, prostate, or urethra, causing urinary symptoms such as frequent urination, urgency, difficulty starting or stopping urine flow, or pain during urination.
End-Stage Symptoms
In advanced stages, when rectal cancer has spread to other parts of the body (metastasized), additional symptoms may emerge.
Jaundice
Jaundice, a condition where the skin and whites of the eyes turn yellow, can occur if rectal cancer spreads to the liver, interfering with the liver’s ability to process bilirubin, leading to its buildup in the body. Jaundice may also cause dark urine and pale-colored stools.
Back Pain
If the cancer spreads to the bones in your spine, you may experience back pain. This pain could be constant or intermittent and should be reported to your healthcare provider, especially if you have other symptoms of rectal cancer.
Pelvic Pain
An advanced rectal tumor might press on nerves and other structures in the pelvis, leading to dull aches, sharp pain, or a feeling of pressure or heaviness in the pelvic region.
Other Symptoms
Depending on where the cancer has spread, you may experience a variety of other symptoms. For example, if cancer spreads to the abdomen, it can cause ascites, which is a buildup of fluid that causes swelling and discomfort. If it spreads to the lungs, you may develop shortness of breath or a persistent cough. Bone pain or swollen lymph nodes can occur if the cancer spreads to the lymphatic system.
Symptoms in Younger Adults
Although colorectal cancer was once more common in people over 50, the incidence has been rising among younger adults, with early-onset colorectal cancers (EO-CRCs) becoming more prevalent. It’s important for younger adults to be aware of the symptoms and to start regular screening at age 45.
Research has shown that certain symptoms, such as abdominal pain, rectal bleeding, and diarrhea, which appear months or even years before diagnosis, are linked to an increased risk of early-onset colorectal cancer. Experiencing these symptoms, especially if they occur together, should prompt an immediate conversation with a healthcare provider.
When to Contact a Healthcare Provider
If you experience symptoms of rectal cancer or believe you may be at risk, it’s crucial to consult with a healthcare provider. Changes in digestion or bowel habits can have various causes, but early detection of rectal cancer can significantly improve the effectiveness of treatment.
Regular screening is key to preventing and detecting rectal cancer early. The American Cancer Society recommends that individuals at average risk start screening at age 45, often through a colonoscopy. Those with higher risk factors, such as a family history of colorectal cancer or polyps, genetic conditions, or inflammatory bowel diseases, may need to begin screening earlier.
Questions to Ask Your Healthcare Provider
Preparing questions ahead of your appointment can help ensure you get the most out of your discussion. Here are some questions to consider:
- Could my symptoms be related to another health condition?
- Based on my risk factors, when should I begin rectal cancer screening?
- Are there any lifestyle changes I can make to reduce my risk of rectal cancer?
- If I have rectal cancer, what treatments are available to help manage my symptoms?
Minimally Invasive Treatment: TAMIS and the Expertise of Dr. Sarath Kumar Reddy
In recent years, Transanal Minimally Invasive Surgery (TAMIS) has emerged as a promising and less invasive treatment option for certain cases of rectal cancer. This innovative procedure enables surgeons to remove early-stage tumors from the rectum through the anus, eliminating the need for large abdominal incisions. As a result, patients benefit from shorter recovery times, reduced pain, and a lower risk of complications compared to traditional surgical methods.
Dr. Sarath Kumar Reddy, a leading expert in colorectal surgery, has played a significant role in advancing the use of TAMIS for rectal cancer treatment. His extensive experience and skill in performing this procedure have led to improved outcomes for patients, offering them a less invasive option with excellent results in both cancer control and overall quality of life.
A Quick Summary
The initial signs of rectal cancer often include blood in the stool and changes in bowel habits. As the cancer progresses, symptoms such as unintentional weight loss, fatigue, anemia, and abdominal pain may develop. If the cancer spreads to other parts of the body, additional symptoms can occur.
While rectal cancer is more commonly diagnosed in older adults, younger people are increasingly at risk. If you notice any unusual changes in your body or experience any symptoms of rectal cancer, it’s important to see a healthcare provider for an evaluation and, if necessary, early treatment.
