Presentation
Abstract The early and precise diagnosis of linitis plastica-type tumours of the rectum and anal canal is difficult because of their insidious presentation and anaplastic nature. [ncbi.nlm.nih.gov]
Moreover, the patients who have bone metastasis at presentation are even rare. [cancerjournal.net]
Entire Body System
- Pain
For instance: If the bones are affected, symptoms may include pain, fractures, constipation and/or high calcium levels. If the lungs are affected, symptoms may include shortness of breath, difficulty breathing, coughing, pain and/or fatigue. [cancercenter.com]
The stent relieves painful symptoms and improves quality of life. [dukehealth.org]
Herein, we report a 15-year-old boy who presented with rectal bleeding, lower abdominal pain, and diarrhea. His physical examination revealed tender abdomen with hepatomegaly. A hard mass was palpated by digital rectal examination. [ncbi.nlm.nih.gov]
- Fatigue
If the lungs are affected, symptoms may include shortness of breath, difficulty breathing, coughing, pain and/or fatigue. [cancercenter.com]
Side effects include fatigue, nausea, increased risk of infection, anemia, and peripheral neuropathy (tingling or numbness of the fingers and toes). [emedicinehealth.com]
- Anemia
Patient 3 A 70-year-old man with metastatic RCC presented with acute painless hematochezia and anemia. A colonoscopy showed a 2-cm firm rubbery mass in the submucosa adjacent to the dentate line. [cureus.com]
The main laboratory finding was a mild anemia. A barium enema and a proctoscopy revealed a rectal neoplasm at eight cm from the anal verge. A transendoscopic biopsy demonstrated an squamous rectal carcinoma. [ncbi.nlm.nih.gov]
Unexplained anemia : Anemia is a shortage of red blood cells—the cells that carry oxygen throughout the body. If you are anemic, you may experience shortness of breath. [my.clevelandclinic.org]
If early-stage colorectal cancer does cause symptoms, they most often include: Rectal bleeding, either bright or dark red in color Narrow stools Tenesmus, which is the feeling that you have to empty your bowel but nothing passes Anemia caused by iron [cancercenter.com]
Right-sided lesions usually manifest with bleeding and anemia; left-sided lesions usually manifest with obstructive symptoms (eg, colicky abdominal pain). [merckmanuals.com]
- Anorexia
Clinical manifestations of SCC of the rectum are similar to those of adenocarcinoma: change in bowel habits, pain, tenesmus and rectal bleeding, anorexia and weight loss. [wjso.biomedcentral.com]
The symptoms gradually worsened and the patient experienced hematochezia, anorexia and weight loss of ~10% body weight. The patient had a history of smoking and alcohol consumption. [spandidos-publications.com]
The patient also complained of severe constipation, nausea, vomiting, anorexia, loss of appetite, abdominal cramps, incontinence of faeces and weight loss during the past four months. [jmedicalcasereports.biomedcentral.com]
- Perineal Pain
Anal and perineal pain, initially on defecation and later continuous, occurs with low rectal cancer invading the anal sphincters. Sacral pain, sometimes radiating down the legs, results from tumour invasion of the sacrum and sacral nerve plexus. [surgwiki.com]
Respiratoric
- Dyspnea
Shortness of breath (dyspnea). Confusion. You know your body best, so trust your gut. If something doesn’t seem quite right, make an appointment with your healthcare provider. They can find ways to ease your symptoms and help you feel better. [my.clevelandclinic.org]
Gastrointestinal
- Diarrhea
This case highlights the need for awareness of colorectal carcinomas and their invasive nature in the differential diagnosis of rectal bleeding and diarrhea in adolescents. [ncbi.nlm.nih.gov]
Common local symptoms include: Constipation Diarrhea Alternating diarrhea and constipation, or other changes in bowel habits Rectal bleeding or blood in the stool Abdominal bloating, cramps or discomfort A feeling that the bowel doesn't empty completely [cancercenter.com]
Side effects include fatigue, diarrhea, increased risk of infection, and anemia. Because both irinotecan and 5-FU cause diarrhea, this symptom can be severe and should be reported immediately to a doctor. [emedicinehealth.com]
- Abdominal Pain
Herein, we report a 15-year-old boy who presented with rectal bleeding, lower abdominal pain, and diarrhea. His physical examination revealed tender abdomen with hepatomegaly. A hard mass was palpated by digital rectal examination. [ncbi.nlm.nih.gov]
For instance: If the bones are affected, symptoms may include pain, fractures, constipation and/or high calcium levels. If the lungs are affected, symptoms may include shortness of breath, difficulty breathing, coughing, pain and/or fatigue. [cancercenter.com]
pain or a cramping pain in your lower stomach Bloating or full feeling Change in appetite Weight loss without dieting Fatigue These symptoms do not always mean you have rectal cancer. [mdanderson.org]
Patients undergoing an LAR may experience lower abdominal pain after the operation. Less common complications related to surgery include bleeding, infection and temporary difficulty with emptying the bladder. [texasoncology.com]
Herein, we report a case of an 82-year-old female who presented with a 2-month history of worsening abdominal pain, hematochezia, and bilateral inguinal lymphadenopathy with right-sided purulent discharge. [karger.com]
- Rectal Bleeding
Herein, we report a 15-year-old boy who presented with rectal bleeding, lower abdominal pain, and diarrhea. His physical examination revealed tender abdomen with hepatomegaly. A hard mass was palpated by digital rectal examination. [ncbi.nlm.nih.gov]
bleeding Abdominal pain, bloating or cramps A persistent feeling that you cannot completely empty your bowels Rectal cancer symptoms The symptoms of rectal cancer may be similar to those of other bowel diseases, such as ulcerative colitis or Crohn's [cancercenter.com]
- Rectal Mass
The lesions appeared as indurated, ulcerated rectal masses that resembled carcinoma on endoscopic examination. Deep mucosal biopsy results demonstrated no malignancy and barium sulfate crystals in tissue macrophages. [ncbi.nlm.nih.gov]
On digital rectal examination a palpable mass was noted. The colonoscopy confirmed the presence of a partially obstructing ulcerated rectal mass ( Fig 2 ) which was biopsied. The colonoscopy impression was consistent with primary rectal carcinoma. [jgo.amegroups.com]
Hypoechoic rectal mass extending into the muscularis propria. Fig. 3. Enlarged perirectal lymph node. Fig. 4. H&E-stained squamous cell carcinoma arising from the rectal mucosa. Discussion SCC is one of the rarest forms of rectal cancer. [karger.com]
Growth of rectal mass in the passage of stool. Obstruction in bowel movement. Anemia, fatigue, and at times loss of breath. Incomplete secretion of stool. Unexplained weight loss. Causes No cancer grows overnight. [medanta.org]
- Nausea
If the liver is affected, symptoms may include nausea, fatigue, swelling of the feet and hands, increased abdominal girth and/or jaundice. [cancercenter.com]
[…] constipation A feeling that your bowel does not empty completely Blood (either bright red or very dark) in your stool Stools that are narrower than usual Frequent gas pains or cramps, or feeling full or bloated Weight loss with no known reason Fatigue Nausea [medlineplus.gov]
Patient 5 A 67-year-old man with a history of stage-3 left-sided RCC who had undergone left nephrectomy 9 years earlier presented with acute onset of abdominal distention, nausea, vomiting, and hematochezia. [cureus.com]
Liver, Gall & Pancreas
- Hepatomegaly
His physical examination revealed tender abdomen with hepatomegaly. A hard mass was palpated by digital rectal examination. Histologic examination revealed a mucinous rectal adenocarcinoma. He died 4 months after diagnosis. [ncbi.nlm.nih.gov]
Some patients first present with symptoms and signs of metastatic disease (eg, hepatomegaly, ascites, supraclavicular lymph node enlargement). [merckmanuals.com]
Jaundice and hepatomegaly indicate advanced disease with extensive liver metastases. [patient.info]
Diagnosis Perform physical examination with specific attention to the size and location of the rectal tumor in addition to possible metastatic lesions, including enlarged lymph nodes or hepatomegaly. In addition, evaluate the remainder of the colon. [emedicine.medscape.com]
Neurologic
- Irritability
Irritable bowel syndrome (IBS) is a common disorder affecting over 15 percent of the population. [fascrs.org]
They’re more likely to be caused by something less serious, including constipation, irritable bowel syndrome, or Crohn’s disease. More than 40,000 new cases of bowel cancer are diagnosed in the UK every year. [express.co.uk]
This type of seeding produces small nodules throughout the abdomen which irritates tissues and causes the production of large amounts of ascites (fluid). Direct spread from the rectum may attach the tumour to the bladder in males and cause fistulas. [myvmc.com]
It reasons that irritation from various stressors causes architectural distortion within the epithelial layer. If the inciting stressor is not removed, the area of metaplasia can subsequently undergo dysplasia and subsequent carcinoma. [karger.com]
- Dizziness
The major symptom of rectal cancer is bleeding from the rectum; other symptoms include anemia, fatigue, shortness of breath, dizziness and/or a fast heartbeat, bowel obstruction, small diameter stools, and weight loss. [emedicinehealth.com]
- Lethargy
Lethargy or fever of unknown origin. These symptoms are due to a small occult, localised perforation or from tumour burden. Metastases tend to be more aggressive and grow more rapidly than the primary tumour. [surgwiki.com]
Workup
CT scan Part of routine workup of patients Useful in identifying enlarged pelvic lymph-nodes and metastasis outside the pelvis than the extent or stage of primary tumor Limited utility in small primary cancer Sensitivity 50-80% Specificity 30-80% Ability [slideshare.net]
The image below depicts the staging and workup of rectal cancer. Diagnostics. Staging and workup of rectal cancer patients. Signs and symptoms Bleeding is the most common symptom of rectal cancer, occurring in 60% of patients. [emedicine.medscape.com]
One (8.3%) of the patients had defaulted treatment and not completed full metastasis workup. The most common site of metastasis was bone (five patients). It is the same with adults [17]. [ejo.eg.net]
Eleven patients had no further workup aside from the routine evaluation. Fifty-six patients were treated with curative intent. [jamanetwork.com]
Treatment
Local treatment seems a much more desirable form of therapy. [ncbi.nlm.nih.gov]
The potential benefits of receiving cancer treatment must be carefully balanced with the potential risks of receiving cancer treatment. The following is a general overview of the treatment of Stage III rectal cancer. [texasoncology.com]
Fight Colorectal Cancer, along with our Medical Advisory Board, has taken the time to break down colorectal cancer treatment by stage, which includes both colon cancer treatment by stage and rectal cancer treatment by stage. [fightcolorectalcancer.org]
Prognosis
However, no significant differences were observed in the postoperative prognosis for cases with no lymph node metastasis and/or with tumors limited to the muscularis propria between these two groups. [ncbi.nlm.nih.gov]
The prognosis of IIIA approaches that of IIB etc. This is not yet in widespread use). The advent of the newer chemotherapy agents has made a significant impact on rectal cancer prognosis. [myvmc.com]
Etiology
Though its etiology and pathogenesis remains unclear, it has been associated with chronic inflammation and infections. [karger.com]
The etiology of colorectal SCC is still unclear; however, chronic inflammation (infectious or autoimmune) may play a pivotal role. [jgo.amegroups.com]
[…] hepatocellular carcinoma irrespective of the baseline ECOG performance status (0-2), tumor burden (w/ or without macrovascular invasion &/or extrahepatic spread), presence or absence of either lung or lymph node metastasis, tumor stage, prior therapy & disease etiology [specialty.mims.com]
Etiological agents Environmental & dietary factors Chemical carcinogenesis. [slideshare.net]
"On the etiology of anal squamous carcinoma". Danish Medical Bulletin. 49 (3): 194–209. PMID 12238281. ^ Frisch M, Glimelius B, van den Brule AJ, et al. (November 1997). "Sexually transmitted infection as a cause of anal cancer". N. Engl. J. [en.wikipedia.org]
Epidemiology
A weaker association between S japonicum infection and colorectal neoplasia has been proposed, although reports are limited to case reports, a case series, and epidemiologic studies. [ncbi.nlm.nih.gov]
Objectives The aim of this epidemiology study was to compare the features of colon and rectal cancer by using recent national cancer surveillance data. [journals.plos.org]
Access personal reporting Related Content This Book Next chapter Rectal Cancer Epidemiology By Miguel Henriques Abreu, Eduarda Matos, Fernando Castro Poças, Rosa Rocha and Jorge Pinto Related Book Contemporary Issues in Colorectal Surgical Practice Edited [intechopen.com]
Pathophysiology
Although rectal SCC is a well-established entity, the pathophysiology and risk factors remain largely unknown. Diagnostic criteria are based on the widely-accepted Williams exclusion criteria. [jgo.amegroups.com]
Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 126. National Cancer Institute website. [mountsinai.org]
Almost four different pathophysiological theories regarding the origin of squamous cell carcinoma of the colorectum have been proposed in the literature so far. [jmedicalcasereports.biomedcentral.com]
Univariate sub-group analyses showed that the treatment effect for surgery alone vs preoperative radiotherapy plus surgery was not significant in patients whose cancer (TNM stage I to IV) was located between 10.1 cm and 15 cm from the anal verge. [5] Pathophysiology [emedicine.medscape.com]
Prevention
Can colon cancer be prevented? Colon cancer is preventable. The most important step towards preventing colon cancer is getting a screening test. Any abnormal screening test should be followed by a colonoscopy. [ccrcfw.com]
Statistics BC Canada Can I help to prevent it? Research shows that about 50% of colorectal cancers can be prevented by following a healthy lifestyle. [bccancer.bc.ca]
Accordingly, preventing local recurrence is one of the main treatment goals with rectal cancer. [medicinenet.com]
Visit our Cancer Nutrition Services Program for recipes and nutrition recommendations to prevent or reduce your risk of cancer. Kale contains special cancer preventing properties. Learn more » [stanfordhealthcare.org]
CAN RECTAL CANCER BE PREVENTED? Rectal cancer is preventable. Nearly all rectal cancer develops from rectal polyps, which are benign growths on the rectal wall. [fascrs.org]