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Colon cancer and rectal cancer sometimes are grouped together and called colorectal cancer.
The rectum is a part of the digestive system, also called the gastrointestinal (GI) tract. The colon is the first 4 to 6 feet of the large intestine, also called the large bowel. The rectum is the last part of the large intestine, which ends in the anus.
Rectal cancer develops slowly and usually starts as polyps, which are overgrowths of tissue in the lining of the colon. Rectal cancer may develop within a polyp, but not all polyps contain cancer.
Types of Rectal Cancer
More than 95% of colorectal cancers are adenocarcinomas. Approximately 90% of colorectal adenocarcinomas began as adenomas, which are a type of polyp that may become cancer.
Rectal Cancer Risk Factors
Anything that increases your chance of getting rectal cancer is a risk factor. Rectal cancer risk factors include:
- Age: Rectal cancer is found most often in people over 50 years old.
- Family history of colorectal cancer or polyps
- Inherited disorders such as hereditary nonpolyposis colorectal cancer (HNPCC or Lynch) syndrome or familial adenomatous polyposis (FAP)
- Race or ethnic background: African Americans and Jews of Eastern European descent (Ashkenazi Jews) are at higher risk.
- Inflammatory bowel disease (Crohn’s disease or chronic ulcerative colitis)
- Colorectal cancer or polyps
- Lack of exercise
- Eating a lot of red meat, processed meats or meats cooked at very high heat
- Diabetes Type 2
- Cigarette smoking
- Drinking too much alcohol
Not everyone with risk factors gets rectal cancer. However, if you have risk factors, it’s a good idea to discuss them with your doctor. If you are concerned about inherited family syndromes that may cause rectal cancer, we offer advanced genetic testing to let you know your risk.
Rectal Cancer Prevention
Certain lifestyle choices may lower your chances of getting rectal cancer. Try to:
- Have regular screening tests
- Stay at a healthy weight
- Exercise regularly
- Eat a healthy diet with lots of fruits and vegetables
- Avoid cigarettes.
- Drink alcohol only in moderation
Some people have an elevated risk of developing rectal cancer. Review the rectal cancer screening guidelines to see if you need to be tested.
Some cases of rectal cancer can be passed down from one generation to the next. Genetic counseling may be right for you. Learn more about the risk to you and your family on our genetic testing page.
Learn more about rectal cancer:
Why choose MD Anderson for rectal cancer treatment?
MD Anderson's Colorectal Center cares for rectal cancer with a specialized team approach that is personalized, yet comprehensive.
Our rectal cancer treatment options include the most effective therapies, including proton therapy, intensity modulated radiation therapy (IMRT) and novel chemotherapies. Many of these are available at only a few cancer centers in the United States.
Advanced sphincter-preserving surgical techniques may help you avoid the need for a colostomy. If a colostomy is necessary, our specialized team of specially trained nutritionists and enterostomal nurses helps you make that transition.
Rectal Cancer Expertise
Many times, we can offer minimally invasive laparoscopic and robotic surgeries to patients with rectal cancer. These minimally invasive techniques often help reduce pain, recovery time and time in the hospital.
If chemotherapy is needed to treat rectal cancer, we offer the latest, most advanced options. Our world-renowned team of colorectal medical oncologists directs your therapy to maximize benefit while minimizing the risk for impact on your body. If radiation therapy is recommended, our colorectal radiation oncologists specialize in treating rectal cancer with the most effective techniques.
MD Anderson has special expertise in advanced rectal cancer that has spread (metastasized) to other parts of the body. We offer novel chemotherapy and biological agents, as well as a dedicated surgery program with extensive experience in advanced disease.
Groundbreaking Research, Comprehensive Care
As one of the world's largest cancer research centers, MD Anderson is a leading center for looking into new methods of rectal cancer diagnosis and treatment. You benefit from the most advanced research, delivered as quickly as possible.
And at MD Anderson you're surrounded by the strength of one of the nation's largest and most experienced comprehensive cancer centers. We have all the support and wellness services needed to treat the whole person – not just the disease.
When it comes to dealing with cancer, it is what is it and you’ve got to seek the best care that you can.
Colorectal Cancer Moon Shot
MD Anderson’s Colorectal Cancer Moon Shot® aims to rapidly and dramatically improve the disease’s survival rates and reduce suffering through prevention, early detection, research and new treatments.Learn more about the Colorectal Cancer Moon Shot
BY Jill Stein
Some days, I look back at my rectal cancer treatment, and I honestly can’t believe how far I’ve come. The fact that I’m not only alive but stable is remarkable.
My nightmare with rectal cancer began in November 2016, when I was 54. I started to feel discomfort just days before my first colonoscopy. My doctor couldn’t find anything wrong with my colon, but because my pain was intensifying, he sent me to a colorectal surgeon. A biopsy confirmed I had adenocarcinoma in my rectum.
I’d worked as a nurse in Houston for 32 years, and even though I really liked my colorectal surgeon, I knew I’d be crazy if I didn’t come to the world’s top cancer hospital for treatment. So, I scheduled an appointment at MD Anderson in Sugar Land, which is just minutes from my home.
My rectal cancer treatment
From the start, surgical oncologist Dr. Craig Messick told me that even though my cancer hadn’t spread, adenocarcinoma like mine tends to be more aggressive when it starts in the rectum, compared to the colon. Still, I wasn’t prepared for what was to come.
I finished 28 days of simultaneous radiation therapy and oral chemo and prepared for an abdominoperineal resection, a surgery to remove my rectum and distal colon. But during my pre-op preparation, new scans showed the cancer had spread to my liver.
My surgery was canceled, and I quickly met with surgical oncologist Dr. Yun Shin Chun. Within days, my care team had developed a new plan: two months of chemotherapy, followed by a liver resection and two more months of chemo.
After the first two months of chemotherapy, my rectal pain became too brutal to bear. So on June 2, 2017, Dr. Messick performed a laparoscopic diverting colostomy, during which he rerouted my bowels to a colostomy bag. A few weeks later, Dr. Chun resected 30% of my liver to remove the three lesions on it. I started my second two months of chemotherapy that August.
In late October 2017, I started experiencing really bad abdominal pain and couldn’t keep down any food. Turns out, my cancer had spread to my entire abdominal cavity. There were too many tumors to count.
Immunotherapy offers hope
At that point, my care team had exhausted all of the standard rectal cancer treatment options. My oncologist, Dr. Janet Tu, suggested we try immunotherapy because the tumor showed microsatellite instability changes that have shown to respond well to the treatment. She said it would be a shot in the dark, but I was willing to try anything if it could buy me even an extra day with my children.
I met with Dr. Scott Kopetz, and he agreed I could try the immunotherapy drug pembrolizumab. But before I could start treatment, I grew so weak and was in so much pain that I was hospitalized. I couldn’t eat anything, so I had to get my nutrients through an IV. As a result of my tumors, my stomach kept filling up with fluid, so I had a catheter placed to drain it all out.
My situation was dire, and Dr. Tu was honest about it. But she and my nurse practitioner, Laurie Hughes, didn’t give up. They raced to get me evaluated for immunotherapy, and toward the end of November, I received my first infusion.
Living with rectal cancer
After my third infusion, I started to tolerate enough food to get off IV nutrition. By January, my stomach had stopped accumulating fluid, and I was able to have the catheter removed.
I continue to feel better, and my disease hasn’t progressed. I must continue the immunotherapy indefinitely, but I’m OK with that. To me, it’s an incredible feeling just to wake up in the morning.
I’m so thankful for MD Anderson. Every doctor, every nurse, every person that I have been in contact with has been outstanding. They did everything to try and help me, and that’s evident by the fact that I am still here today.
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