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Rectal Cancer – Leading Treatment Options and Comprehensive Care
Stages of rectal cancer
Early stages of rectal cancer (stage 0)
- Preinvasive cancer or early stages of rectal cancer is the earliest stage of the disease.
- At this stage, cancer cells do not penetrate beyond the lamina propria of the intestinal mucosa, and all that is needed is the removal of these cells.
- As a rule, cancer at this stage is discovered by chance, since the patient does not present any complaints. Symptoms are poor in specific manifestations - patients may experience constipation, a feeling of heaviness in the rectum.
- Most often, the disease proceeds without any symptoms and if it is detected at this early stage, then thanks to a doctor's examination by palpation or during a rectoscopy. Rectosigmoidoscopy or rectoscopy allows the doctor to see the inner surface of the rectum and assess its changes, see polyps.
- There are practically no contraindications to the procedure of rectoscopy of the rectum. The radical treatment for early stage rectal cancer is either endoscopic polypectomy, transanal excision or transanal resection of the rectum.
- Further treatment for early stage rectal cancer (stage 0) is not required.
Stage I rectal cancer (stage I)
Invasive cancer. At this stage, the cancer grows into the mucous, submucous and muscular layers of the intestinal wall, but has not grown through the wall of the rectum. The size of the cancerous tumor does not exceed 2 cm, there is no regional metastasis. The main treatment for rectal cancer at the first stage is surgery - intra-abdominal (anterior) resection of the rectum or abdominoperineal extirpation of the rectum, depending on the level of localization (location) of the tumor in the rectum. Operations are also distinguished by the location of the anastomosis (anastomosis is the connection of two sections of the rectum during surgery). The anastomosis is formed using special devices and must ensure tightness (prevent leakage), and there should be no narrowing at the site of the anastomosis.
Stage I
As a rule, further postoperative (adjuvant) treatment is not required. If the examination of the material removed during surgery reveals significant spread of the tumor, the patient is prescribed postoperative radiation and/or chemotherapy. In some cases, at stage I, organ-preserving operations can be performed without penetrating the abdominal cavity - transanal endoscopic microsurgery or transanal resection.
Stage II
At stage II, cancer grows through all layers of the rectal wall and can spread to surrounding tissues (pararectal tissue), but the patient does not have regional lymph nodes affected by metastases.
Treatment of this stage of the disease is an operation in the same volume as in the treatment of stage I - intra-abdominal (anterior) resection of the rectum or abdominoperineal extirpation of the rectum.
Recently, most specialists and scientific research data are inclined to the need for preoperative (neoadjuvant) chemoradiation therapy. In the postoperative period, radiation and/or chemotherapy are also possible.
Treatment of this stage of the disease is an operation in the same volume as in the treatment of stage I - intra-abdominal (anterior) resection of the rectum or abdominoperineal extirpation of the rectum.
Recently, most specialists and scientific research data are inclined to the need for preoperative (neoadjuvant) chemoradiation therapy. In the postoperative period, radiation and/or chemotherapy are also possible.
Rectal cancer. Stage III
At the third stage of rectal cancer, there are already metastases in the regional lymph nodes, but there is no spread of cancer to other organs (distant metastases). At this stage of the disease, treatment is always combined.
As a rule, it begins with preoperative (neoadjuvant) chemoradiation therapy. Such therapy can reduce the primary tumor, transfer it from the inoperable category to the operable one, and also reduces the likelihood of local (locoregional) recurrence of the tumor in the pelvis.
The next stage of treatment is an operation in one of the previously listed volumes, depending on the size, prevalence and localization of the tumor. In the case of large tumors penetrating into neighboring organs (uterus, vagina, bladder, prostate gland), an extensive operation is performed - pelvic exenteration - complete removal of all of the listed organs.
In the postoperative period, a 6-month course of adjuvant (postoperative) chemoradiation therapy is mandatory.
As a rule, it begins with preoperative (neoadjuvant) chemoradiation therapy. Such therapy can reduce the primary tumor, transfer it from the inoperable category to the operable one, and also reduces the likelihood of local (locoregional) recurrence of the tumor in the pelvis.
The next stage of treatment is an operation in one of the previously listed volumes, depending on the size, prevalence and localization of the tumor. In the case of large tumors penetrating into neighboring organs (uterus, vagina, bladder, prostate gland), an extensive operation is performed - pelvic exenteration - complete removal of all of the listed organs.
In the postoperative period, a 6-month course of adjuvant (postoperative) chemoradiation therapy is mandatory.
Stage 4 Rectal Cancer (IV)
Stage IV rectal cancer is when cancer has spread to other organs (distant metastases), regardless of the size of the primary tumor and the presence or absence of affected regional lymph nodes.
Treatment options for this stage vary from case to case and depend primarily on the extent of the disease.
If there is a possibility of complete removal of both the primary tumor and its metastases (for example, single metastases in the liver and/or lungs), the following treatment options are possible:
1. Extensive combined surgery with resection of the rectum and removal of metastases in any organ, followed by chemotherapy, or
2. Preoperative chemotherapy followed by surgery to remove the tumor and its metastases and postoperative massive chemotherapy, or
3. Preoperative chemoradiation therapy, then surgery, and then even more powerful postoperative chemotherapy.
These options can significantly prolong life, and in some rare cases even cure cancer. If rectal cancer cannot be removed surgically, the main treatment option is chemotherapy.
Treatment
Treatment of rectal cancer is a pressing issue in modern oncology. In some cases, rectal cancer requires combined treatment, that is, a combination of surgical, radiation and chemotherapeutic methods, the choice of stages and volume of which
Radiation therapy is mainly carried out at the preoperative stage, in cases of significant locoregional (local) spread of the tumor, in order to reduce its size and increase the radicality of the upcoming operation. Radiation therapy for rectal cancer is carried out when the tumor is localized in the middle and lower ampullar sections of the rectum. When the tumor is localized in the upper ampullar and/or rectosigmoid section of the rectum, radiation therapy is not carried out. depends on the stage of the disease.
Chemotherapy can be administered both at the preoperative stage, in order to reduce the size of the primary tumor, reduce the size of existing metastases, and in the postoperative period, in cases where the examination of the material removed during surgery reveals lymph nodes with tumor metastases (regional metastases). Another reason for prescribing chemotherapy is the presence of distant metastases.
But in any case, surgery is the main stage of treatment.
Chemotherapy can be administered both at the preoperative stage, in order to reduce the size of the primary tumor, reduce the size of existing metastases, and in the postoperative period, in cases where the examination of the material removed during surgery reveals lymph nodes with tumor metastases (regional metastases). Another reason for prescribing chemotherapy is the presence of distant metastases.
But in any case, surgery is the main stage of treatment.
Stage IV rectal cancer is when cancer has spread to other organs (distant metastases), regardless of the size of the primary tumor and the presence or absence of affected regional lymph nodes.
Treatment options for this stage vary from case to case and depend primarily on the extent of the disease.
If there is a possibility of complete removal of both the primary tumor and its metastases (for example, single metastases in the liver and/or lungs), the following treatment options are possible:
1. Extensive combined surgery with resection of the rectum and removal of metastases in any organ, followed by chemotherapy, or
2. Preoperative chemotherapy followed by surgery to remove the tumor and its metastases and postoperative massive chemotherapy, or
3. Preoperative chemoradiation therapy, then surgery, and then even more powerful postoperative chemotherapy.
These options can significantly prolong life, and in some rare cases even cure cancer. If rectal cancer cannot be removed surgically, the main treatment option is chemotherapy.
Treatment
Treatment of rectal cancer is a pressing issue in modern oncology. In some cases, rectal cancer requires combined treatment, that is, a combination of surgical, radiation and chemotherapeutic methods, the choice of stages and volume of which
Radiation therapy is mainly carried out at the preoperative stage, in cases of significant locoregional (local) spread of the tumor, in order to reduce its size and increase the radicality of the upcoming operation. Radiation therapy for rectal cancer is carried out when the tumor is localized in the middle and lower ampullar sections of the rectum. When the tumor is localized in the upper ampullar and/or rectosigmoid section of the rectum, radiation therapy is not carried out. depends on the stage of the disease.
Chemotherapy can be administered both at the preoperative stage, in order to reduce the size of the primary tumor, reduce the size of existing metastases, and in the postoperative period, in cases where the examination of the material removed during surgery reveals lymph nodes with tumor metastases (regional metastases). Another reason for prescribing chemotherapy is the presence of distant metastases.
But in any case, surgery is the main stage of treatment.
Chemotherapy can be administered both at the preoperative stage, in order to reduce the size of the primary tumor, reduce the size of existing metastases, and in the postoperative period, in cases where the examination of the material removed during surgery reveals lymph nodes with tumor metastases (regional metastases). Another reason for prescribing chemotherapy is the presence of distant metastases.
But in any case, surgery is the main stage of treatment.
Our hospital provides combined treatment for malignant tumors of the rectum. It includes:
Surgical treatment:
Traditional (open) surgeries
Laparoscopic surgeries
Transanal endoscopic microsurgery
Laparoscopic surgeries
Transanal endoscopic microsurgery
Chemotherapy treatment:
Preoperative (neoadjuvant) chemotherapy
Postoperative (adjuvant) chemotherapy
Postoperative (adjuvant) chemotherapy
Our contacts
+7 777 825 18 18
oncobiomedical@gmail.com
Almaty, Abdulla Rozybakiev street, 33A
oncobiomedical@gmail.com
Almaty, Abdulla Rozybakiev street, 33A
