Rectal Cancer

Being diagnosed with colorectal cancer can be scary and intimidating. Here at Colorectal Surgery Associates, we focus on treating your condition with the most cutting-edge standard of care so that you experience as few functional life changes as possible. Our surgeons perform a high volume of robotic rectal cancer surgery, making us one of the most experienced practices in the region.

What Causes Rectal Cancer?
For most cases, the exact cause of rectal cancer is unclear. Commonly rectal cancers are adenocarcinoma cancers. Certain inherited gene mutations, such as Lynch Syndrome, Familial Adenomatous Polyposis (FAP),and MYH polyposis mutation can increase risk but do not guarantee cancer will develop. Genetic testing can identify these and other inherited syndromes. 99% of all colorectal cancers start as a polyp.

Other risk factors, similar to those for colon cancer, include:

• Obesity, smoking, and alcohol use
• Diets high in fat and refined carbohydrates
• Sedentary lifestyle
• Older age (though rates are rising in people under 50)
• History of inflammatory bowel disease or colon polyps
• Diabetes
• Family history of colon or rectal cancer
• African-American race

Symptoms
Common symptoms include:

• Changes in bowel habits, such as diarrhea or constipation
• Blood in the stool, dark maroon or bright red
• Narrow stool
• Feeling that the bowel doesn’t empty completely
• Abdominal pain, weakness, fatigue, or unexplained weight loss

Diagnosis
Rectal cancer is often detected during routine colorectal screening, such as a colonoscopy. Suspicious areas are biopsied for further analysis. We always order a staging MRI for rectal cancers first. Additional staging studies such as CAT scan, PET scan may be ordered.

Treatment
Treatment depends on the cancer’s stage and location within the rectum. It may include a combination of surgery, chemotherapy, radiation, targeted therapy, or immunotherapy.

• Transanal Local Excision: For early-stage cancers, the tumor can be removed through the anus without abdominal incisions.
• Rectal Resection (low anterior resection): The diseased section of the rectum and nearby lymph nodes are removed, and the healthy ends of the intestine are reconnected.
• Rectal Resection (abdominal perineal resection): The diseased section of the rectum and nearby lymph nodes are removed and a permanent colostomy is created. NOTE: link to colostomy page

Minimally invasive approaches help reduce recovery time and complications:

• Robotic-assisted Surgery: Uses the da Vinci® system for precise, small-incision surgery.
• Laparoscopic Surgery: Uses small incisions and long-handled tools with a camera for guidance.

After surgery, additional treatments such as chemotherapy, radiation, or targeted drug therapy may be recommended to ensure the best outcome.