Rectal Cancer

By | June 8, 2022

Malignant tumors that develop in the rectum are called rectal cancer or rectal carcinoma. Colon cancer is one of the colorectal carcinomas, which in Germany is the second most common type of cancer in both men and women.

What is rectal cancer?

Colon cancer is the collective term for all malignant tumors of the colon. The rectum is a part of the rectum and thus also part of the large intestine. It is the approx. 15-18 cm long section of intestine between the sigmoid colon and the anal canal. For rna – ribonucleic acid, please visit

It is used to store intestinal contents until the next defecation and is lined with intestinal mucosa, which differs significantly from that of the upstream sections of the large intestine. Cancer of the rectum (rectal carcinoma) can be distinguished from cancer of the colon (colon carcinoma), although both types of cancer are similar and are therefore often summarized under the term colorectal carcinoma.


Cancer of the rectum usually develops as an adenocarcinoma, ie the tumor develops from glandular tissue. The tumor cells multiply uncontrollably and without regard to the surrounding tissue. As with other types of cancer, mutations are also responsible for the uncontrolled division of the tumor cells in rectal cancer.

In about 95% of cases, the fatal gene mutations occur sporadically, only in 5% are they of a hereditary nature. It is assumed that rectal cancer only develops into malignant cancer after several benign preliminary stages. The precursors are called colon adenomas or polyps and can exist as benign growths for years before they degenerate.

Symptoms, Ailments & Signs

Colon cancer often does not cause any clear symptoms at the beginning. As the disease progresses, the tumor can cause stomach cramps and constipation or an intestinal blockage. The constant pain is usually accompanied by reduced performance and exhaustion. Sufferers generally feel very fatigued, with fatigue increasing as the disease progresses.

Loss of appetite usually occurs, which can lead to weight loss. Colon cancer is manifested by visible bleeding from the anus and painful bowel movements. Bowel habits can change for no apparent reason. These signs are accompanied by general symptoms such as fever and an increasing feeling of being unwell.

Symptoms of rectal cancer develop gradually, often over several years, and get worse over time. In the advanced stage, chronic stomach pain sets in. Patients also develop intolerance to certain foods, particularly meat, spicy foods, alcohol, and coffee.

If the cancer is not treated, it will continue to progress and cause serious complications. Untreated cancer is usually fatal. First, the physical condition decreases sharply and the person concerned becomes bedridden, which leads to further health problems.

Diagnosis & History

Colorectal carcinoma is one of the most common cancers in Germany. The annual number of new cases is 20 to 40 per 100,000 inhabitants, with the peak incidence occurring in the 6th and 7th decade of life.

Older insured persons are entitled to colonoscopies and stool tests at regular intervals for early detection. In addition, symptoms such as blood in the stool, a noticeable change in bowel movements, pain, weight loss and exhaustion can lead the patient to see a doctor. The history and current symptoms are used for diagnosis.

The diagnosis is confirmed by a colonoscopy, during which biopsies are also taken. A pathologist then examines the tissue sample to differentiate between benign and malignant growths. X-ray contrast enemas, computed tomography or ultrasound examinations can be further instrument -based examinations.

If the diagnosis of rectal cancer is confirmed, the tumor stage must be determined. For this purpose, it is checked how deep the tumor cells have penetrated into the intestinal wall and whether they have already metastasized to neighboring organs or lymph nodes or even to distant structures such as the liver or lungs.


Colon cancer initially causes digestive problems and severe pain. Typical complications are intestinal obstruction due to the tumor and subsequent perforation of the intestinal wall. This can lead to peritonitis with life-threatening sepsis. Sometimes the cancer spreads to neighboring organs (bladder, vagina, liver) or squeezes vital blood vessels.

This can lead to tissue necrosis, i.e. infarction and death of the intestine or the surrounding organs. Far advanced rectal cancer often forms metastases. These can affect the liver and cause coagulation disorders, edema and inflammation. Ultimately, liver failure occurs and the patient dies as a result. Wound infection, bleeding and pain can occur after colorectal cancer surgery.

A temporary bowel failure can lead to intestinal paralysis and subsequent digestive problems. In addition, a so-called anastomotic insufficiency can occur, in which the seam between two ends of the intestine is leaky. Occasionally, complications such as digestive problems, incontinence, and bladder and sexual dysfunction remain permanent. On the other hand, complications caused by the prescribed drugs (eg side effects, allergic reactions, interactions) usually do not last long.

When should you go to the doctor?

Persistent or increasing digestive problems should be clarified by a doctor. If you experience repeated discomfort with a bowel movement, this should be discussed with a doctor. If you feel tired, lose your appetite or feel exhausted, you should consult a doctor. Rapid fatigue when performing everyday and light physical tasks is a concern. If this condition occurs despite a restful night’s sleep, a doctor is needed. If you experience unwanted weight loss, a deterioration in general performance or stomach problems, you should see a doctor. Pain in the upper abdomen or in the intestines, a general feeling of illness and a feeling of being unwell should be examined and treated by a doctor.

Discomfort when going to the toilet, bleeding from the intestines and pain in the anus are also signs of an existing irregularity. A doctor’s visit is necessary so that the cause can be clarified. Fever, social withdrawal, irritability, and a decrease in well-being indicate impaired health. Since rectal cancer can be fatal if left untreated, a doctor’s visit should be made as soon as the first discrepancies arise. If the symptoms increase in scope and intensity, we urgently recommend consulting a doctor. If you have an intolerance to food, spicy food, caffeinated drinks or alcohol, you should consult a doctor.

Treatment & Therapy

Treatment planning for rectal cancer depends on various aspects, including the size and extent of the tumour, the degree of metastasis and the general condition of the patient. In most cases, treatment begins with surgical removal of the tumor tissue from the intestine. Nowadays, a natural stool passage can often be maintained. If the sphincter has to be removed, an artificial colon outlet (so-called colostomy) is created. Chemotherapy or radiation therapy is used after surgery to kill remaining tumor cells and prevent recurrence.

These can also be indicated as palliative therapy if a cure is no longer possible but the life expectancy and/or quality of life of the patient can still be improved. Even in patients with a good prognosis, careful tumor follow-up care is essential: regular follow-up checks should be carried out up to 5 years after successful tumor resection. The 5-year survival rate for rectal cancer is 40 to 60%.

Outlook & Forecast

The stage of the disease at the time of diagnosis is decisive for the chances of recovery and survival. If no metastases have formed, there is a good chance of healing. About three quarters of such patients are still alive five years after the start of therapy. Significantly poorer prospects result from metastasis in the lungs or liver. Such forms can no longer be successfully remedied.

Like many tumor diseases, rectal cancer carries a high risk of recurrence. If you want to live a life-long symptom-free life, you cannot avoid regular follow-up care. The life-threatening tumors develop when the original tumor has not been completely removed. The experience and skill of the surgeon therefore have a decisive influence on the prognosis.

The risk of disease increases significantly with age. Most patients are 60 and older at the time of diagnosis. Long-term smokers are strikingly often found among them. People with a strong history of alcohol are also occasionally encountered. In total, about 30 out of 100,000 inhabitants develop rectal cancer every year. Refraining from treatment proves to be a serious mistake. Because the disease is constantly progressing. The infestation of vital organs can no longer be stopped if the diagnosis is made late.


Advanced age is a major risk factor for rectal cancer. But there are also risk factors that can be influenced: Long-term smoking significantly increases the risk of developing the disease.

A high consumption of red meat is also suspected of increasing the risk of colon cancer. The consumption of fish and roughage, on the other hand, is said to have a protective effect, as is an adequate supply of vitamin D, which can be ensured through food or sufficient exposure to the sun. Preventive medical check-ups also help: early detection and preventive removal of polyps can help prevent them from developing into rectal cancer. Especially people with known cases of colorectal cancer in the family history should take advantage of the early detection examinations.


After the actual treatment of rectal cancer, those affected need ongoing care. In addition to regular medical examinations and the use of other therapies, a change in lifestyle is also part of the aftercare. Those affected must now restore their quality of life.

The support of the responsible doctors as well as acquaintances and friends is also important when dealing with the illness. Those affected can consult cancer counseling centres, psycho-oncologists, or it may help to visit a self-help group to exchange information. Visiting a self-help group is also an important part of aftercare.

The aftercare plan is drawn up together with the doctor and is based on the symptoms, the general course of the disease and the prognosis. In the first phase, when patients are still processing the consequences of the disease and treatment, aftercare is particularly important. The key is to support patients until remission is achieved.

The risk of recurrence decreases every year. The rule of thumb is five years, although the stage of the cancer is also important. Medical rehabilitation may also include taking anti-hormones and other medications. In the case of protracted illnesses, follow-up checks and aftercare go hand in hand. The details of aftercare are discussed at the discharge interview or at a separate appointment. The further course of rectal cancer depends very much on the time of diagnosis, so that no general prediction can be made.

You can do that yourself

Dealing with cancer is particularly challenging in everyday life. Contacting self-help groups can be helpful. Sick people can exchange information here in an anonymous setting and give each other tips on how to overcome various challenges. It is very unlikely that the disease will be cured without medical care. Therefore, cooperation with the treating doctor is very important.

In individual cases, there are reports that the symptoms have been alleviated by changing one’s lifestyle. However, there is no proven and statistically verifiable method. A healthy lifestyle helps to improve general well-being. The diet should be balanced and wholesome. It is particularly important to take in plenty of dietary fiber, vitamins and minerals. Despite a loss of appetite or nausea, it is important to ensure that you eat enough food. The consumption of pollutants and toxins such as nicotine, alcohol and drugs should always be avoided.

Relaxation techniques are recommended for mental support and stabilization of the psyche. Yoga, meditation, autogenic training or Qi Gong are the methods that are used most frequently. If health permits, physical activity can be promoted by sufficient movement. Walks or light exercises to strengthen the muscles promote well-being. At the same time, a heavy load on the organism should be avoided.

Rectal Cancer