Our Approach
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.
Rectal cancer often does not have symptoms in the early stages. When it does have symptoms, they vary from person to person. Most rectal cancers begin as polyps, small non-cancerous growths on the rectum wall that can grow larger and become cancer.
Symptoms of rectal cancer may include:
- Rectal bleeding
- Blood in the stool or toilet after a bowel movement
- Diarrhea or constipation that does not go away
- A change in size or shape of your stool
- Discomfort or urge to have a bowel movement when there is no need
- Abdominal 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. But if you notice one or more of these signs for more than two weeks, see your doctor.
Finding rectal cancer early greatly increases your chance for effective treatment. If diagnosed early, many rectal cancers can be treated successfully.
At MD Anderson, our specialists have remarkable expertise and skill in diagnosing rectal cancers. And they use the most advanced equipment and techniques to help them customize the best treatment for you. We are one of the leading centers in advanced rectal MRI evaluation and virtual colonoscopy (also called CT or computed tomography colonoscopy).
Rectal Cancer Diagnosis
If you have symptoms that may signal rectal cancer, your doctor will examine you and ask you questions about your health; your lifestyle, including smoking and drinking habits; and your family medical history.
One or more of the following tests may be used to find out if you have rectal cancer and if it has spread. These tests also may be used to find out if treatment is working.
Digital rectal exam: The doctor inserts a gloved finger into the rectum to feel for polyps or other problems.
Fecal occult blood test (FOBT): This take-home test looks for blood in stool. A stool sample is examined for traces of blood not visible to the naked eye.
Fecal immunochemical test (FIT): This take-home test detects blood proteins in stool.
Endoscopic tests, which may include:
Proctoscopy: A thin, tube-like instrument (proctoscope) is inserted into the rectum. This lets the doctor view the rectum. Suspicious tissue or polyps can be biopsied (removed) for examination.
Sigmoidoscopy: Flexible plastic tubing with a camera on the end (sigmoidoscope) is inserted into the rectum. This gives the doctor a view of the rectum and lower colon. Suspicious tissue or polyps can be biopsied (removed) for examination. The tumor can be marked to help the doctor do minimally invasive surgery. Also called flexible sigmoidoscopy or flex-sig.
Colonoscopy: A colonoscope is a longer version of a sigmoidoscope. Doctors use it to look at the entire colon.
Endoscopic ultrasound (EUS): An endoscope is inserted into the body. A probe at the end of the endoscope bounces high-energy sound waves (ultrasound) off internal organs to make a picture (sonogram). Also called endosonography.
Imaging tests, which may include:
- CT or CAT (computed tomography) scan
- MRI (magnetic resonance imaging) scan
- PET/CT (positron emission tomography) scan
- Virtual colonoscopy or CT (computed tomography) colonoscopy: A scope is not put into the rectum, and you do not have to be sedated.
- Double contrast barium enema (DCBE): Barium is a chemical that allows the bowel lining to show up on X-ray. A barium solution is given by enema. Then a series of X-rays are taken.
Blood test for carcinoembryonic antigen (CEA): This blood test looks for CEA, a tumor marker made by most rectal cancers. It also can be used to measure tumor growth or find out if cancer has come back after treatment.
Our Treatment Approach
Your care for rectal cancer is customized by a team of experts with incredible expertise and experience. We work together to provide the most advanced, least invasive therapy, while focusing on your quality of life. Your treatment team may include:
- Oncologists
- Surgeons
- Radiation oncologists
- Gastroenterologists
- Genetics specialists
- Gynecologists
- Specially trained nurses, ostomy nurses, nutritionists and social workers
Our doctors have special expertise in treating hereditary types of rectal cancer, as well as rectal cancer that has metastasized (spread) to other parts of the body or has returned being treated. Advanced genetic testing allows us to personalize your treatment for rectal cancer and determine if you or any of your family members may be at risk for other cancers.
Rectal Cancer Screening
Cancer screening exams are important medical tests done when you're healthy and don't have symptoms. They help find cancer at its earliest stage, when the chances for successful treatment are best.
When it is detected very early, rectal cancer has a greater than 90% chance for successful treatment. That's why you should be screened regularly.
MD Anderson recommends the following screening guidelines for people at average risk with no colorectal cancer symptoms:
Beginning at age 50, men and women should follow ONE of these screening schedules:
Colonoscopy every 10 years
Virtual colonoscopy (also known as CT colonography) every five years. A colonoscopy will be performed if polyps are found. If you choose a virtual colonoscopy, check with your insurance provider before scheduling an exam. Not all insurance providers cover the cost of this exam.
Fecal occult blood test (FOBT) every year. This take-home test finds hidden blood in the stool, which may be a sign of cancer. A colonoscopy will be performed if blood is found.
Review your screening colonoscopy report and note what was found, including:
- Number of polyps
- Type of each polyp
- Size of each polyp
To get a copy of your colonoscopy report, call the clinic or doctor who did the test. Ask for both the colonoscopy and pathology reports. Share this information with your doctor at your next check-up. The doctor will use this information to decide if your chances of getting colon cancer are higher than normal.
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