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Approximately 50,000 new rectal cancers are diagnosed each year in the United States. Each patient is treated differently and consultation with a colon and rectal surgeon is very important to determine which treatment is best for you. Cancers may arise in either the anus or rectum and it is important to make a distinction about the site of origin, because treatments are different.
Once rectal cancer is found (usually with a colonoscopy), additional testing is performed with a CT scan. Often a rectal ultrasound is performed as well. The CT scan is a special type of X-ray that checks your other organs to ensure that the cancer has not spread. The ultrasound determines how deep the cancer has penetrated into the rectal wall and whether there are enlarged lymph nodes outside of the rectum inside your pelvic area. Lymph nodes are small structures located throughout our bodies that act as filters for the bloodstream. These nodes are the first site cancer cells may travel to when they leave the original site. After these tests have been completed, you will meet with your colorectal surgeon to plan treatment.
Early tumors may be treated with conservative surgery that involves removing the tumor through the anus. Whether or not you are a candidate for this type of surgery is best determined by the surgeon. Cancers that have penetrated deeply into the wall of the rectum or have enlarged lymph nodes seen on an ultrasound or CT are first treated with radiation and chemotherapy to shrink the tumor. This treatment lasts about 6 weeks. Another 6 weeks are then spent allowing your body to recover and then surgery is performed. Again, consultation with your colorectal surgeon is important to learn all about the operation and what you should expect during the recovery period. Chemotherapy may be recommended once you recover from the surgery.
One of the most frequently asked questions is "Will I have to wear a bag?" This refers to patients needing a colostomy to eliminate stool. Fortunately, most patients with rectal cancer do not need a permanent colostomy. But a temporary bag might be necessary for some patients to heal safely. Again, this will be determined on an individual basis. Loyola has specially trained nurses who will guide you on how to care for a colostomy and live a normal life without restrictions. You will meet these nurses before the operation and during your hospital stay, and they will be available on an outpatient basis to help you if any problems arise. As expected, most patients wish to avert a colostomy. For this reason you should choose a highly skilled colorectal surgeon, such those with the experience of Loyola surgeons. Loyola’s surgeons, who are widely known for their expertise, teach and train other surgeons.