Is rectal bleeding an indication of rectal cancer?

Written by Si Li Li
Gastroenterology
Updated on November 24, 2024
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Rectal bleeding is not necessarily colorectal cancer; there are several reasons for rectal bleeding: First, caused by constipation, which leads to difficulty during bowel movements and tearing of the anal mucosa, resulting in bleeding. Second, ulcerative colitis, which commonly presents symptoms such as abdominal pain, diarrhea, and blood and mucus in the stool. Third, rectal or colon cancer, where the main symptoms also include abdominal pain, changes in stool characteristics, and rectal bleeding. Fourth, ischemic bowel disease, generally seen in older patients with some cardiovascular and ischemic diseases, where symptoms mainly include significant abdominal pain and rectal bleeding. Therefore, not all cases of rectal bleeding are due to rectal cancer; there are many causes, and it is essential to diagnose clearly before treatment.

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What are the differences between colon cancer and rectal cancer?

The fundamental difference between colon cancer and rectal cancer lies in their locations of occurrence. Both are collectively referred to as colorectal cancer, which is one of the more prevalent malignancies of the digestive system in China. Colon cancer originates from the mucosa of the colon, while rectal cancer originates from the mucosa of the rectum, with different points of origin. In terms of treatment, there are significant differences between colon and rectal cancer. In surgical treatment, both cancers typically require surgery as the first choice. However, patients with colon cancer can preserve their anus, whereas some patients with low rectal cancer might face situations where anus preservation is not possible. In internal medicine, the chemotherapy drugs used for colon and rectal cancer are quite similar. In terms of radiation therapy, there are notable differences; radiation treatment is generally not included for colon cancer but is an important treatment method for rectal cancer.

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How to differentiate rectal cancer from hemorrhoids

Rectal cancer is a malignant lesion, with clinical symptoms mainly causing an increase in the frequency of bowel movements, changes in stool characteristics such as grooved stools or stools with mucus and pus and blood. Severe patients may experience abdominal pain, weight loss, anemia, and other accompanying symptoms. Generally, low-lying rectal cancer can be seen during a digital rectal examination or with an anoscope. If the cancer is located higher up, an electronic colonoscopy is needed to see the cauliflower-like mass. Hemorrhoids, on the other hand, are benign lesions often caused by improper diet or poor bowel habits, leading to pathological hypertrophy and descent of the anal cushions. They are mostly characterized by intermittent painless rectal bleeding with bright red blood, along with a feeling of heaviness and a foreign body sensation in the anus.

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How long can one live after rectal cancer surgery?

The specific life expectancy after radical resection for rectal cancer varies among individuals and is dependent on various factors including the patient's general and physical condition, pathological staging post-surgery, and whether there are high-risk factors for recurrence such as lymph node metastasis, vascular tumor thrombus, and nerve invasion. The overall five-year survival rate post-surgery is approximately 50%. If the disease is confined to the submucosa and lacks high-risk factors such as vascular tumor thrombus, nerve invasion, or lymph node metastasis, the five-year survival rate after radical surgery can reach up to 90%. However, if post-surgery pathology reveals lymph node metastasis, vascular tumor thrombus, and nerve invasion, among other high-risk factors, the patient's five-year survival rate will decrease. Thus, survival rates are closely related to many factors.

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Could having blood in the stool for five years be rectal cancer?

If there has been blood in the stool for five years, whether it's colorectal cancer or not, this can only be confirmed through a colonoscopy. Furthermore, pathological tissue analysis and biopsy are necessary to make a definitive diagnosis. Pathological examination is the gold standard for diagnosing cancer. If cancerous changes are present, surgical treatment should be undertaken promptly to prevent the spread of cancer cells. If there are no malignant changes, symptomatic treatment measures can be adopted. Conditions such as chronic colitis, ulcerative colitis, or hemorrhoids could also cause blood in the stool.

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Can rectal cancer be cured?

If rectal cancer is detected in its early stages, such as stage I or II, curative surgery can be performed. Postoperative decisions regarding the necessity of adjuvant radiotherapy or chemotherapy are based on the postoperative pathological staging. Early-stage rectal cancer patients can achieve a cure through surgical treatment combined with some postoperative adjuvant therapies. After curative surgery, the overall five-year survival rate is approximately 50%. However, this rate can vary and is associated with several factors such as postoperative pathology, whether there is lymph node metastasis, the presence of vascular tumor thrombi, and nerve invasion, among other high-risk factors for recurrence, showing certain individual differences. Yet, early-stage rectal cancer patients can achieve a cure through these methods.