About Rectal Cancer

About Rectal Cancer

At Penn Medicine, patients with rectal cancer receive their care from a multidisciplinary team of nationally recognized experts in the diagnosis, treatment and research of rectal cancer.

The rectum is a 5-inch structure located at the end of the colon. The rectum is usually empty except when stool is propelled by the upper colon into the rectum just prior to a bowel movement.

Rectal cancer is cancerous tissue that grows along and invades the wall of the rectum. Rectal cancer and colon cancer are very similar and share many common features.  The difference in location creates important differences in how each is treated.   Rectal cancer, like colon cancer, may start as a polyp that becomes cancerous.

Penn Medicine’s multidisciplinary approach to cancer diagnosis and treatment provides better outcomes and gives patients access to the most advanced treatment, surgical techniques and clinical trials.

Because navigating a cancer diagnosis and treatment options can be difficult, patients who wish to connect with a cancer specialist at Penn Medicine can speak with a cancer nurse, who can help them make an appointment with the right physician.

To connect with a cancer nurse at Penn Medicine, patients should call 800-789-PENN (7366).


Rectal Cancer Risk and Prevention

Most risk factors for rectal cancer, like age and family history, cannot be prevented. Patients who feel they are at risk may benefit from consulting with a risk assessment specialist within one of Penn Medicine’s gastrointestinal cancer risk evaluation programs.

Rectal Cancer Risk Factors

Risk factors affect the chance of getting rectal cancer. Having a risk factor, or even several, does not mean that someone will get cancer.

There are different kinds of risk factors. Some factors, like age or race, can't be changed. Some risk factors for rectal cancer include.

  • Age. Most people diagnosed with rectal cancer are age 40 or older.
  • Hereditary conditions. Having certain hereditary conditions such as familial adenomatous polyposis (FAP) and hereditary nonpolyposis colon cancer, HNPCC or Lynch syndrome.
  • Personal history. Having a personal history of colorectal cancer, polyps or, endometrial or ovarian cancer.
  • Family history. Having a parent, brother, sister or child with a history of colorectal or related cancer or polyps.
  • Lifestyle. Studies suggest that being obese, smoking, excessive alcohol intake and eating a diet high in fat and red meat may play a role in rectal cancer development.

Rectal Cancer Prevention

  • Quit smoking. Smoking or chewing tobacco can increase the risk of developing cancer. Patients can get help to stop smoking through Penn Medicine’s Lung Center or through a smoking cessation research program at the Abramson Cancer Center.
  • Control weight. Maintaining a healthy weight with diet and exercise can help prevent cancer. 
  • Get regular colonoscopies. Since most rectal cancers are found during a colonoscopy, it’s important for people who are at risk to get recommended screenings. Also, it is recommended people over the age of 50 get regular screenings.
  • Know your family history. Knowledge of familial risk factors may change the frequency of colonoscopy testing, and lead to better detection of polyps in the precancerous stages. 

In addition to these preventative measures, there are several ongoing studies looking at how vitamins, hormones and other agents may help prevent cancer. Penn Medicine is a leader in cancer prevention. Visit the clinical trials to for available cancer prevention trials. 

Rectal Cancer Risk Assessment

People with a personal or familial history of colorectal cancer, or those with conditions that put them at risk may benefit from consulting with a genetic counselor to determine their risk of developing cancer.

Younger patients who develop rectal cancer sometimes have a family member or close relative who has a history of rectal cancer.

The Gastrointestinal Cancer Risk Evaluation Program at Penn Medicine offer knowledge about the presence of genetic risk factors for rectal cancer and provide patients with important, sometimes life-saving options.

Rectal Cancer Symptoms

Symptoms of rectal cancer may be similar to other conditions. Patients with any of the following symptoms should visit their physician.

  • Change in bowel habits including: diarrhea, constipation, feeling that the bowel has not completely emptied, stools that are narrow in shape
  • Bright red, or dark blood in the stool
  • Abdominal discomfort
  • Change in appetite
  • Losing weight without dieting
  • Fatigue

Staging Rectal Cancer

Staging systems provide doctors with a common language for describing tumors. After cancer is first diagnosed, a series of tests are used to investigate the extent of the cancer and to see whether it has spread to other parts of the body from where it started. Staging is a way of recording the size and growth of a cancer, and determining the plan for treatment. By understanding the stage of their cancer, patients can make informed decisions about their treatment.

Staging cancer attempts to discover the following:

  • The size of the tumor
  • Whether the cancer has spread to nearby tissues or lymph nodes
  • Whether the cancer has spread to other parts of the body

Rectal Cancer Treatment at Penn

After being diagnosed with rectal cancer, patients at the Abramson Cancer Center may be evaluated through the Gastrointestinal Cancer Evaluation Center (GICEC). The center provides patients with expert support and evaluation to discuss treatment options and individualized treatment plans.

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Patients with pancreatic cancer are treated by a multidisciplinary team of cancer specialists who see more patients with gastrointestinal (GI) cancers in one year than many doctors see in their careers.

The physicians of Penn Medicine’s GI cancer program are nationally recognized for their expertise in the diagnosis and treatment of cancer.

Penn’s GI cancer treatment team includes:

  • Nationally recognized medical experts with years of experience in diagnosing and treating GI cancer.
  • Nurses with advanced training and experience in caring for patients with GI cancer.
  • Oncology Navigation Specialists to help patients navigate the health system.
  • Registered dietitians to provide nutrition counseling.
  • Cancer counselors to provide individual or family counseling for issues many cancer patients face.
  • Rehabilitation therapists who specialize in the diagnosis and treatment of physical effects from cancer and its treatment.

Penn’s GI cancer program is also supported by a robust research program with immediate translation from bench to bedside.

Patients at Penn Medicine can benefit from participating in clinical trials. Patients interested in learning more about clinical trials should speak with someone on their treatment team.

Patient navigation Specialists

Every step of cancer treatment; from a cancer diagnosis, to surgery and treatment to forming a survivorship plan; comes with different needs and issues that should be addressed.

Oncology Navigation Specialists at the Abramson Cancer Center are available to make a patient’s experience as seamless as possible. As experts in navigating complex health care situations, patient support specialists serve as a consistent point of contact and a reliable source for advice, support and direction for patients and families. They can help in a variety of ways including; provide emotional support, identify resources, and ensure access to information, support services, educational programs and community resources.

Learn more about Oncology Navigation Specialists at the Abramson Cancer Center.

Diagnosing Rectal Cancer

An accurate cancer diagnosis from trusted cancer specialists is the first step in getting personalized treatment options to treat rectal cancer.

Patients who choose Penn’s Abramson Cancer Center benefit from a multidisciplinary team of cancer specialists including gastroenterologists, radiologists, pathologists and surgeons who work together to provide a diagnosis and treatment plan custom designed for each patient with rectal cancer.

Cancer specialists at Penn Medicine are highly experienced in using the most advanced techniques for diagnosing rectal cancer and are actively researching better and more precise ways to detect rectal cancer.

Because an accurate diagnosis is a critical step in planning cancer treatment, it’s important patients know that when they come to the Abramson Cancer Center, they are taking an important step in getting the best cancer treatment.

Navigating a cancer diagnosis and treatment options can be difficult, patients who wish to connect with a cancer specialist at Penn Medicine can speak with a cancer nurse, who can help them make an appointment with the right person. Penn Medicine’s contact center has experienced cancer nurses available and ready to guide patients in finding the cancer specialist right for them.

To connect with a cancer nurse at Penn Medicine, patients should call 800-789-PENN (7366).

Read more Diagnosing Rectal Cancer

Rectal Cancer Treatments

Following the diagnosis and staging of rectal cancer, cancer specialists at Penn’s Abramson Cancer Center develop a personalized treatment plan. Penn’s treatment options for rectal cancer include:

  • Surgery
    • Local excision via the anus through transanal endoscopic microsurgery (TEM) or endoscopic mucosal resection (EMR)
    • Laparoscopic, robotic-assisted or open excision
    • Pelvic exenteration (removal of other affected organs in the pelvis)
  • Radiation therapy
    • Three-dimensional conformal radiation
    • Intensity-modulated radiation therapy (IMRT)
    • Proton therapy
    • Volumetric-modulated arc therapy
  • Chemotherapy and biologic therapies
    • Chemotherapy
    • Monocolonal antibiody therapy
  • Clinical trials
    • Monoclonal antibody therapy
  • Other treatments
    • Integrative medicine and wellness
    • Palliative care
    • Penn Home Care and Hospice Services

Because navigating a cancer diagnosis and treatment options can be difficult, patients who wish to connect with a cancer specialist at Penn Medicine can speak with a cancer nurse, who can help them make an appointment with the right physician.

To connect with a cancer nurse at Penn Medicine, patients should call 800-789-PENN (7366).

Read more Rectal Cancer Treatments

Rectal Cancer Survivorship

Survivorship programs at Penn Medicine are a distinct phase of cancer care and are designed to help patients' transition from their cancer treatment routine to a post-cancer care lifestyle.

There are more than 12 million cancer survivors living and thriving today as a result of advances in cancer treatment. However, cancer treatments can result in physical, emotional and financial complications long after the therapy is complete.

Read more Rectal Cancer Survivorship


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