Colon cancer develops in the large intestine (colon), the lower part of your digestive system. Rectal cancer develops in the rectum, which makes up the last several inches of your intestinal tract. Together, they're referred to as colorectal cancers.
Rectal cancer begins as small clumps of cells called polyps. Although most polyps are noncancerous (benign), some become cancerous over time. Regular screening to find and remove precancerous polyps can prevent rectal cancer from developing. Changes in your diet and lifestyle — such as healthy eating and increasing your physical activity — can help prevent polyps from forming, greatly reducing your risk of rectal cancer.
- Experience and expertise. As one of the nation's leading centers for screening and treatment of colon and rectal cancers, Mayo Clinic performs more than 20,000 colonoscopies and hundreds of virtual colonoscopies each year. Mayo Clinic led the way in studying and using virtual colonoscopy and was one of the first to offer it for routine care.
- Multispecialty team. At Mayo Clinic, specialists in medical oncology, gastroenterology, radiation oncology, colon and rectal surgery, radiology, medical genetics, nutrition, and other areas work together to ensure that you receive comprehensive care. Experienced and caring staff also provide support services for you and your family before, during and after treatment.
- Advanced screening techniques. Advances in screening techniques, some of which were pioneered at Mayo Clinic, make early diagnosis possible.
- Minimally invasive techniques. At Mayo Clinic, almost all colorectal surgeries are performed using minimally invasive (laparoscopic) surgery. An advanced procedure called robotic surgery gives surgeons a degree of precision and control that can't be achieved with standard laparoscopic techniques. This typically results in a shorter hospital stay, a faster, less painful recovery, and preservation of normal bowel, bladder and sexual function. Mayo colorectal surgeons are among the nation's most experienced and successful in these types of techniques.
- Comprehensive cancer center. Mayo Clinic Cancer Center meets strict standards for a National Cancer Institute comprehensive cancer center, recognizing scientific excellence and a multispecialty approach focused on cancer prevention, diagnosis and treatment.
Rectal cancer often doesn't cause symptoms in the early stages. The most common signs of the disease include:
- Rectal bleeding
- Changes in appetite and the frequency, consistency or size of bowel movements
- Unintended weight loss
- Extreme tiredness
Although many rectal cancers develop for reasons that aren't well understood, certain factors increase your risk, including:
Mayo Clinic in Rochester, Minn., and Mayo Clinic in Scottsdale, Ariz., are ranked among the Best Hospitals for cancer by U.S. News & World Report. Mayo Clinic in Jacksonville, Fla., is ranked high performing for cancer by U.S. News & World Report.
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At the Colorectal Neoplasia Clinic at Mayo Clinic in Arizona, specialists in medical oncology, gastroenterology, radiation oncology, colon and rectal surgery, radiology, medical genetics, nutrition, and other areas as needed work together to treat your rectal cancer and provide comprehensive and supportive care.
For appointments or more information, call the Central Appointment Office at 800-446-2279 (toll-free) 8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday or complete an online appointment request form.
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At the Gastrointestinal Neoplasia Interest Group at Mayo Clinic in Florida, specialists in medical oncology, gastroenterology, radiation oncology, colon and rectal surgery, radiology, medical genetics, nutrition, and other areas as needed work together to treat your rectal cancer and provide comprehensive and supportive care.
For appointments or more information, call the Central Appointment Office at 904-953-0853 8 a.m. to 5 p.m. Eastern time, Monday through Friday or complete an online appointment request form.
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The Colorectal Neoplasia Interest Group at Mayo Clinic in Minnesota specializes in colorectal cancer. Mayo Clinic specialists in medical oncology, gastroenterology, radiation oncology, colon and rectal surgery, radiology, medical genetics, nutrition, and other areas as needed work together to treat your rectal cancer and provide comprehensive and supportive care.
For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.
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See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.
Regular screening and removal of precancerous polyps are crucial to preventing rectal cancer. Screening increases the likelihood of finding and treating cancer in its earliest stage, when the cure rate is high. Mayo Clinic uses the screening and diagnostic tests below. In tests that involve radiation, specialists carefully monitor doses to avoid the risk of radiation overexposure.
- Colonoscopy. Colonoscopy is generally considered the best screening and diagnostic test for rectal cancer. If your doctor discovers small polyps during the exam, they are usually removed immediately. Large polyps and tumors require surgical removal. In such cases, the doctor can mark them during colonoscopy to help guide future surgery.
- Sigmoidoscopy. For this exam, doctors use a flexible, fiber-optic tube to examine your rectum and sigmoid colon — the last two feet (61 centimeters) of the large intestine. A sigmoidoscopy can detect rectal polyps and cancer, but it can't identify problems higher in your colon.
- Virtual colonoscopy. A minimally invasive alternative to traditional colonoscopy, virtual colonoscopy uses a CT scanner to detect polyps, but polyps can't be removed during this test. If polyps are found during the procedure, your doctor can perform a traditional colonoscopy to remove them the same day or next day.
- Probe-based laser confocal endomicroscopy. The confocal laser endomicroscopy probe system enables experts to analyze colon polyps during colonoscopy instead of in the lab. A miniature microscope probe can provide the same level of detail that a pathologist sees during analysis under a lab microscope. This means that your doctor can target removal of only cancerous or precancerous polyps, sparing you unnecessary procedures.
- DNA stool tests. Colon polyps and cancers continuously shed mutated cells that eventually make their way into stool. Analyzing these cells for genetic mutations may detect polyps and early-stage cancers. Although not yet widely used, this test is likely to become more common in the future.
- Staging tests. Identifying the extent and spread of the disease is essential for choosing the best treatment for you. Staging tests, such as computerized tomography (CT), positron emission tomography (PET) scan and X-rays help your doctor determine how deeply the cancer has invaded the colon wall and whether it spread to nearby lymph nodes or organs. Your doctor may perform a colonoscopy and endoscopic ultrasound of the rectum, mark the location of a lesion, and then perform an ultrasound-guided fine-needle aspiration of any suspicious lymph nodes.
Read about colonoscopy, virtual colonoscopy, endoscopy, ultrasound, PET scan and CT scan.
Treatment for rectal cancer varies, depending on how large the tumor has grown, how deeply it has invaded the wall of the rectum, and whether it has spread to the lymph nodes or other organs. At Mayo Clinic, a dedicated team of colorectal specialists works together to develop a comprehensive, personal treatment plan for you. Options include:
- Surgery. At Mayo Clinic, surgeons perform most colorectal cancer surgeries using minimally invasive (laparoscopic) surgery. Depending on the location and progression (stage) of your cancer, it may be treated with surgery alone or require a temporary or permanent colostomy — a small opening in your abdomen for eliminating waste. Mayo Clinic colorectal surgeons specialize in procedures that help avoid the need for a colostomy and preserve the nerves that are essential for normal sexual and urinary functioning.
- Robotic surgery. Surgeons at Mayo Clinic in Minnesota increasingly use robotic surgery to treat rectal cancer. The robotic system is particularly helpful in treating cancers located close to the anus. Using robotic surgery, surgeons can often preserve the sphincter muscle as well as normal sexual and urinary function.
- Chemotherapy and radiation therapy (chemoradiation). When rectal cancer has spread into surrounding tissue or lymph nodes, Mayo Clinic specialists recommend radiation therapy and chemotherapy before surgery to help shrink the tumor, making it easier to perform the delicate surgery that preserves sphincter muscle and vital nerves. You may also receive chemoradiation after surgery, especially if cancer has spread to your lymph nodes. Chemotherapy drugs make cancer cells in the rectum more sensitive to radiation. Advanced technologies such as image-guided radiation therapy and intensity-modulated radiation therapy target tumors with great precision and reduce the chance of damage to nearby organs and bones.
- Intraoperative radiation therapy. An innovative treatment called intraoperative radiation therapy (IORT) is used to treat locally advanced or recurrent rectal cancer. IORT is effective for tumors that the surgeon can't completely remove. If you receive IORT, you'll also receive a course of external beam radiation therapy combined with chemotherapy before surgery.
- Lifestyle counseling. To help prevent colon polyps and colorectal cancers, Mayo experts can advise you on lifestyle issues such as improving your food choices, drinking alcohol in moderation (if at all), getting regular exercise and quitting smoking.
Mayo Clinic is a leader in developing colorectal cancer screening procedures and investigating new drugs or combinations of drugs to prevent the spread or recurrence of cancer. Mayo is a member of the Alliance for Clinical Trials in Oncology, a national clinical research group that conducts top-quality trials aimed at controlling, treating and preventing cancer. Areas of research include:
- New diagnostic approaches, such as testing DNA in the stool
- New treatments, such as combination therapies
- Environmental and genetic risk factors
- New clinical pathways for molecular testing to identify people with young-onset colorectal cancer syndrome
- Testing the effectiveness and safety of new technology for minimally invasive surgical procedures for colorectal cancer
- Measurement of quality of life after surgery for colorectal cancer
- Early recognition of young-onset colorectal cancer to improve outcomes
See a list of publications by Mayo doctors on rectal cancer on PubMed, a service of the National Library of Medicine.
Jun. 27, 2013