Rectal cancer is a type of cancer that occurs in the cells in the rectum — the last section of your large intestine.

Rectal cancer is often grouped together with colon cancer, and together they're called colorectal cancer.

Rectal cancer most often begins in the cells that line the inside of the rectum. Rectal cancer often first forms as precancerous polyps.

Colorectal cancer screening tests can discover rectal cancer before it begins or at its earliest stages — when treatment has the greatest chance for success.

Rectal cancer treatment often involves surgery to remove the cancer. Other treatments, such as chemotherapy and radiation therapy, may be used as well.

  • Collaboration. At Mayo Clinic, digestive disease specialists (gastroenterologists) form a multidisciplinary team with colon and rectal surgeons, oncologists, radiation oncologists, pathologists, and radiologists to provide whole-person care for people with rectal cancer. Other professionals are included as needed.
  • Experience. Mayo Clinic doctors have extensive experience caring for people with rectal cancer. Your care team is prepared with the knowledge and resources to provide you with exactly the care you need.
  • Access to minimally invasive treatment options. Mayo Clinic doctors have access to the latest minimally invasive treatment options, including minimally invasive surgery, robotic surgery and endoscopic microsurgery.
  • A full range of treatment options to consider. Mayo Clinic doctors will work with you to review all of your treatment options and choose the treatment that best suits your needs and goals. The range of treatment options available for people with rectal cancer includes many types of surgery, radiation therapy and chemotherapy.
  • Comprehensive cancer center. Mayo Clinic Cancer Center meets strict standards for a National Cancer Institute comprehensive cancer center, which recognizes scientific excellence and a multidisciplinary approach to cancer prevention, diagnosis and treatment.

Mayo Clinic in Rochester, Minn., Mayo Clinic in Jacksonville, Fla., and Mayo Clinic in Scottsdale, Ariz., are ranked among the Best Hospitals for cancer by U.S. News & World Report.

At Mayo Clinic, we assemble a team of specialists who take the time to listen and thoroughly understand your health issues and concerns. We tailor the care you receive to your personal health care needs. You can trust our specialists to collaborate and offer you the best possible outcomes, safety and service.

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Screening for cancer with colon cancer screening tests can also detect rectal cancer. Screening tests may identify rectal cancer before it begins or at its earliest stages, when successful treatment is more likely.

If your doctor suspects you may have rectal cancer or signs of cancer have been detected during a screening test, you may undergo additional tests, such as:

  • Proctosigmoidoscopy. During a proctosigmoidoscopy exam, your doctor uses a long, thin tube equipped with a camera to examine your rectum and the lower part of your colon. This allows your doctor to evaluate the size of your rectal cancer and to collect a sample of cells for laboratory testing.
  • Endorectal ultrasound. Once your rectal cancer is confirmed, your doctor may recommend an ultrasound exam of your rectum. This is done using a thin probe that emits sound waves to create images. An endorectal ultrasound can help your doctor understand how deep the cancer extends into the wall of the rectum.
  • Colonoscopy. During a colonoscopy exam, your doctor uses a long, thin tube equipped with a camera to examine the inside of your rectum and your entire colon. Sometimes colon cancer and rectal cancer can occur at the same time. So your doctor may want to examine all of your large intestine for signs of cancer.
  • Imaging tests to look for cancer spread. Rectal cancer can spread (metastasize) to other areas of the body, such as the liver and the lungs. You may undergo imaging tests to look for signs that cancer has spread, such as an X-ray, CT scan, MRI and positron emission tomography (PET) scan.

Which tests you undergo will depend on your individual situation

Your rectal cancer treatment options depend on the size, stage and location of your cancer, your overall health, and your preferences. Your treatment team will discuss all of your options with you and help you decide which treatment best fits your needs.

Rectal cancer treatment typically involves surgery to remove the cancer. Chemotherapy and radiation therapy also may be used.

Surgery

The goal of surgery for rectal cancer is to remove the cancer and a small amount of the healthy tissue that surrounds it.

For small cancers on the surface of the rectum, surgery may be simple and require no incisions.

For larger cancers, surgery may involve removing all or part of the rectum (proctectomy). In some cases the remaining pieces of your intestine can be rejoined so that you'll expel waste normally. In other cases, your remaining intestine may be connected to your abdominal wall (colostomy), so that waste is collected in a bag on the outside of your body.

Mayo Clinic surgeons specialize in procedures that help avoid the need for a colostomy and that preserve the nearby nerves that are essential for normal bowel, bladder and sexual function.

Surgical approaches used to remove rectal cancer include:

  • Endoscopic surgery. During endoscopic surgery, the doctor uses a long, thin tube equipped with a camera and special tools to remove the rectal cancer. Endoscopic surgery can use cutting tools or lasers to remove small cancers from the surface of the rectum.

    A specialized type of endoscopic surgery called endomicrosurgery uses a high-powered microscope to analyze tissue samples. It allows for more rapid analysis of tissue samples, so that your doctor can be sure all the cancer is removed during surgery.

  • Minimally invasive surgery. During minimally invasive (laparoscopic) rectal cancer surgery, several small incisions are made in your abdomen. Special tools and a camera are inserted through the incisions and allow the surgeon to remove the rectal cancer without making one large incision.

    Minimally invasive surgery may offer a quicker recovery and a shorter hospital stay.

  • Robot-assisted minimally invasive surgery. Robotic surgery is a type of minimally invasive surgery. During robotic surgery, the surgeon sits at a console and uses controls to guide high-tech surgical tools.

    Robotic surgery has the advantage of allowing the surgeon to work more easily in small spaces and gives the surgeon an enhanced view of the area where the operation is taking place.

  • Traditional surgery. During a traditional, open procedure, a single incision is made in your abdomen and allows the surgeon to remove your rectal cancer.

Combined chemotherapy and radiation therapy

Chemotherapy is a drug treatment that uses chemicals to kill cancer cells. Radiation therapy uses high-powered beams, such as X-rays, to kill cancer cells. For certain cancers, such as rectal cancer, undergoing both treatments at the same time enhances the effectiveness of each.

Combined chemotherapy and radiation therapy is sometimes called chemoradiotherapy or radiochemotherapy. This treatment is often used after surgery in people with rectal cancer who have an increased risk of recurrence. For people with locally advanced rectal cancer, it may be used before surgery to shrink the cancer to a more manageable size.

Chemotherapy and radiation therapy may also be used on their own or in combination with surgery.

Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

At Mayo Clinic, digestive disease specialists (gastroenterologists) form a multidisciplinary team with experts in colon and rectal surgery, radiation oncology, oncology, pathology, and radiology to care for people with rectal cancer. Other experts are included as needed.

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.

At Mayo Clinic, digestive disease specialists (gastroenterologists) form a multidisciplinary team with experts in colon and rectal surgery, radiation oncology, oncology, pathology, and radiology to care for people with rectal cancer. Other experts are included as needed.

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.

At Mayo Clinic, digestive disease specialists (gastroenterologists) form a multidisciplinary team with experts in colon and rectal surgery, radiation oncology, oncology, pathology, and radiology to care for people with rectal cancer. Other experts are included as needed.

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.

See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.

Mayo Clinic doctors and scientists are studying new ways to diagnose and treat rectal cancer. Learn more about gastrointestinal cancer research.

Cancer research is conducted in coordination with the Mayo Clinic Cancer Center. The Mayo Clinic Cancer Center receives funding from the National Cancer Institute and is designated as a comprehensive cancer center — recognition for an institution's scientific excellence and multidisciplinary resources focused on cancer prevention, diagnosis and treatment.

See a list of publications by Mayo Clinic authors on rectal cancer on PubMed, a service of the National Library of Medicine.

Feb. 26, 2015