Rectal Cancer

Why choose Henry Ford for rectal cancer care?

At our comprehensive rectal cancer care program, you’ll find:

• Nationally accredited rectal cancer tumor board: Henry Ford is one of only 69 hospitals in the nation recognized by the National Accreditation Program for Rectal Cancer (NAPRC). NAPRC accreditation highlights our multidisciplinary approach and evidence-based methods for treating rectal cancer. A team of colorectal cancer experts, including surgeons, medical oncologists, radiation oncologists and pathologists, reviews your case and collaborates on your care plan.
• Focus on quality of life: We tailor rectal cancer treatment to your age, lifestyle and preferences. For example, we may treat rectal cancer without radiation therapy to reduce the risk of pain and sexual side effects. Or we may recommend a longer course of radiation therapy, which can reduce (or eliminate) the need for invasive surgery. You and your doctor work together to select the right therapies for your needs.
• Sphincter-sparing surgery: Our colon and rectal surgeons use the least invasive techniques possible to remove rectal cancer while preserving bowel function. We specialize in transanal, laparoscopic and robotic techniques, which reduce the risk of damage to nerves and tissues that control how you have bowel movements. Most people we treat for rectal cancer do not need a permanent colostomy after surgery.

What is rectal cancer?

Rectal cancer is caused by cancerous (malignant) cells that grow in the tissues of the rectum. The rectum is the tube that connects your colon to your anus. It is the last part of your large intestine.

Sometimes, we talk about rectal cancer and colon cancer together using the term colorectal cancer. The rectum and colon are both part of your lower gastrointestinal tract. Although these organs are close together, treatment is different depending on where the cancer is located. That’s why it’s so important to get a diagnosis from a team that has experience differentiating colon and rectal cancers.

Rectal cancer is not as common as colon cancer but is more likely to:

• Affect bowel, urinary and sexual function
• Come back after treatment (recur)
• Spread (metastasize) to surrounding tissues and organs

What are rectal polyps?

Rectal polyps are abnormal growths in the lining of your rectum. Polyps can be benign (noncancerous), precancerous (potential to turn into cancer) or malignant (cancerous). Most rectal cancers start as polyps, but most polyps aren’t harmful. You may have rectal polyps but not cancer.

We find and remove rectal polyps during a colorectal cancer screening exam called a colonoscopy. A pathologist examines a sample from the polyp under a microscope and looks for signs that it is precancerous or cancerous. Removing precancerous polyps can prevent rectal cancer.

What are the symptoms of rectal cancer?

Symptoms of rectal cancer can be similar to those of common conditions such as hemorrhoids or inflammatory bowel disease. However, don’t ignore symptoms. Talk to your doctor right away if you notice anything unusual. Rectal cancer is curable if we find and remove it early.

Signs of rectal cancer can include:

• Blood in your stool or bleeding from your rectum
• Changes in bowel habits, such as constipation, diarrhea or narrow stools
• Decreased appetite and unexplained weight loss
• Nausea or vomiting
• Pain, cramping, gas or bloating in your abdomen
• Pressure in your abdomen that isn’t relieved by a bowel movement
• Tiredness

What increases the risk of rectal cancer?

Some people are at a higher risk of developing rectal cancer. Risk factors include:

• Age: Most cases of rectal cancer occur in people over 50.
• Family history: Having a parent or sibling with rectal cancer increases your risk.
• Inflammatory bowel disease: Having ulcerative colitis or Crohn’s disease for more than eight years increases your risk of rectal cancer and colon cancer.
• Inherited diseases: Genetic syndromes such as Lynch syndrome and familial adenomatous polyposis increase your risk of rectal cancer.
• Lifestyle: Smoking, heavy drinking, a poor diet, being overweight and not exercising increase your risk of rectal cancer.
• Race: For unknown reasons, rectal cancer is more common in Black men and women.
• Rectal polyps: A history of rectal polyps makes you more likely to develop rectal cancer.

How is rectal cancer treated?

We treat rectal cancer with chemotherapy, radiation therapy and surgery. A combination of chemotherapy and radiation therapy before surgery can shrink the tumor and allow us to do less invasive surgery. Minimally invasive procedures lower the chances of needing a temporary or permanent colostomy.

In some cases, we can eliminate radiation therapy before rectal cancer surgery. Skipping radiation therapy lowers the risk of side effects such as sexual dysfunction, infertility or problems with urination and bowel movements. We work together to select treatments with the least impact on your quality of life.

Colon and rectal surgeons at Henry Ford specialize in sphincter-sparing surgeries and other techniques that preserve rectal function. We offer:

• Transanal endoscopic microsurgery (TEM): We insert a scope and surgical tools through your anus to remove early-stage rectal cancer. TEM is similar to a colonoscopy, so you don’t have an incision in your abdomen.
• Low anterior resection (LAR): We may remove part of your rectum to treat larger tumors. Your surgeon reconnects the remaining part of your rectum to your colon, so you still have normal bowel movements. We may do LAR using open or minimally invasive techniques.
• Total mesorectal excision (TME): We remove the entire rectum along with the tissues and lymph nodes around it. In some cases, we perform this procedure through your anus, called transanal total mesorectal excision (TaTME). We are the first and only program in Michigan to offer TaTME.

We also offer complex combination surgeries if you have rectal cancer that has spread to your lungs or liver. Surgeons from multiple specialties work together to remove metastatic cancer during a single procedure.

Can I avoid a colostomy bag after rectal cancer surgery?

At Henry Ford, the expertise of our colon and rectal surgeons means that many patients will not need a permanent colostomy bag after rectal cancer surgery. In most cases, we can successfully reconnect sections of your bowel so that you can use the bathroom normally.

However, you may need a temporary colostomy following treatment. We direct the remaining part of your large intestine to a surgically created opening in your abdomen. A colostomy bag attached to your abdomen collects stool. Some people have a temporary colostomy to allow their bowel to heal after surgery. We can often do a reversal procedure after several months. Our patients also benefit from the expertise of specialized ostomy nurses at our outpatient ostomy clinic.