Rectal cancer is a slow growing cancer that occurs in the rectum, at the last part of the large intestine (the colon) and on the internal end of the anal canal. Rectal cancer often starts as an abnormal growth (polyp) that eventually becomes cancerous.

Rectal cancer and colon cancer are often grouped together under the term colorectal cancer. They share some common features, but rectal cancer treatments differ. This is because the rectum is situated near other organs and structures, making cancer removal challenging due to limited space. Rectal cancer symptoms aren’t always obvious early on, which is why it’s important to have regular colorectal screening.

Rectal cancer is treated by specialists who focus on disorders of the colon and rectum, including colorectal surgeons, gastroenterologists, oncologists, and radiation oncologists. Penn Medicine’s Colorectal Cancer Care specialists include nationally and internationally known colorectal surgeons who perform delicate procedures to remove cancer while preserving function.

Types of rectal cancer

There are several types of rectal cancer. Most people diagnosed with rectal cancer have a type called adenocarcinoma. This cancer begins in the glandular cells that produce mucus in the rectum. The mucus helps the stool pass through the rectum and colon.

Other types of rectal cancer are less common:

• Carcinoid tumors
• Gastrointestinal stromal tumors
• Leiomyosarcomas
• Melanomas
• Primary colorectal lymphomas

Recognizing rectal cancer symptoms

Most people with early-stage rectal cancer don’t have symptoms. When there are symptoms, diarrhea, fatigue, abdominal pain, and unexplained anemia can easily be overlooked or mistaken for another, less serious problem.

Sometimes, an irregular bowel movement—like stools that are pencil-thin or bloody—is the only clue that something’s wrong. Changes in bowel habits, such as always having a regular schedule but now frequently feeling constipated or noticing blood in your stool accompanied by abdominal pain, can be signs of rectal cancer.

Screening for rectal cancer

A colonoscopy or other rectal cancer prevention technique can help your doctor detect and treat abnormal cells before they cause obvious symptoms. Before the colonoscopy, you’ll receive medication to help you relax and minimize any discomfort. During the procedure, a gastroenterologist examines the inside of your colon using a thin, flexible tube with a camera attached. This allows them to look for abnormalities such as polyps or signs of cancer. Because some rectal polyps can turn into cancer if left untreated, doctors remove them during a colonoscopy.

Doctors recommend people at average risk of rectal cancer start colorectal screening at age 45. People considered high risk may need more frequent testing or to start at an earlier age. Regular colonoscopies are especially important for people with inflammatory bowel disease, such as ulcerative colitis or Crohn’s disease, since these conditions can increase your risk of colorectal cancer.

Rectal cancer diagnosis and testing

An accurate rectal cancer diagnosis from trusted cancer specialists is the first step in getting personalized treatment options to treat rectal cancer. Penn Medicine offers leading-edge diagnostic tools and tests to diagnose rectal cancer. Our skilled pathologists are highly experienced in using the most advanced techniques for diagnosing rectal cancer, so you can get the right treatment as soon as possible.

Treatment options for rectal cancer

To effectively treat rectal cancer, doctors from different specialties must collaborate to provide complete care. At Penn Medicine, we excel at this treatment approach.

Your team includes nationally-renowned experts in medical oncology, gastroenterology, radiology, pathology, and rectal surgery—coming together to create personalized treatment plans that lead to the best possible outcomes. Our specialists are in constant communication about patients and meet regularly to work through complicated cases.

Why choose Penn Medicine for rectal cancer care?

Our experienced team at Penn Medicine offers thorough, compassionate treatment and support throughout your care journey.

• Skilled surgeons: Our colorectal surgeons are all board-certified and fellowship-trained, with the highest level of surgical education possible. Their specialized expertise in rectal cancer surgery allows them to take on even the most complicated cases and deliver the best possible outcomes.
• Minimally invasive options: We offer laparoscopic and robotic surgeries to treat rectal tumors. These minimally invasive methods make recovery easier and lower complication risks.
• Enhanced recoveries: Our enhanced recovery after surgery (ERAS) protocols help our patients experience better pain management, fewer complications, and shorter hospital stays after surgery.
• Latest treatments: Through our robust clinical trial program, you have access to promising new rectal cancer treatments. We are the only health care facility in the U.S. using proton therapy in clinical trials to treat recurrent gastrointestinal (GI) tumors (cancer that returns after treatment). Proton therapy is a highly precise form of radiation that minimizes damage to healthy tissues near the tumor.
• Treatment side effect management: Rectal cancer treatment sometimes causes bowel, bladder, or sexual function problems. Providers in our Palliative Care Program work with your treatment team to proactively address these concerns and enhance your quality of life.
• Prehab before surgery: Good health before surgery leads to better outcomes. If you’re not healthy enough for surgery or more likely to experience complications, we can address those issues ahead of time. In our Cancer Appetite and Rehabilitation (CARE) Clinic, we provide personalized care to optimize your health, including nutrition counseling and physical therapy.
• Seamless care: Our skilled oncology nurse navigators provide an extra layer of support. They use their colorectal cancer expertise to provide reliable advice, respond to your concerns, and help you navigate the care you receive across our health system.