Rectal cancer: risk factors, symptomatology and treatment

In terms of mortality, colorectal cancer is the second major human neoplasia in countries with a high socioeconomic standard. In Romania, it is the second leading cause of cancer deaths in men and the third cause of death after breast and cervical cancer among women. • Diet: Hypercaloric diet rich in protein and red meat and low in fiber, fresh fruits and vegetables, vitamins represent a risk factor for colorectal cancer. • Age: The risk of developing colorectal cancer increases exponentially after age 40. It is estimated that people over 50 years of age have a 5% risk of developing an age of 80 and a 2. 5% risk of dying due to this malady.

• Genetic predisposition: The following forms of colorectal cancer are present: colorectal cancer, occurring in the colon adenomatous polyposis syndrome responsible for 1% of all colorectal cancers, non-polyposis hereditary colorectal cancer responsible for approximately 5% of all colorectal cancers, familial colorectal cancer . • Adenomatous polyps and colorectal cancer in a history: It is estimated that approximately 5% of colon adenomas degenerate malignantly within an average of 5-10 years. • Inflammatory bowel diseases (ulcer-hemorrhagic rectocolitis and) • Tobacco •. Compared to gastric or esophageal cancer, rectal cancers are well circumscribed, with a submucosal invasion usually limited to the macroscopic tumor limit, which usually makes a 2 cm resection limit of the tumor to be sufficient for excision in . They are described macroscopically: • Ulcerative tumors: the most common, associated with colon obstruction.

They appear more often at the left. • Polyphoid tumors. The second form as frequency, appears as a conopidiform formation. They are usually well differentiated and meet more often on the left colon. • Ringworm or schiros carcinoma (stenosis).

It occurs more frequently on the sigmoid colon and the rectum develops circumferentially and leads to the appearance of the typical appearance of \. • Infiltrative carcinoma (diffuse lesions), which infiltrate the entire thickness of the intestinal wall, with extensive propagation in the submucosa. • Colloidal carcinoma: Soft, gelatinous, friable, bleeding, and often infected. It occurs more frequently on the right colon. The classification of rectal tumors is based on the degree of locoregional invasion after several systems.

Symptoms suggestive of a colorectal disorder are: - intestinal transit disorders: constipation or alternating diarrhea - abdominal colic pains, sometimes with a subclusive character - change in the appearance of the stool: reduced caliber, mucus and \. Rectal cancer is treated according to the following situations: - Localized tumor, operable - Inoperable primary tumor - Completely resected primary tumor but present - Inoperable primary tumor and / or present metastasis - Localized, operable tumor. a) Radical Surgery Radical Surgery is the primary therapeutic method in colorectal cancer. Radicality of surgical intervention consists in the excision of the tumor with wide limits of safety, the excision of the vessels and the mesoloconus, concurrently with the regional lymphadenectomy, preserving if possible the function. In very elderly patients at high risk, in cases where the conditions of safe anastomosis are not met, it is advisable to carry out the Hartmann operation, which will allow for a better recovery of digestive transit.

In principle, Hartmann's surgery is similar to previous resection. b) Adjuvant treatments (chemotherapy) Although approximately 75-80% of patients present with localized disease despite potentially curative radical surgery, patients have an increased risk of relapse and death through disease progression. Inherited primary tumor Currently, systemic chemotherapy has gained a definite place in the treatment of advanced forms of colon cancer. Primary resected primary tumor but liver metastases present In the presence of less than 4 resected metastases, their resection can be performed. Systemic chemotherapy treatment will be given postoperatively.

Inoperable primary tumors and / or metastases present In this case paler chemotherapy is recommended. Palliative radiotherapy can be indicated for rectal tumors. It will be initially performed in the case of sacral plexus invasion, moderate rectal or after 3 cycles of objective response. This pathology is characterized by a slow growth process and a late metastasis, so it is very important that its discovery be made at a very early stage, and treatment should be applied as quickly as possible and very well adapted for a longer . It is scientifically proven that following a balanced diet and controlling body weight by performing (at least half an hour a day), rectal cancer can be reduced by 40%.

The ideal therapeutic strategy for local rectal cancer management involves multidisciplinary treatment consisting of radiotherapy, chemotherapy and surgical treatment. .