Prof. Dr. Emre Sivrikoz

Specialty Area

Rectal Cancer

Rectal cancer is a malignant tumor that develops in the rectum, the last 12–15 cm of the large intestine. Because of its location, diagnosis, staging, and treatment may differ from colon cancer. With early detection, treatment success rates are high.

Information

What Is Rectal Cancer?

Definition

Rectal cancer is a type of cancer that develops in the rectum, the final part of the large intestine. When detected early, success rates are high with surgery and complementary treatments.

Although it shares similarities with colon cancer, the anatomy of the rectum means the diagnostic work-up, staging, and treatment plan can differ. Therefore, accurate staging and multidisciplinary planning are critical.

The goal is to treat in the right sequence—achieving cancer control while preserving quality of life.

Why Does Rectal Cancer Occur?

Major factors that may contribute to rectal cancer include:

Adenomatous polypsMay carry a risk of turning into cancer over time.
Older ageRisk increases after age 50.
Family historyA history of colorectal cancer can increase risk.
IBDInflammatory bowel diseases may increase risk.
Diet / lifestyleLow-fiber diet, obesity, and inactivity.
Smoking / alcoholLong-term use may increase risk.

Who Gets Rectal Cancer?

Most commonly over age 50
May occur earlier with family history
Similar rates in women and men
May be increasing in younger adults

What Are the Symptoms of Rectal Cancer?

Most common symptoms

  • Rectal bleeding
  • Narrowing of stool caliber
  • Persistent feeling of needing to pass stool (tenesmus)
  • Lasting change in bowel habits (constipation or diarrhea)
  • Anemia and fatigue
  • Unexplained weight loss
Rectal bleeding is not always cancer, but it should always be evaluated.

Does Rectal Cancer Cause Symptoms in Early Stages?

In many cases, there may be no symptoms in early stages. That’s why screening programs—and prompt evaluation of suspicious signs—are vital.

How Is Rectal Cancer Diagnosed?

Diagnosis is usually confirmed by biopsy obtained during colonoscopy. Then, imaging studies are planned to determine how far the disease has spread.

1 Colonoscopy + biopsy

The core step for a definitive diagnosis.

2 Pelvic MRI

Critical for rectal-cancer staging and surgical planning.

3 CT / PET-CT

Used when needed to assess distant spread.

Rectal Cancer Stages and Staging

Staging determines the treatment sequence and method. In rectal cancer, pelvic MRI is decisive for evaluating the tumor’s relationship to surrounding tissues and lymph nodes.

Stage IEarly, localized disease.
Stage II–IIIInvolvement of surrounding tissues and/or lymph nodes.
Stage IVSpread to distant organs (metastasis).

Treatment for Rectal Cancer

Treatment is planned by a multidisciplinary team (general surgery, medical oncology, radiation oncology). The goals are tumor control, reducing recurrence risk, and preserving function when possible.

Neoadjuvant therapy (before surgery) In selected stages, chemoradiotherapy may shrink the tumor and improve surgical success.
Surgery TME (Total Mesorectal Excision) principles; sphincter-preserving approaches in suitable patients.
Adjuvant therapy (after surgery) Depending on stage, chemotherapy may be recommended.

Specialist approach

In rectal cancer, accurate staging and the right treatment sequence determine both oncologic success and quality of life.

After Surgery and Follow-up

  • Hospital stay is usually short.
  • Bowel function is closely monitored.
  • Regular oncologic follow-ups and colonoscopies are performed.
  • Long-term outcomes are closely related to stage and response to treatment.

When Should I See a Doctor?

Situations that should be evaluated without delay

  • If you have rectal bleeding
  • If you develop narrowing of stool caliber or persistent tenesmus
  • If you develop anemia and fatigue
  • If you have a family history of colorectal cancer

Early evaluation can significantly improve treatment success.

FAQ

Frequently Asked Questions About Rectal Cancer Surgery

This section summarizes the most commonly asked topics in rectal cancer surgery in a patient-friendly language.

The goal is to remove the tumor completely, reduce the risk of recurrence, and—when possible—preserve the anal sphincter to maintain normal bowel function.
TME is a modern technique where the rectum and surrounding lymphatic tissue (mesorectum) are removed as a single specimen while respecting anatomical planes, significantly reducing local recurrence.
In rectal cancer, spread is often within the mesorectum. Complete clearance improves survival and reduces the chance of the disease returning locally.
It involves removing the rectum while preserving the anal muscles (when suitable), and restoring bowel continuity.
Sphincter preservation is often possible when tumor distance to the anus, stage, response to therapy, and sphincter function are appropriate.
No. With modern techniques, many patients may not need a permanent stoma. In some cases, a temporary protective stoma may be planned.
A temporary stoma may be chosen to protect the bowel connection while it heals and to reduce the impact of a potential leak; it can be reversed when appropriate.
In suitable patients, minimally invasive approaches can be performed in line with TME principles and may support faster recovery.
Some patients may experience frequent bowel movements or urgency. In many cases this improves over time. Personalized recommendations are provided during follow-up.
Accurate staging, the right treatment sequence, and an experienced team following TME principles are the most critical factors for both cancer control and quality of life.
Real Reviews

Patient Information Note

This content is for general informational purposes only and does not replace diagnosis or treatment. If you have rectal bleeding, persistent changes in bowel habits, or anemia, please consult a general surgery specialist.

Author

Prof. Dr. Emre Sivrikoz, Specialist in General Surgery
Clinical experience in colorectal surgery

Medical Review

Last updated: 02 / 2026

References

  • American Society of Colon and Rectal Surgeons (ASCRS)
  • National Comprehensive Cancer Network (NCCN)
  • National Cancer Institute (NCI)

Rectal cancer is a treatable disease.

With multidisciplinary treatment and effective surgery, it is possible to overcome this disease.

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