RECTUM CANCERSymptom: Bleeding with stool is main symptom. If the patient thinks that bleedings is always due to piles. Then it becomes dangerous. Because cancer remains undetected .With passage of times cancer spreads to the surrounding area making it hard to treat. Symptom includes bleeding mixed with stool and mucous, sense of incomplete evacuation, increased frequency of stool, pain in anus after defecation. If the cancer grows bigger, patient cannot pass stool. Abdomen gets distended; even flatus or gas can not be passed. Patient may suffer from weakness and anemia (shortage of blood). There can be abdominal pain. If cancer spreads to urinary passage there is difficulty in passing urine. In case of ladies, cancer can invade vagina and stool may come out through vagina.

Investigation: Occult blood test of stool, sigmoidoscopy, Full colonoscopy and biopsy, Barium enema X-Ray of colon, USG of abdomen, CT scan of abdomen.

Cause: Exact cause is unknown. Rich people have more, Alcohol and smoking increases the risk. Fruits, green leafy vegetables and fiber containing food decreases the chance. Risk increases after 40 years of age. In Bangladesh we see more young people with cancer than in western countries.

Treatment: Surgical operation is the main treatment. Colon and rectum are tube like structures. We are to excise the affected rectum along with surrounding area where cancer might have spread. The main question here is, whether colostomy (stool passage shifting to abdomen) is permanently required or not? Due to sophisticated technology i.e. stapling technique, now a days we don’t need to shift the stool passage in 60-70 % of rectum cancer patients. I introduced this technology for the first time in Bangladesh in February 1997. Now we do nearly 200 rectum and colon cancer every year in Eden Multicare Hospital, Dhanmondi, Dhaka. If the cancer is very very low in the rectum then we need to do a permanent colostomy (diversion of stool passage to abdomen).
Chemotherapy and Radiotherapy is given after the wound healing. Sometimes chemotherapy is given before operation also. But operation must be done. There is no alternative to operation.

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