Rectal Cancer Specialist

What is rectal cancer?

Rectal cancer is a type of colorectal cancer arising in the lowest most portion of the intestinal tract, the rectum. 

Rectal cancer can affect men and women, but the incidence is rising in younger adults. Rectal cancer generally arises from a precancerous polyp known as an adenoma. 

The best way to prevent rectal cancer is to undergo a routine colonoscopy procedure where Dr. Zaghiyan can detect any precancerous polyps you may have and remove them to prevent cancer from developing.

What are the symptoms of rectal cancer?

In the early stages, rectal cancer may cause no symptoms whatsoever. As the cancer grows, it may cause rectal bleeding, anal or rectal pain or a protrusion, abdominal pain or cramping, or a change in bowel habits such as thin stool, constipation or diarrhea. 

How is rectal cancer diagnosed?

Rectal cancer is generally diagnosed through a routine colonoscopy but may also be detected by a digital exam of the rectum or a proctoscopy procedure performed in the office. 

Once the cancer is diagnosed, further testing will be ordered to determine the stage of the cancer. In general, rectal cancer that has not spread to other organs is treated with surgery or a combination of chemotherapy, radiation therapy, and surgery.

Why would I need rectal cancer surgery?

Rectal cancer surgery is an effective way of managing cases of cancer in your rectum, either in conjunction with chemotherapy or as the sole treatment. 

Before creating an appropriate treatment plan for your rectal cancer, Dr. Zaghiyan needs to know as much as possible about the location and stage of development of the condition. To help provide this information, you need to undergo some tests, such as:

• CEA (carcinoembryonic antigen) blood level
• CT or PET scan of your chest, abdomen, and pelvis
• Digital rectal exam (DRE)
• Proctoscopy
• Pelvic MRI 

In general, if your rectal cancer spreads through the muscle of the rectum or is affecting your lymph nodes, you’ll need a combination of chemotherapy and radiation followed by surgery. 

In this case, Dr. Zaghiyan works with your medical oncologist and radiation oncologist, arranging neoadjuvant chemoradiation, which is where you undergo chemotherapy and radiation before having your rectal surgery.

Dr. Zaghiyan carries out your surgery between 6-12 weeks after completion of chemoradiation, giving time for the tumor to continue to shrink and respond to the effects of the radiation.

What does rectal cancer surgery involve?

If you need rectal cancer surgery, Dr. Zaghiyan carries out a low anterior resection with a total mesorectal excision (TME), which means she removes your rectum and the mesentery containing all the draining lymph nodes, then reconnects your colon to your lower rectum or anus. 

Dr. Zaghiyan is one of few international leading experts in transanal total mesorectal excision (taTME), a minimally invasive approach to rectal cancer surgery. 

In this approach, the dissection is performed through the anus, allowing Dr. Zaghiyan a closer and better vantage point to target and remove the tumor and associated lymph nodes. In this innovative technique, abdominal incisions are also minimized or eliminated to reduce surgical pain and healing time. 

In very low tumors, a temporary ileostomy may be needed to collect fecal matter and allow the connection point to heal. You may also need further chemotherapy sessions after your rectal cancer surgery. 

Once you finish chemotherapy, or two months after the surgery, Dr. Zaghiyan reverses the ileostomy.

What is sphincter-sparing surgery?

When the tumor is very low in the rectum or involving the anal sphincter muscles, reconnection of the bowel may still be achievable in some cases. Sphincter-sparing surgery for rectal cancer involves Dr. Zaghiyan removing the rectum, then connecting the colon to the anus or lower part of the anus after partial removal of the anal sphincter muscle known as an intersphincteric resection or coloanal anastomosis. 

That means you can still pass stools through your anus after recovery, preserving continence and avoiding the need for a permanent colostomy. 

Only in rare cases, when there is deep or complete involvement of the anal sphincter muscle, an abdominoperineal resection with a permanent colostomy may be necessary to achieve cancer remission.

Dr. Zaghiyan can carry out the majority of sphincter-sparing rectal cancer surgeries using minimally invasive techniques such as laparoscopy, taTME, and robotic-assisted surgery. 

To arrange a rectal cancer surgery consultation, call Karen Zaghiyan MD or book an appointment online today.