What are the treatments for rectal cancer

Generally speaking, rectal cancer is mostly treated with surgery because surgery can be performed quickly and directly. The treatment of rectal cancer is relatively mature, but after treatment, patients still need to pay attention to their diet care.

The most common Western medical treatment for rectal cancer is surgery, and the surgical method depends on the location of the cancer in the rectum. There are two systems in the rectal wall: the submucosal lymph plexus and the intermuscular lymph plexus. The metastasis of cancer cells to the lymphatic system in the intestinal wall is rare. Once the cancer cells penetrate the intestinal wall, they spread to the lymphatic system outside the intestinal wall.

Generally, the intestinal lymph nodes at the same level or slightly higher than the tumor are affected first, and then gradually move upward to involve the intermediate lymph node group accompanying the superior hemorrhoidal artery, and finally to the lymph node group beside the inferior mesenteric artery. The above-mentioned upward lymph node metastasis is the most common metastasis mode of rectal cancer.

If the tumor is located in the lower rectum, the cancer cells may also invade the obturator lymph nodes laterally along the lymphatic vessels of the levator ani muscle and pelvic wall fascia, or flow along the middle hemorrhoidal artery to the internal iliac lymph nodes. Sometimes cancer cells can also pass downward through the levator ani muscle and drain along the inferior hemorrhoidal artery to the ischiorectal lymph nodes and inguinal lymph nodes. Since the lymphatic metastasis of upper rectal cancer is almost always upward, surgical removal of the lymphatic tissue adjacent to the tumor and above this plane can achieve the purpose of radical cure. The surgery has the possibility of preserving the anal sphincter.

Although the lymph node metastasis of lower rectal cancer is mainly upward, it may also metastasize laterally to the internal iliac lymph nodes and obturator lymph nodes. Radical surgery must include the tissues around the rectum and anal canal and the anal levator muscles, so the anal sphincter cannot be preserved.