Rectal Cancer (cont.)
IN THIS ARTICLE
Exams and Tests
Appropriate colorectal screening leading to the detection and removal of precancerous growths is the only way to prevent this disease. Screening tests for rectal cancer include the following:
If rectal cancer is suspected, the tumor can be physically detected through either digital rectal examination (DRE) or endoscopy.
Because the depth of the cancer's growth into the rectal wall is important in determining treatment, an endoscopic ultrasound (EUS) may be performed during endoscopy.An endoscopic ultrasound uses an ultrasound probe at the tip of an endoscope that allows a doctor to see how deeply the cancer has penetrated.In addition, a doctor can measure the size of the lymph nodes around the rectum during an endoscopic ultrasound.Based on the size of the lymph nodes, a good prediction can be made as to whether the cancer has spread to the lymph nodes. Once an abnormality is seen with endoscopy, a biopsy specimen is obtained using the endoscope and sent to a pathologist. The pathologist can confirm that the abnormality is a cancer and needs treatment.A person may experience small amounts of bleeding after a biopsy is performed.If this bleeding is heavy or lasts longer than a few days, a doctor should be notified immediately.A chest X-ray and a CT scan of the abdomen and pelvis are most likely performed to see whether the cancer has spread further than the rectum or surrounding lymph nodes.
Routine blood studies are performed to assess how a person might tolerate the upcoming treatment.
In addition, a blood test called CEA (carcinoembryonic antigen) is obtained.The CEA is often produced by colorectal cancers and can be a useful gauge of how the treatment is working. After the treatment, the doctor may regularly check the CEA level as one indicator of whether the cancer has returned.However, checking the CEA level is not an absolute test for colorectal cancers, and other conditions may cause a rise in the CEA level.Likewise, a normal CEA level is not a guarantee that the cancer is no longer present.
Timothy Kuo, MD
George Fisher, MD, PhD
Winston W Tan, MD
Mary L Windle, PharmD
Koyamangalath Krishnan, MD, FRCP
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