The term "rectal cancer" refers to a pathological process, the course of which is accompanied by the formation of a malignant tumor. According to statistics, 45% of cases of neoplasms of the gastrointestinal tract occur precisely in this disease. The disease is included in the International Classification of Diseases (ICD 10). Rectal cancer belongs to the group of neoplasms of the digestive organs of a malignant nature.
Currently, there are several ways to treat pathology. With timely access to a doctor, the prognosis is usually favorable.
Pathogenesis
The rectum is the final section of the intestine, ending in the anus. It is through the latter that feces leave the body into the environment. In an adult, the length of the rectum can vary between 15–20 cm. Its widest part is the ampulla located in the pelvis and surrounded by fattyinterlayer.
In the mucous membrane of the body there is a huge number of cells responsible for the production of mucus. It, in turn, facilitates the passage of feces through the intestines, that is, it plays the role of a kind of lubricant.
Under the influence of various adverse factors, the development of a pathological process that affects the mucous membrane is triggered. It gradually begins to form a tumor that has a malignant character. As a result, the patient's condition worsens, emptying the organ is difficult. Ignoring pathology poses a threat not only to he alth, but also to the life of the patient.
Assigned ICD-10 code C20 to rectal cancer.
Etiology
The development of the disease can occur under the influence of a large number of triggers. The main causes of rectal cancer (in ICD-10, some of them are also assigned codes):
- Polyps. Their size is of clinical importance. These neoplasms are benign, but if their height is 1 cm or more, the risk of degeneration is significantly increased.
- Diffuse polyposis. This is a pathology, the development of which is most often due to hereditary predisposition. This is not rectal cancer yet (in ICD-10, the pathology has a different code), but already a condition that precedes it. The disease is characterized by the formation of a large number of polyps on the mucous membrane.
- Human papillomavirus. The active life of the pathogen in the area of the anus is also not alwaysleads to colon cancer. In the ICD-10, the papillomavirus code is B07, that is, in fact, the pathology is characterized by the formation of warts and genital warts. However, these neoplasms sometimes have a tendency to become malignant.
- Unbalanced diet. Most often found in people who consume a large amount of meat products. Such food, getting into the intestines, is a favorable environment for the reproduction of pathogens. Reducing the intake of plant-derived fiber makes it difficult for the feces to pass out, which is why their contact with the tissues becomes longer.
- Hypovitaminosis. With regular use of foods rich in vitamins A, E and C, the process of inactivation of carcinogens starts. With their deficiency, the degree of negative impact on the mucous membrane increases.
- Obesity. According to statistics, overweight people are most often diagnosed with rectal cancer (ICD-10 also indicates a large number of diseases that develop against the background of excess weight).
- Inactivity. Contrary to popular belief, it is a disease. It also has its own ICD-10 code. Rectal cancer often develops in people who lead an extremely sedentary lifestyle.
- Frequent consumption of alcoholic beverages. Ethyl alcohol not only irritates the mucous membrane, but also promotes the formation of cancer cells.
- Regular contact with harmful substances. In this case, we are talking about persons whose professional activities are related to work with toxicconnections.
- Genetic predisposition.
Regardless of the severity of the symptoms and causes of rectal cancer (in the ICD-10, as mentioned above, a large number of provoking pathologies are indicated), it is impossible to delay the treatment of the disease. This is due to the fact that the disease poses a threat to the life of the patient.
Clinical manifestations
According to ICD-10, rectal cancer is a malignant neoplasm that forms on the mucous membrane. This process is accompanied by the appearance of specific symptoms. Its intensity directly depends on the size and location of the tumor, the nature of its growth and the duration of the course of the disease.
The main symptoms of rectal cancer (ICD-10 also lists some of them):
- Isolation of blood from the anus.
- Diarrhea or constipation.
- Discharge from the anus of pus or mucus.
- Fecal incontinence.
- Meteorism.
- Frequent urge to defecate (up to 16 times a day). As a rule, they cause torment to the patient.
- Bloating.
- Signs of intestinal obstruction (vomiting, severe pain in the abdomen).
- Dramatic weight loss.
- "Stool Symptom". A patient with a tumor tries not to sit on hard surfaces with both buttocks, but only with one.
- Increased degree of fatigue.
- General weakness.
If you experience any of the above symptoms, you should consult a doctor. On thethe initial appointment is desirable to come to the therapist. The doctor will prescribe a number of studies and, if there is a suspicion of a tumor, he will refer you to an oncologist and a proctologist.
Diagnosis
The first step is to take an anamnesis. The doctor carefully listens to the patient's complaints and asks him questions about his lifestyle. Already at this stage, the specialist may suspect that the patient has a neoplasm - rectal cancer. ICD-10 (code), existing complaints, examination results - this is a list of what the doctor enters into the medical record. To confirm the diagnosis, consultation of narrow specialists is required. They are the ones who treat the patient.
Currently, the following tests are ordered to confirm the diagnosis of rectal cancer:
- Rectal speculum examination.
- Irrigoscopy.
- Digital rectal examination.
- Ultrasound.
- Sigmoidoscopy.
- Computed tomography.
- Blood test for tumor markers.
- Biopsy.
- Histological examination.
- Cytological analysis.
If necessary, the doctor prescribes additional studies: X-ray of the abdominal organs, fibrocolonoscopy, laparoscopy, intravenous urography.
Based on the results, the doctor records the diagnosis with the ICD-10 code and signs of rectal cancer on the card. Treatment is also detailed.
Types of tumors
Each neoplasm has a specific histological structure. In this regard, tumors of the rectum are classifiedas follows:
- Adenocarcinomas. Formed from glandular tissue.
- Ricoid cell cancer. Extremely rare, has a high mortality rate.
- Solid cancer. Occurs rarely. Tumor cells are arranged in layers.
- Sciatica cancer. The neoplasm is characterized by a large volume of intercellular substance.
- Squamous cell carcinoma. It is characterized by early metastasis.
- Melanoma. The tumor is located in the area of the anus.
According to ICD-10, rectal cancer is a malignant process. In the classification of diseases, the above types of tumors are not assigned separate codes. They are all marked with the designation C20.
Tumor growth pattern
The neoplasm may rise above the surface of the mucosa. In this case, it is customary to speak of exophytic cancer. Sometimes the tumor grows into the intestinal wall. This is endophytic cancer. Often diagnosed and mixed form. In this case, the tumors grow both inside and into the lumen of the rectum.
Degree of aggressiveness
The course of the disease is also classified according to the rate of progression of the pathological process. In this case, the cancer can be low-, medium-, and highly differentiated. Accordingly, in the first case, the pathology develops slowly and is not accompanied by painful symptoms, in the latter, the tumor grows rapidly, and the process of metastasis starts in a short time.
Surgical treatment
In ICD-10 rectal cancer as mentionedabove, belongs to the group of malignant diseases. That is, in some cases, it is possible to get rid of this pathology only with the help of surgical intervention.
Any operation on the rectum is traumatic. Currently, there are several intervention methods that allow you to maintain a normal act of defecation in the future and avoid negative consequences.
Main types of operations used in practice:
- Resection of the anal sphincter and rectum. It is advisable to carry out this type of intervention in the presence of a tumor in the anus.
- Removal of part of the rectum. After resection, the tissues located above are sutured to the anus.
- Abdo-anal operation. In this case, the rectum is removed completely and a new canal is formed by stitching tissues.
- Abdominal-anal resection with excision of the muscle sphincter. The operation is identical to the previous one. The difference is that the anal sphincter is removed along with the rectum.
- Abdo-perineal extirpation. It involves the removal of the rectum and anal canal. The formation of the reservoir is carried out by lowering down the sigmoid colon.
The most difficult operation is pelvic evisceration. It involves the removal of all organs from this zone. It is advisable to carry out this type of intervention if the tumor has grown significantly into neighboring tissues.
Radiation and chemotherapy
These treatments areauxiliary. Radiation therapy is carried out mainly in the preoperative period. The course of treatment is 5 days.
During therapy, the following complications may occur:
- Skin ulcers in the radiation area.
- Diarrhea.
- Anemia.
- Cystitis.
- Atrophy of internal organs.
- Leukemias.
- Necrosis.
Chemotherapy is indicated after surgery. The goal of treatment is to consolidate the effect of the intervention and prevent the spread of cancer cells. The drugs are administered intravenously to the patient.
Features of food
In the presence of rectal cancer, the diet should be balanced. It is important to limit the consumption of foods rich in animal fats. The menu must contain vegetables and fruits. It is necessary to exclude fried, spicy and sour foods from the diet.
It is recommended to eat food 5 times a day. At the same time, the size of one serving should not exceed 200 g. It is desirable to observe equal intervals between meals.
Forecast
The outcome of the disease directly depends on the timeliness of the visit to the doctor. According to statistics, with early diagnosis and well-conducted treatment, survival in the next 5 years is 80%. If the first activities were carried out already at the stage of metastasis, this figure is half as much.
Prevention
To prevent the development of the disease, you do not need to follow specific recommendations. Generalprevention rules look like this:
- It is advisable to reduce the amount of food rich in animal fats in the diet.
- Exercise regularly.
- Control body weight.
- Timely treat identified diseases of the digestive tract.
- Quit smoking and drinking alcohol.
Persons whose close relatives have suffered from rectal cancer are recommended to be screened once a year. It includes both laboratory and instrumental diagnostic methods.
In closing
Rectal cancer is a disease characterized by the formation of a malignant tumor on the mucous membrane. Pathology poses a threat not only to he alth, but also to life. In this regard, it is necessary to consult a doctor at the first warning signs. The main treatment for the disease is surgery. The choice of technique is carried out on the basis of the results of diagnostic measures. Additionally, radiation and chemotherapy are performed. ICD-10 code C20 was assigned to rectal cancer.
