Rectal Cancer | Symptoms & Signs | MedStar Health

There are over 43,000 people diagnosed with rectal cancer every year, according to the American Cancer Society. When combined with colon cancer, colorectal cancer is the second leading cause of cancer deaths for men and women.

The good news is that more advanced screening and treatment options are resulting in an increased survival rate for patients with rectal cancer. This is especially true at places like MedStar Health, where our cancer specialists treat a high number of patients.

In addition, rectal cancer is preventable if you undergo regular screening via colonoscopy, starting at the age of 45. During a colonoscopy, your doctor can look for polyps and remove them before they become cancerous.

About rectal cancer

This type of cancer begins in the rectum, which is the last six inches of the large intestine. Sometimes it develops from an abnormal growth called a polyp—but not all polyps lead to cancer.

Rectal cancer is similar to colon cancer because the colon and rectum are both part of the digestive system. However, the diseases require different approaches to treatment. In fact, rectal cancer is more challenging to treat because of its proximity to other organs, bones, and tissue.

That’s why it’s important to seek care from someone with experience using innovative techniques to treat patients with complex cases. Studies prove that outcomes are better at high volume centers like MedStar Health, as they result in:

  • Greater success at removing the cancer
  • Less chance of recurring cancer
  • Minimized risk of needing a colostomy bag
  • More likelihood of preserving your ability to use the bathroom naturally

Rectal cancer care at MedStar Health

When you’re cared for at MedStar Health, you can expect comprehensive care that starts with a full range of advanced diagnostic options and continues with groundbreaking treatments that eliminate your cancer—and minimize the likelihood it will return.

Our team approach involves a variety of specialists who are focused on customizing your treatment plan using the most effective surgical techniques. Through innovative clinical trials and complex procedures only available at a few cancer centers in the nation, we can reduce your chances of needing a colostomy through sphincter preservation.

You’ll benefit from:

  • An experienced tumor board that allows surgical, radiation, and medical oncologists, radiologists, gastrointestinal specialists, therapists, and nurses to review and design a customized treatment plan as unique as your case
  • Novel surgical procedures that include minimally invasive and robotic options that result in less pain, fewer risks, and shorter recovery times
  • Oncologists and researchers pioneering new methods for diagnosing and treating rectal cancer while preserving your quality of life and minimizing the chances of your disease returning


The symptoms are similar to colon cancer symptoms. In fact, the two kinds of cancer are often grouped together and called “colorectal cancer.” However, the location of the cancer is different. Rectal cancer often develops from a small, abnormal growth in the rectum called a polyp.

Polyps are so small that it’s impossible to feel them. Even as they become cancerous, many people are unaware that they have this disease.

Most people don’t have symptoms

Most people with early-stage colon cancer don’t experience any symptoms. By the time signs of rectal cancer appear, it’s already progressing to a more advanced stage. And when cancer is advancing, that means it’s spreading and is harder to treat.

Noticing symptoms?

Many symptoms could be related to other health conditions, including colon cancer. However, if the following symptoms continue for more than two weeks, be sure to check-in with your doctor to rule out cancer.

Symptoms may include:

  • Bloating, cramping, and/or frequent gas pains
  • Bloody stool
  • Constipation or diarrhea
  • Persistent fatigue
  • Unexplained, sudden weight loss
  • Vomiting


A colonoscopy can help prevent rectal cancer—or find it early when it’s treatable.

You shouldn’t wait for symptoms to appear before seeing a doctor. Getting regular colonoscopies is the best prevention because your doctor can remove polyps in the rectum before they turn into cancer.

Risk factors

Knowing your risk ahead of time can help you take action to stay healthy and minimize the likelihood that you develop rectal cancer.

At MedStar Health, you’ll benefit from genetic counselors who are experts in evaluating your family history and risk for inherited cancers. This allows us to help you proactively take steps to minimize your chances through earlier screening and lifestyle changes.

Your risk is affected by age, lifestyle, background, and medical history

Risk factors may include:

  • Age: Once you turn 50, you are more likely to develop rectal cancer.
  • Race/Ethnicity: If you are African-American or Jewish with an Eastern European background, you are at an increased risk.
  • Medical history: Certain health conditions raise your risk, including ulcerative colitis, Crohn’s disease, Type 2 diabetes, or other types of cancer. And, if your doctor found polyps during a colonoscopy, you are also at an elevated risk.
  • Family history: If you have family members with rectal cancer, you are at a higher risk. Our genetic counselors can help you determine how much you are at risk and take action to reduce your chances of developing rectal cancer.
  • High-fat diet: Lifestyle choices greatly impact your risk. Studies show that you have a increased risk if you eat a diet high in fatty calories, such as those in red meat. You may be at a higher risk if you don’t eat enough food with fiber, such as fruits and vegetables.
  • Not enough exercise: If you aren’t active, you may be more likely to develop rectal cancer.
  • Tobacco and alcohol use: Poor lifestyle choices such as smoking cigarettes and drinking too much alcohol ca n increase your risk.

If one or more risk factors apply to you, that doesn’t mean that you will get rectal cancer. But, it’s a good idea to talk to your doctor about ways to minimize your risk. Your doctor may suggest getting screened regularly and making healthy lifestyle choices, including:

  • Eating fruits and vegetables
  • Staying active
  • Maintaining a healthy weight
  • Avoiding smoking
  • Drinking alcohol in moderation

It’s important to remember if you don’t have any risk factors, you can still get this disease, so you should be screened every 10 years once you turn 45.


Unlike some other forms of cancer, rectal cancer is preventable. Most rectal cancers develop from polyps, which are unusual growths that develop on the wall of the rectum. A doctor can spot and remove polyps during rectal screenings called colonoscopies.

Get screened regularly

While polyps themselves are not cancerous, they can grow into cancer. That’s why your doctor will remove them if they are found during a colonoscopy. Removing the polyps significantly decreases your risk of cancer.

Some people are afraid of getting screened for rectal cancer out of fear that the doctor will find something. But, the earlier cancer is found, the more treatable it is. In fact, most early-stage rectal cancer can be cured.

Make healthy choices

A healthy lifestyle may also help prevent rectal cancer, based on some studies. Consider taking the following steps to lower your risk of developing colon cancer:

  • Get screened every 10 years, starting at age 45
  • Maintain a healthy weight
  • Exercise regularly
  • Eat a low-fat diet and less red meat
  • Consume more fruits and vegetables
  • Avoid smoking and excessive alcohol consumption

If you are considered to be at a high risk of developing this type of cancer, talk to your doctor about screening guidelines, as you may need to be screened earlier or more frequently. A genetic counselor can also help you manage your risk if colorectal cancer runs in your family.


A screening is a test used to look for signs of disease, even if you don’t have any symptoms. Screenings can save your life because they allow doctors to find abnormal growths, called polyps, before they turn into cancer.

If cancer is found during a screening, the chances of it being cured are much higher when it’s caught early. That’s why the American Cancer Society recommends screening via colonoscopy beginning at the age of 45. For men and women who are at a higher risk of developing rectal cancer, your doctor may recommend you begin screening earlier.

While there are multiple ways to screen for this cancer, a colonoscopy is the best way to find the disease early while it’s still treatable.

A colonoscopy can be used to screen or diagnose colorectal cancer, which refers to both colon and rectal cancer.

During a colonoscopy, your doctor uses a thin, flexible tube attached to a small camera. This is inserted into the rectum and colon, allowing your doctor to look for anything unusual, such as:

  • Abnormal growths, or polyps
  • Bleeding
  • Inflammation
  • Tumors
  • Ulcers

Many people delay colonoscopies for fear of what to expect, including how to prepare for a colonoscopy. But, it’s not that bad thanks to advances over the past 10 years. You may be surprised to hear that:

  • You’ll be sedated during the procedure, so you won’t feel anything
  • The procedure is short, lasting only 15 to 20 minutes
  • The drink you have to consume the day before tastes better than it used to

Who should be screened

If you have an average risk: All men and women should be screened for both rectal cancer and colon cancer beginning at age 45, if they are considered to have an average risk. Being at an average risk means that you do not have:

  • A personal history of these types of cancers
  • A family history of these types of cancers
  • A confirmed hereditary condition that makes you more likely to develop colorectal cancer
  • Related health conditions, such as Crohn’s disease or ulcerative colitis

People with an average risk should continue screenings every 10 years through the age of 75. According to the American Cancer Society, you and your doctor should determine whether or not to continue screening between the ages of 76 and 85. You do not need to be screened once you are over the age of 85.

If you have a high risk: You may be at a higher risk and need to be screened earlier than the age of 45 if you have:

  • A personal or family history of polyps or colorectal cancer
  • A medical history of inflammatory bowel disease (including Crohn’s disease or ulcerative colitis)
  • An inherited gene that makes you more likely to develop colorectal cancer

If you meet any of these criteria, talk to your doctor about when and how you should be screened.

You may be eligible for a free screening

If you are uninsured or underinsured, you may qualify for a free colorectal cancer screening in Baltimore if you are:

  • A Baltimore City, Baltimore County, or Anne Arundel County resident
  • Age 50 or older
  • Under 50 with symptoms or a family history of colon cancer
  • Living on a limited income

Call us today to at 410-350-8216 or 410-350-3444 (Spanish) to find out if you qualify for a free rectal cancer screening in Baltimore.


During the early stages of rectal cancer, it is unlikely that you will experience symptoms. That’s why it’s important to proactively prevent it by making healthy lifestyle choices and getting regular rectal cancer screenings.

At MedStar Health, our colorectal specialists are experts in diagnosing and treating rectal cancer because we see a high number of patients every year. Seeing such a high volume of cases is proven to result in better outcomes, like higher survival rates and a lower risk of needing a colostomy.

An accurate diagnosis leads to more effective treatment

We believe an accurate diagnosis is the most important step to getting treatment that will give you the best results and the highest quality of life.

Screenings allow your doctor to see the inside of the rectum—and the colon—during a procedure called a colonoscopy. If something unusual is found, our team of experts move quickly to find out if it is or isn’t cancer.

There are a variety of tests that your doctor may use to confirm your diagnosis and understand the size and location of your rectal tumor, as well as if it has spread, or metastasized. These may include:

  • Physical exam: Your doctor will review your medical history and symptoms. They’ll also examine your body for anything abnormal. This may include a digital rectal exam (DRE) where your doctor will use a gloved finger to feel for anything unusual in the rectum.
  • Colonoscopy: A colonoscopy may be used as both a screening and a diagnostic procedure because it allows your doctor to view the inside of your rectum. During a colonoscopy, your doctor can see polyps or other signs that cancer is developing.
  • Biopsy: Your doctor will take a small sampling of suspicious tissue from your rectum using a procedure called a biopsy. This is the most definitive way to find out if your tumor is cancerous or not
  • Proctoscopy: If your doctor suspects cancer, they may use a proctoscope to look inside the rectum. During a proctoscopy, your doctor will insert a thin, lighted tube with a camera into the rectum. This allows them to identify the location and size of your tumor.
  • Imaging: Your doctor may use a combination of x-ray, computed tomography scans (CT scans), or ultrasound to take pictures of the inside of your body. This allows them to see if the tumor has spread to other parts of the body.
  • Blood tests: Your doctor may use various blood tests to:
    • Look for blood in your stool that may not be otherwise visible
    • Measure the types of cells in your blood
    • Identify tumor markers found in blood
    • Check your liver function
    • View rectal cancer treatment options

The stages of rectal cancer

As part of your diagnosis, your doctors will evaluate the stage of your cancer, or how much it has grown and spread. Your stage will determine what kind of treatment is necessary to remove your cancerous tumor and prevent it from coming back.

The staging system is complex and indicates:

  • The tumor size (T)
  • How much it is affecting the lymph nodes (N)
  • How far it has spread to other parts of the body (M)

Your doctor will take into account all three factors to describe your cancer on a scaled stage of zero to four. The higher the number, the more your cancer has progressed and the harder it is to treat.

For example, the following system is used to describe the size of the tumor (T):

  • T : There are abnormal cells in the innermost rectum lining. This is the earliest possible sign of cancer and is highly treatable.
  • T 1: The tumor has grown beyond the inner lining of the rectum. However, it’s still contained in the rectum and has not spread to nearby lymph nodes.
  • T 2: Cancer has expanded to the outer layer of the rectum but has not spread to the lymph nodes.
  • T 3: Cancer has grown through the rectum wall and has reached one or more lymph nodes.
  • T 4: Cancer has spread to other vital organs in the body, such as the lungs. There may also be cancer in the lymph nodes.

Get a second opinion

Once you have a diagnosis, it may be beneficial to ask another doctor to look at your case. Getting a second opinion can ensure that you receive the most accurate diagnosis possible, and you may find that there are additional treatment options that you didn’t know were available.

The specialist may confirm your initial diagnosis and treatment recommendations, provide additional treatment options, or even give more details about your type and stage of recta; cancer. Even if you’ve already had treatment, it’s not too late to get a second opinion.


When you receive rectal cancer treatment at MedStar Health, you can expect the highest quality of care from specialists who have more experience treating this disease than most cancer centers in the region. Because we treat a high number of patients with this disease, we offer unmatched expertise that leads to your best possible outcome.

In fact, studies show that surgeons like ours who perform a high volume of the same surgeries are more successful in:

  • Removing rectal cancer
  • Preventing cancer from returning
  • Preserving the sphincter
  • Lowering the risk of a colostomy

Your treatment plan will be designed by a variety of medical, surgical, and radiation oncologists, as well as specialists, including gastroenterologists and gynecologists. Involving experts across a variety of disciplines allows us to customize a comprehensive treatment plan that considers your most promising options. Your treatment plan will be based on a variety of factors, including:

  • Where cancer is located in the rectum
  • How far cancer has spread
  • If the bowel is blocked
  • If there is a hole in the bowel
  • If it’s a new tumor or a recurring tumor
  • Your overall health condition


What it is: When cancer is contained in the rectum, surgery is the most common treatment. During surgery, a specialist removes the tumor by entering through the opening of the rectum or the abdomen. This may be performed as open surgery or a minimally invasive procedure, like robotic surgery, which results in fewer risks, less pain, and faster recovery than traditional surgery.

Your surgery type will vary based on the stage and location of your tumor.

  • If you have a polyp: When a polyp appears suspicious or is confirmed to be cancerous, a surgeon can remove it during colonoscopy using a procedure called a polypectomy.
  • If you have a small tumor: Small tumors may be removed through a local excision, which means a surgeon will remove only the cancerous area.
  • If you have a large tumor: For larger tumors, your surgeon may need to remove tissues surrounding the tumor in addition to the tumor in a procedure called resection.

Because the rectum is a small body part, it’s important to select a highly trained surgeon with experience in reconnecting the colon to the rectum using a sphincter-preserving procedure. Otherwise, you may need a colostomy.

During a colostomy, your surgeon will cut a hole in your abdomen and attach a bag to the outside of your body to collect waste. Choosing someone who specializes in sphincter-preserving procedures can significantly lower your risk of needing a colostomy.

How it works: For early-stage rectal cancer, surgery may be the only treatment necessary to completely remove the cancerous tumor. In other cases when rectal cancer has grown or spread, it may be combined with other treatments, including radiation or chemotherapy.

Robotic surgery

Robotic surgery is a minimally invasive procedure that allows highly trained surgeons to remove rectal cancer with more precision and less pain and risk than traditional surgery. This allows you to recover faster, have less scarring, and experience fewer side effects. Learn more about the benefits of robotic surgery for colorectal patients.


What it is: Chemotherapy uses drugs to destroy cancerous cells and prevent them from growing. There are a variety of chemotherapy options that can be useful in shrinking the tumor before surgery and minimizing your risk of cancer returning after surgery, especially if cancer spreads to your lymph nodes.

How it works: Chemotherapy is considered a systemic treatment, which means that it affects your entire body. When you need chemotherapy, our oncologists work hard to minimize your side effects so you can maintain a high quality of life.

Your team of oncologists and specialists will carefully calculate a dosage that may be given several ways, including:

  • Intravenously through a needle
  • Orally as a pill
  • Injected in a muscle


What it is: During radiation, our radiation specialists use advanced techniques to deliver radiation directly to cancerous cells while preserving the healthy tissue nearby.

How it works: When you have a tumor that is growing or has spread, radiation may be given before surgery to help increase the effectiveness of surgery. When radiation and/or chemotherapy treatments are used as a supplement to surgery, the recurrence of cancer is less than 10%, compared to historical rates of 20% to 30%.

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