Rectal tumours currently account for 30% of colorectal tumours.
They are most often detected by the presence of blood in the stool, either directly by the patient or via a screening test. They can also be responsible for a rectal disorder with the presence of mucus in the stool, a false sensation of needing to defecate or by rectal contraction.
The diagnosis is made through colonoscopy and biopsies.
The most common histological type is adenocarcinoma.
Tumours of the upper, middle and lower rectum are classically distinguished according to their distance from the anal region.
The management of rectal tumours has 2 objectives: to reduce the mortality of rectal cancers and to ensure the return to normal anal continence.
Tumours of the upper rectum are the consequence of surgery which are more or less complimented by chemotherapy.
For locally advanced tumours of the lower and middle rectum, radiotherapy combined with chemotherapy before surgery can reduce the rate of local/regional relapse.
For tumours of the lower rectum, the surgery performed is often an abdominal amputation. The result is a loss of permanent continence and thus a permanent stoma.
To avoid that, rectal preservation strategies based on radiotherapy and chemotherapy are being developed to avoid surgery and therefore not having an ostomy.
