Colon & Rectal Surgery
Rectal cancer begins in the rectum, which is the last several inches of the large intestine. It starts at the end of the final segment of your colon and ends when it reaches the short, narrow passage leading to the anus.
Cancer inside the rectum, or rectal cancer, and cancer inside the colon, or colon cancer, often are referred to together as colorectal cancer.
While rectal and colon cancers are similar in many ways, their treatments are quite different. This mainly is because the rectum sits in a tight space, barely separated from other organs and structures. The tight space can make surgery to remove rectal cancer complex.
In the past, long-term survival was uncommon for people with rectal cancer, even after extensive treatment. Thanks to treatment advances over the last few decades, rectal cancer survival rates have greatly improved.
Personalized cancer care
Receiving a cancer diagnosis is life-altering and overwhelming. Our Oncology team in La Crosse will work with you to create a cancer treatment plan designed to meet your needs and preferences, whether you need radiation, chemotherapy or surgery, or would benefit from cancer support groups. Our goal is to provide you with the highest quality of life possible. Learn more about our oncology services and teams.
Rectal cancer treatment often involves a combination of therapies. When possible, surgery is used to cut away cancer cells. Other treatments, such as chemotherapy and radiation therapy, may be used after surgery to kill any cancer cells that remain and reduce the risk that cancer will return.
If surgeons are concerned that the cancer can't be removed completely without damaging nearby organs and structures, your doctor may recommend a combination of chemotherapy and radiation therapy as your initial treatment. These combined treatments may shrink the cancer and make it easier to remove surgically.
Rectal cancer often is treated with surgery to remove cancer cells. Which operation is best for you depends on your particular situation, such as the location and stage of your cancer, how aggressive the cancer cells are, your overall health and your preferences.
Operations used to treat rectal cancer include:
- Removing very small cancers from the inside of the rectum
Very small rectal cancers may be removed using a colonoscope or another specialized type of scope inserted through the anus (transanal local excision). Surgical tools can be passed through the scope to cut away cancer and some of the healthy tissue around it. This procedure might be an option if your cancer is small and unlikely to spread to nearby lymph nodes. If a lab analysis finds that your cancer cells are aggressive or more likely to spread to the lymph nodes, your doctor may recommend additional surgery.
- Removing all or part of the rectum
Larger rectal cancers that are far enough away from the anal canal might be removed in a procedure that removes all or part of the rectum. Nearby tissue and lymph nodes also are removed. This procedure preserves the anus so waste can leave the body normally. How the procedure is performed depends on the cancer's location. If cancer affects the upper portion of the rectum, that part of the rectum is removed and the colon is attached to the remaining rectum. All of the rectum may be removed if the cancer is located in the lower portion of the rectum. Then the colon is shaped into a pouch and attached to the anus.
- Removing the rectum and anus
For rectal cancers that are located near the anus, it might not be possible to remove the cancer completely without damaging the muscles that control bowel movements. In these situations, surgeons may recommend an operation called abdominoperineal resection (APR) to remove the rectum, anus and some of the colon, as well as nearby tissue and lymph nodes. The surgeon creates an opening in the abdomen and attaches the remaining colon, also called a colostomy. Waste leaves your body through the opening and collects in a bag that attaches to your abdomen.