Rectal Cancer : A Mini Literature Review

Abstract

gondhow@gmail.com Rectal cancer, as a part of colorectal cancer, is one of the most common cancer in the world. In Indonesia, as reported in GLOBOCAN 2018, colorectal cancer is number eight by cancer site in term of incidence, mortality, and prevalence. It is also number five of new cases in 2018. Anatomy of rectum starts proximally at rectosigmoid junction which is as high as third sacral and extending to anorectal ring, just proximal to dentate line. In general, the upper third is located intraperitoneally and the lower two-thirds of the rectum extraperitoneally. Adenocarcinoma is the most common type of histopathology in rectal cancer. The etiology of rectal cancer is believed to be multifactorial, including both genetic and environmental factors. Hematochezia is the most common presenting symptom in rectal cancer. Diagnostic tool of rectal cancer is divided into invasive and non-invasive examinations. The simplest method to recognize is digital rectal examination that can detect around 70% of rectal cancer. TNM classification is used as a standard to evaluate the extend of tumour. Surgery alongside with radiation therapy and chemotherapy play important roles as main treatment modality of rectal cancer. The standard treatment for conventional (2-dimensional technique), consists of three 3 fields. If 3-dimensional technique preferred, 3D conformal radiotherapy (3DCRT) is more recommended than intensity-modulated radiation therapy (IMRT). For postoperative cases, the radiation treatment is conventional fractionation to a total dose of 45 Gy to the entire pelvis, followed by a boost of 5.4 Gy to the tumor bed.