Rectal Bleeding

  Metastatic Cancer and Rectal Bleeding


Rectal Bleeding and Metastatic Cancer

Patients who are experiencing rectal bleeding with known metastatic cancer have a very serious medical condition. Rectal bleeding is usually indicative of colon cancer, and the presence of metastatic cancer indicates that the cancer has progressed beyond the colon and has invaded other organs. This presents a poor outlook for the patient, and treatment options become simply palliative treatments.

Significance
Rectal bleeding from a cancer presents a particular dilemma for patients. Due to the metastatic cancer, there is no surgical cure by removing the tumor. However, due to the rectal bleeding, surgical options should be considered. Patients who have lost a significant amount of blood do not tolerate non-surgical treatment options such as chemotherapy due to the depressed blood level. Patients may receive a blood transfusion, but this will not alleviate the problem because the patient will continue to lose blood. The only option for the patient is to have the bleeding cancer surgically removed in order to stop the rectal bleeding.

Identification
When a patient presents with rectal bleeding and metastatic cancer, it is imperative that the type and location of the cancer be identified. In most cases, a CT scan will reveal the location and size of the tumor. It may also show the areas affected by the metastatic cancer, which may be helpful in recommending treatment options.

Size
Determining the size and the extent of the spread of a cancer may determine treatment options to stop the rectal bleeding. Large tumors invading surrounding organs and anatomic structures may make surgical intervention an ill-advised treatment. Surgical intervention to remove these tumors may, in fact, cause the demise of the patient. Smaller tumors that have not invaded other structures may be removed safely.
In cases where the tumor appears small, a colonoscopy may be performed to attempt to stop the bleeding and obtain tissue for pathologic identification. When successful, the colonoscopy may alleviate the need for an operation.

Function
Surgical removal of the colon cancer will stop the rectal bleeding. It may also prevent the colon from becoming obstructed by the tumor. However, it will not stop the progression of the metastatic cancer. From a functionality standpoint, the operation will allow the patient to continue normal oral intake and return to normal colon activity. This will allow the patient to maintain proper nutrition while undergoing other non-surgical treatments for the metastatic cancer.

Considerations
Treatment options for rectal bleeding and metastatic cancer will ultimately be decided by the patient and the family. It is most important that they acquire as much knowledge as possible in order to make sound decisions. The best source of information will come from multiple sources. It is important that patients seek the advice of several physicians with different specialties. These physicians may include the following:
• Primary care physician -- usually the first contact, who is very helpful in referring the patient to other specialists.
• Oncologist: A physician who specializes in all cancers, including metastatic cancer.
• Gastrointestinal physician: Specializes in the gastrointestinal tract and can also perform colonoscopy if needed.
• Surgeon: Physician who specializes in surgery who may determine if an operation is safe.
• Oncology surgeon: A surgeon who specializes in cancer operations. An excellent source of a second opinion for the surgeon.

• Radiation oncologists: A physician who specializes in radiation treatment for cancer.

Other sources of information may be found on the Internet or local support groups. The more information that can be obtained, the more it will help the patient and family make an informed decision about treatment.
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