Transcript of video
Leading Swedish rectal cancer surgeon discusses rectal cancer symptoms and signs. Rectal bleeding and change in bowel habits is a reason for concern about rectal cancer. Bleeding from anus. These symptoms require clinical examination. Dr. Anton Titov, MD. Doctor must do a digital finger rectal examination to make sure no rectal cancer is present. General Practitioners sometimes dismiss patients with rectal bleeding as having hemorrhoids. But these symptoms can signify rectal cancer. Rectal cancer symptoms and signs. Rectal cancer symptoms by stage. Dr. Anton Titov, MD. Rectal bleeding and change in bowel habits – when to be concerned about rectal cancer. When to see doctor for rectal cancer? Bleeding from anus is a rectal cancer sign. Medical second opinion confirms that rectal cancer diagnosis is correct and complete. change in bowel movements, urgency to defecate frequently can be a rectal cancer sign. Medical second opinion also confirms that rectal cancer surgery is required. Medical second opinion helps to choose the best treatment for rectal cancer. Get medical second opinion on rectal cancer and be confident that your treatment is the best. Dr. Anton Titov, MD. Video interview with leading expert in rectal cancer treatment surgery and minimally invasive rectal caner treatment. You must see doctor if bleeding from anus and rectum. It is not always hemorrhoids or anal fissure. Bleeding from anus could be rectal cancer symptom. Rectal cancer symptoms. Rectal bleeding. Dr. Anton Titov, MD. Hello! Today we are with Dr. Thorbjorn Holm. He is Professor of Surgery at the Department of Surgery and Molecular Medicine at Karolinska Institute in Stockholm, Sweden. Professor Holm has made significant advancements in the surgical treatment of rectal cancer. Dr. Holm advanced rectal cancer treatment methods in difficult situations with recurrent cancer. Professor Holm published over scientific articles on colorectal cancer and in on rectal cancer symtpms and treatment. He wrote several textbooks on treatment of rectal cancer. Dr. Holm, hello and welcome! Dr. Anton Titov, MD. Let’s start the conversation about rectal cancer with a general question. How do people present with rectal cancer? Dr. Anton Titov, MD. What are the symptoms of rectal cancer? When somebody should be concerned about rectal cancer symptoms? Because a big problem for cancer diagnosis in general is late diagnosis. Late diagnosis is a problem for rectal cancer. So the earlier rectal cancer symptoms must be recognized earlier. Correct diagnosis of rectal cancer is required. Then it will be better for the patient. You have forty years of surgical experience treating rectal cancer. You are an international authority on rectal cancer symptoms, diagnosis and treatment. What are common presenting symptoms of rectal cancer? Dr. Torbjorn Holm, MD (Rectal Cancer surgeon, Karolinska Institute, Stockholm). The most important symptoms of rectal cancer are a combination of rectal bleeding and altered bowel habits. So if you have only a slight red bleeding on the toilet paper or in the toilet, it may not be rectal cancer. It could be the hemorrhoid or it could be anal fissure. But if you have a bleeding from the anus, you should always have an examination. Because even a slight bleeding from anus could mean a symptom of rectal cancer. So my advice is this. Sometimes you have a rectal bleeding. Always have an examination by the doctor. Examination by the doctor on suspicion of rectal cancer symptoms has to include digital examination of the rectum. Proctoscopy is a visual examination of the rectum. It should also be done. Sometimes you don’t find any rectal tumor there. The patient is young and there is an explanation for the bleeding. It could be hemorrhoids. Then we can stop further investigation of rectal cancer symptoms. For the patient it’s extremely important not ignore several weeks of rectal bleeding without the medical examination. Rectal bleeding is a very important symptom of rectal cancer. Also change in bowel habits is an important symptom of rectal cancer. Sometimes you had regular bowel habits. Then suddenly you start to have some loose stools and some hard stools. If you feel urgency and you have to go to the toilet very often. That could be a rectal cancer symptom. Sometimes you empty only a little bit of stool. Then maybe in several minutes you have to go to the toilet again. Again you empty a little bit of stool. Then there could be something filling out the rectum. You may feel that it is stool (feces) but it could be a rectal tumor inside your rectum. So tumor filling rectum is also leading to change in the bowel habits and frequent urgency to defecate. Rectal bleeding and change in bowel habits, urgency to defecate. These are serious symptoms of rectal cancer. Sometimes you have them, you have to seek medical attention. Dr. Anton Titov, MD. Colonoscopy has been recommended for people over years of age to check for bowel cancer. What is recommended for rectal cancer as a screening tool? Dr. Torbjorn Holm, MD (Rectal Cancer surgeon, Karolinska Institute, Stockholm). We have screening for colorectal cancer in Sweden by fecal occult blood test. We do not have colonoscopy requirement for colon cancer screening. But fecal occult blood test could be positive. Then colonoscopy is required. There is no specific screening for rectal cancer. Screening is the same as for colorectal cancer. You have to remember that the median age for rectal cancer is about 70 years of age. But that means 50% of the rectal cancer patients are younger than medial age. So even people are in their 40s or 50s could have symptoms of bleeding from the rectum. We should have the digital rectal examination. Because it may be a symptom of rectal cancer. We have seen people as young as 20 years old with rectal cancer symptoms. The youngest person we ever operated for rectal cancer in my own hospital was a girl of 13 years old with rectal cancer. So age is not a definite excluding criterion for rectal cancer symptoms. You have to remember this. Dr. Anton Titov, MD. I had a patient rectal cancer, a female physician of 50 years of age. She presented with very late stage rectal cancer. Her symptoms of rectal cancer were bleeding and change in bowel habits. At that time her rectal cancer has already invaded the uterus, urinary bladder and even pubic bone. Dr. Anton Titov, MD. So it was very difficult to treat this patient with rectal cancer. Rectal cancer treatment required complete removal of all pelvic organs (evisceration). Late presentation of rectal cancer is a big problem. Dr. Torbjorn Holm, MD (Rectal Cancer surgeon, Karolinska Institute, Stockholm). One of the big problem is that the patient seeks medical attention. Usually they go to the primary care doctor. Not all primary care doctors have this knowledge. Primary care physicians often do not know that all patients with rectal bleeding or change in bowel habits have to have digital rectal examination. So a patient goes to see primary care doctor. Patient says: “I have a problem with bleeding from my anus when I go to the toilet.” This can be a rectal cancer symptom. Doctors often say “it’s hemorrhoids”. They prescribe suppositories. Doctors don’t even examine patient’s rectum with a finger to feel if there is a tumor there. We have several such patients. They have been to the primary doctor maybe three or four or five times with rectal cancer symptoms. They did not have a correct diagnosis of rectal cancer. Eventually these patients are examined and have a rectoscopy or colonoscopy. We have to educate our primary care doctors. They always have to examine the patient. Primary care doctors must do rectal examination by finger. There is a symptom of rectal bleeding. This is very important. Dr. Anton Titov, MD. Hemorrhoids are also very common. You can have hemorrhoids and something more serious cause of rectal bleeding at the same time. It could be cancer of the rectum. Hemorrhoids and rectal cancer symptoms can co-exist. Dr. Torbjorn Holm, MD (Rectal Cancer surgeon, Karolinska Institute, Stockholm). Absolutely correct. Sometimes you examine the patient. You find hemorrhoids and the patient has no sign of rectal cancer and he’s young. He has no hereditary form of rectal cancer predisposition. Then you can just leave the patient be. But a doctor should always examine patient’s rectum by finger. This is very important. Rectal Cancer Symptoms and Signs. Dr. Anton Titov, MD. Video interview by leading Swedish rectal cancer surgeon. Rectal bleeding and change in bowel habits. Patient must have rectal finger exam.