Diagnosis
History
Presenting Complaint
Rectal cancer is diagnosed in several common ways:
- Screen detected with faecal occult blood test kits
- Macroscopic rectal bleeding
- Large bowel obstruction, often requiring emergency surgery for a defunctioning ileostomy.
Past History
It is important to ask about conditions that may affect chemotherapy, radiotherapy or surgery.
- Past surgery within the abdomen is important, both for surgical management and the likelihood of non-mobile bowel loops for radiation toxicity.
- Cardiovascular health is important for surgery and some chemotherapy agents (eg. 5-fluorouracil).
- Respiratory health is important for surgery
- Gastrointestinal history:
- Inflammatory bowel disease is associated with an increased risk of bowel cancers. It also causes increased toxicity from chemotherapy and radiotherapy.
- Haemarrhoids are likely to flare up during radiotherapy treatments
- Previous radiotherapy is always important to know about
