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

Medication and Allergies