cancer of rectum is the abnormal proliferation of the rectal cells this ppt will help the nursing students to know the disease process and its management and also this help the students to apply these in their clinical practice and to improve their academic performance

1. RECTAL CANCER
DEPARTMENT
OF
MEDICAL SURGICAL NURSING

2. Learning Objectives
At the end of this lecture, students should be
able to:
• define rectal cancer.
• enlist the stages of cancer of rectum .
• explain the causes of cancer of rectum.
• describe the clinical features of rectal
cancer.
• describe the management of rectal cancer.
• enumerate the complications of rectal
cancer.

3. DEFINITION
Abnormal proliferation & differentiation of
cell
of rectum is called as cancer of rectum.

4. CAUSES & RISK FACTORS
1.Smoking
2. Increasing age
3. Family history
4. High fat diet
5. Personal history of polyps
6. Physical inactivity

5. • Race
• Inflammatory bowel disease
• Diabetes
• Obesity
• Drinking alcohol
• Radiation therapy for any genital cancer

6. STAGES
The stages of rectal cancer are as follows:
STAGE-1: The tumor involves only the first or
second layer of the rectal wall & no lymph
nodes are involved.
STAGE-2: The tumor penetrate into the
mesorectum but no lymph node are
involved.

7. Cont---
STAGE-3: The tumor invade the lymph
nodes.
STAGE-4: Metastasis in the other part of the
body takes place

8. CLINICAL FEATURES
• Rectal bleeding- mixed with stool.
• Anemia, Shortness of breath, fatigue
• Light headache
• Severe constipation
• Abdominal pain or cramping
• Weight loss

9. DIAGNOSTIC EVALUATION
• History collection
• Physical examination
• Fecal occult blood test
• Endoscopy
• A digital rectal examination
• Rigid sigmoidoscopy

10. Cont---
• Colonoscopy
• Endoscopic
• Biopsy specimen
• Chest X-ray
• CT Scan
• Routine blood & urine investigations.

11. Surgical Management
• Transanal Excison
• Mesorectal surgery
• Low anterior resection
• Abdominoperineal resection

12. Radiation therapy
• Goal:-
• Shrink the tumor to make its surgical
removal easier .
• Kill - cancer cells after surgery
to reduce the risk of the cancer returning
or spreading .

13. Radiation therapy
• Typically radiation therapy is given daily
,5days a week for upto 6 wks .
• and is completely painless .
• Side effect of radiation therapy - mild skin
irritation ,diarrhea ,rectal or bladder irritation
and fatigue .

14. Chemotherapy
• This therapy is often given for stages II
and III rectal cancer .
• Preoperative chemotherapy is sometimes
given to reduce the size of the tumor .

15. Chemotherapy drugs used
• 5 Flurouracil
• Capecetabine
• Oxaliplatin
• Camptosar
• Avastin
• Cetuximab

16. Nursing management
• Reduction of the anxiety
• Alleviation of pain
• Attainment of an optimum level of nutrition .
• Maintenance of fluid and electrolyte balance .
• Prevention of infection .
• Adequate information.

17. Complications
• Prolapse of stoma
• Perforation
• Stoma retraction
• Skin irritation

18. Complications
• Leakage from anastomatic site
• Abdominal distension and rigidity
• Temperature elevation
• Signs of shock

19. Prevention
• Colorectal Screening
• Dietary Management
• Appropriate elimination habits

20. Summary
So far we have discussed about definition,
stages of cancer, causes, clinical
manifestations, complications and
managements of rectal cancer.

21. Bibliography
• Lewis et al, Medical Surgical Nursing,
Mosby Elsevier,7th edition.
• Joyce.M.Black et al, Medical Surgical
Nursing, Saunders publication.
• Brunner and Siddhartha, Medical Surgical
Nursing, Lippincott Williams and Wilkins.

22. Thank You