Rectal cancer is a disease in which malignant (cancer) cells form in the tissues of the rectum, the last several inches of the large intestine closest to the anus. Learn about symptoms, risk factors, tests, and treatments.
Colorectal anatomy
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Rectal Cancer
Anorectum-fr
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Anorectum-fr
Anatomie du rectum et de l'anus
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What Is Rectal Cancer?
Rectal cancer is a disease in which malignant (cancer) cells form in the tissues of the rectum.
The rectum is part of the body’s digestive system. The digestive system takes in nutrients (vitamins, minerals, carbohydrates, fats, proteins, and water) from foods and helps pass waste material out of the body. The digestive system is made up of the esophagus, stomach, and the small and large intestines. The colon (large bowel) is the first part of the large intestine and is about 5 feet long. Together, the rectum and anal canal make up the last part of the large intestine and are 6-8 inches long. The anal canal ends at the anus (the opening of the large intestine to the outside of the body).
Anatomy of the lower gastrointestinal (digestive) system showing the colon, rectum, and anus. Other organs that make up the digestive system are also shown.
Health history affects the risk of developing rectal cancer.
Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. Talk to your doctor if you think you may be at risk for colorectal cancer.
Risk factors for colorectal cancer include the following:
Having a family history of colon or rectal cancer in a first-degree relative (parent, sibling, or child).
Having a personal history of cancer of the colon, rectum, or ovary.
Having a personal history of high-risk adenomas (colorectal polyps that are 1 centimeter or larger in size or that have cells that look abnormal under a microscope).
Having inherited changes in certain genes that increase the risk of familial adenomatous polyposis (FAP) or Lynch syndrome (hereditary nonpolyposis colorectal cancer).
Having a personal history of chronic ulcerative colitis or Crohn disease for 8 years or more.
Having three or more alcoholic drinks per day.
Smoking cigarettes.
Being Black.
Being obese.
Older age is a main risk factor for most cancers. The chance of getting cancer increases as you get older.
Source: National Cancer Institute (NCI)
Additional Materials (3)
3D Visualization of colon and rectum
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normal rectum colonoscopy
normal rectum 70y.o. Japanese / colonoscopy
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Rectal Cancer
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3D Visualization of colon and rectum
TheVisualMD
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normal rectum colonoscopy
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Rectal Cancer
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General Info
Rectal Cancer - Treatment Options
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Rectal Cancer - Treatment Options
Colorectal Cancer
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Rectal Cancer
General Information About Rectal Cancer
KEY POINTS
Rectal cancer is a disease in which malignant (cancer) cells form in the tissues of the rectum.
Health history affects the risk of developing rectal cancer.
Signs of rectal cancer include a change in bowel habits or blood in the stool.
Tests that examine the rectum and colon are used to diagnose rectal cancer.
Certain factors affect prognosis (chance of recovery) and treatment options.
Source: National Cancer Institute (NCI)
Additional Materials (17)
Colorectal anatomy
Colorectal anatomy
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Rectal Cancer | Q&A
Video by Johns Hopkins Medicine/YouTube
Testing for bowel cancer
Video by Cancer Research UK/YouTube
Rectal Examination (PR) - OSCE Guide
Video by Geeky Medics/YouTube
Rectal Cancer
Video by Lee Health/YouTube
Richard Rubenstein: Overcoming Rectal Cancer - Mayo Clinic
Video by Mayo Clinic/YouTube
5x5 Rectal Cancer Treatment Protocol | Q&A
Video by Johns Hopkins Medicine/YouTube
Colon or rectal cancer diagnosis: should I get a second opinion?
Video by Swedish/YouTube
A patient's experience with rectal cancer and treatment
Video by Swedish/YouTube
MRI in rectal cancer staging is mandatory
Video by ImedexCME/YouTube
Rectal Bleeding
Video by California Colorectal Surgeons/YouTube
Scott’s Story: Rectal Cancer, Stage II Treated with da Vinci Robot Surgery
Video by Franciscan Health/YouTube
Rectal Cancer Surgery Outcomes Enhanced with Colorectal Surgeons - Mayo Clinic
Video by Mayo Clinic/YouTube
Signs and Symptoms of Colon and Rectal Cancer | Dana-Farber Cancer Institute
Video by Dana-Farber Cancer Institute/YouTube
Rectal Cancer Treatment | Memorial Sloan Kettering
Video by Memorial Sloan Kettering/YouTube
Colon and Rectal Cancer: How much of a problem is it really?
Video by Columbia University Department of Surgery/YouTube
Anal and Rectal Cancer Care and Treatment
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Colorectal anatomy
TheVisualMD
8:46
Rectal Cancer | Q&A
Johns Hopkins Medicine/YouTube
1:37
Testing for bowel cancer
Cancer Research UK/YouTube
3:39
Rectal Examination (PR) - OSCE Guide
Geeky Medics/YouTube
1:49
Rectal Cancer
Lee Health/YouTube
8:28
Richard Rubenstein: Overcoming Rectal Cancer - Mayo Clinic
Mayo Clinic/YouTube
5:19
5x5 Rectal Cancer Treatment Protocol | Q&A
Johns Hopkins Medicine/YouTube
2:40
Colon or rectal cancer diagnosis: should I get a second opinion?
Swedish/YouTube
3:14
A patient's experience with rectal cancer and treatment
Swedish/YouTube
19:41
MRI in rectal cancer staging is mandatory
ImedexCME/YouTube
2:10
Rectal Bleeding
California Colorectal Surgeons/YouTube
3:45
Scott’s Story: Rectal Cancer, Stage II Treated with da Vinci Robot Surgery
Franciscan Health/YouTube
6:47
Rectal Cancer Surgery Outcomes Enhanced with Colorectal Surgeons - Mayo Clinic
Mayo Clinic/YouTube
2:03
Signs and Symptoms of Colon and Rectal Cancer | Dana-Farber Cancer Institute
Dana-Farber Cancer Institute/YouTube
7:59
Rectal Cancer Treatment | Memorial Sloan Kettering
Memorial Sloan Kettering/YouTube
11:42
Colon and Rectal Cancer: How much of a problem is it really?
Rectal valve is one of three transverse folds in the rectum where feces is separated from flatus
Rectum is part of the large intestine between the sigmoid colon and anal canal
Rectum
Food residue leaving the sigmoid colon enters the rectum in the pelvis, near the third sacral vertebra. The final 20.3 cm (8 in) of the alimentary canal, the rectum extends anterior to the sacrum and coccyx. Even though rectum is Latin for "straight," this structure follows the curved contour of the sacrum and has three lateral bends that create a trio of internal transverse folds called the rectal valves. These valves help separate the feces from gas to prevent the simultaneous passage of feces and gas.
Large Intestine
The large intestine includes the cecum, colon, and rectum.
Absorption, Feces Formation, and Defecation
The small intestine absorbs about 90 percent of the water you ingest (either as liquid or within solid food). The large intestine absorbs most of the remaining water, a process that converts the liquid chyme residue into semisolid feces ("stool"). Feces is composed of undigested food residues, unabsorbed digested substances, millions of bacteria, old epithelial cells from the GI mucosa, inorganic salts, and enough water to let it pass smoothly out of the body. Of every 500 mL (17 ounces) of food residue that enters the cecum each day, about 150 mL (5 ounces) become feces.
Feces are eliminated through contractions of the rectal muscles. You help this process by a voluntary procedure called Valsalva's maneuver, in which you increase intra-abdominal pressure by contracting your diaphragm and abdominal wall muscles, and closing your glottis.The process of defecation begins when mass movements force feces from the colon into the rectum, stretching the rectal wall and provoking the defecation reflex, which eliminates feces from the rectum. This parasympathetic reflex is mediated by the spinal cord. It contracts the sigmoid colon and rectum, relaxes the internal anal sphincter, and initially contracts the external anal sphincter. The presence of feces in the anal canal sends a signal to the brain, which gives you the choice of voluntarily opening the external anal sphincter (defecating) or keeping it temporarily closed. If you decide to delay defecation, it takes a few seconds for the reflex contractions to stop and the rectal walls to relax. The next mass movement will trigger additional defecation reflexes until you defecate.If defecation is delayed for an extended time, additional water is absorbed, making the feces firmer and potentially leading to constipation. On the other hand, if the waste matter moves too quickly through the intestines, not enough water is absorbed, and diarrhea can result. This can be caused by the ingestion of foodborne pathogens. In general, diet, health, and stress determine the frequency of bowel movements. The number of bowel movements varies greatly between individuals, ranging from two or three per day to three or four per week.
Source: CNX OpenStax
Additional Materials (18)
Organ of Digestive System
3D visualization of the digestive system in a posterior view. The main duties of the digestive system are to breakdown food mechanically and chemically so the body can absorb nutrients. The digestive system is primarily composed of the alimentary canal, which is simply a long series of tubes starting with the mouth and ending with the rectum and anus. This canal is made up of the oral cavity, esophagus, stomach, small intestines (duodenum, jejunum, & ileum), and the large intestines. The large intestine is subdivided into the cecum, appendix, ascending colon, transverse colon, descending colon, sigmoid colon, rectum, and anal canal.
Image by TheVisualMD
Human Rectum
Diagram of the rectum
Image by Armin Kubelbeck
Human Anus
Diagram of the rectum and anus.
Image by U.S. Government National Institutes of Health
Rectum and anal canal: anatomy and function (preview) - Human Anatomy | Kenhub
Video by Kenhub - Learn Human Anatomy/YouTube
Human Rectum
Scheme of digestive tract, with rectum marked.
Image by Olek Remesz (wiki-pl: Orem, commons: Orem)
The external and internal anal sphincter muscles
Drawing of the external and internal anal sphincter muscles with the internal sphincter, external sphincter, rectum, and anus labeled.
Image by NIDDK Image Library
The lower GI tract (adult)
Drawing of the lower gastrointestinal tract inside the outline of a man’s torso. Inset of the lower gastrointestinal tract with the cecum, ascending colon, transverse colon, descending colon, sigmoid colon, and rectum labeled.
Image by NIDDK Image Library
Drawing of the large intestine. The appendix, cecum, ascending colon, transverse colon, descending colon, sigmoid colon, rectum, and anus are labeled
The sigmoid colon is the last section of the colon.
Image by NIDDK Image Library
Drawing of a rectum and anus
The doctor attaches the healthy part of the intestine to the stoma (a hole in the abdomen).
Image by NIDDK Image Library
Drawing of the lower digestive tract with labels: stomach, large intestine (colon), small intestine, ileum, sigmoid colon, rectum, and anus
Lower digestive system
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Exam, Digital Rectal
Digital rectal exam; drawing shows a side view of the male reproductive and urinary anatomy, including the prostate, rectum, and bladder; also shows a gloved and lubricated finger inserted into the rectum to feel the prostate.
Digital rectal exam (DRE). The doctor inserts a gloved, lubricated finger into the rectum and feels the prostate to check for anything abnormal.
Image by National Cancer Institute / National Cancer Institute
Digestive Systems
The large intestine reabsorbs water from undigested food and stores waste material until it is eliminated.
Image by CNX Openstax
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Prostate Exam Through the Rectum
Three-dimensional visualization reconstructed from scanned human data. Lateral view of across-section through the male reproductive organs with the prostate extending form the cut plane. Doctors examine the prostate for any potentially dangerous changes. The prostate is close to the rectum and easy to check.
U.S. Government National Institutes of Health, vectorisé par User:Waterced/Wikimedia
Signs
Signs & Symptoms
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Signs & Symptoms
Unfortunately, colorectal cancer is often asymptomatic (without symptoms) in its early stages Symptoms may appear only when the cancer has reached an advanced stage and the cancer is more difficult to treat. When symptoms do appear, they vary according to the size of the cancer and its location in the colon or rectum.
Image by TheVisualMD
What Are Signs of Rectal Cancer?
These and other signs and symptoms may be caused by rectal cancer or by other conditions. Check with your doctor if you have any of the following:
Blood (either bright red or very dark) in the stool.
A change in bowel habits.
Diarrhea.
Constipation.
Feeling that the bowel does not empty completely.
Stools that are narrower or have a different shape than usual.
General abdominal discomfort (frequent gas pains, bloating, fullness, or cramps).
Change in appetite.
Weight loss for no known reason.
Feeling very tired.
Source: National Cancer Institute (NCI)
Additional Materials (3)
Constipation - Fecal matter in the lower bowel
Constipation - Fecal matter in the lower bowel
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Bristol Stool Chart
The Bristol stool scale or Bristol stool chart is a medical aid designed to classify the form of human faeces into seven categories. Sometimes referred to in the UK as the "Meyers scale", it was developed by Dr. Ken Heaton at the University of Bristol and was first published in the Scandinavian Journal of Gastroenterology in 1997.
Image by Cabot Health, Bristol Stool Chart
Symptoms and Causes of Constipation
Constipation-Causes
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Constipation - Fecal matter in the lower bowel
TheVisualMD
Bristol Stool Chart
Cabot Health, Bristol Stool Chart
Symptoms and Causes of Constipation
PracticalCures.com
Tests
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Rectal Cancer - Diagnosing and Treating
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Rectal Cancer - Diagnosing and Treating
Diagram showing trans anal endoscopic microsurgery for early stage rectal cancer.
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What Tests Are Used to Detect and Diagnose Rectal Cancer?
Tests that examine the rectum and colon are used to diagnose rectal cancer.
The following tests and procedures may be used:
Physical exam and health history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
Digital rectal exam (DRE): An exam of the rectum. The doctor or nurse inserts a lubricated, gloved finger into the lower part of the rectum to feel for lumps or anything else that seems unusual. In women, the vagina may also be examined.
Colonoscopy: A procedure to look inside the rectum and colon for polyps (small pieces of bulging tissue), abnormal areas, or cancer. A colonoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove polyps or tissue samples, which are checked under a microscope for signs of cancer.Colonoscopy. A thin, lighted tube is inserted through the anus and rectum and into the colon to look for abnormal areas.
Biopsy: The removal of cells or tissues so they can be viewed under a microscope to check for signs of cancer. Tumor tissue that is removed during the biopsy may be checked to see if the patient is likely to have the gene mutation that causes HNPCC. This may help to plan treatment. The following tests may be used:
Reverse transcription–polymerase chain reaction (RT–PCR) test: A laboratory test in which the amount of a genetic substance called mRNA made by a specific gene is measured. An enzyme called reverse transcriptase is used to convert a specific piece of RNA into a matching piece of DNA, which can be amplified (made in large numbers) by another enzyme called DNA polymerase. The amplified DNA copies help tell whether a specific mRNA is being made by a gene. RT–PCR can be used to check the activation of certain genes that may indicate the presence of cancer cells. This test may be used to look for certain changes in a gene or chromosome, which may help diagnose cancer.
Immunohistochemistry: A laboratory test that uses antibodies to check for certain antigens (markers) in a sample of a patient’s tissue. The antibodies are usually linked to an enzyme or a fluorescent dye. After the antibodies bind to a specific antigen in the tissue sample, the enzyme or dye is activated, and the antigen can then be seen under a microscope. This type of test is used to help diagnose cancer and to help tell one type of cancer from another type of cancer.
Carcinoembryonic antigen (CEA) assay: A test that measures the level of CEA in the blood. CEA is released into the bloodstream from both cancer cells and normal cells. When found in higher than normal amounts, it can be a sign of rectal cancer or other conditions.
Certain factors affect prognosis (chance of recovery) and treatment options.
The prognosis and treatment options depend on the following:
The stage of the cancer (whether it affects the inner lining of the rectum only, involves the whole rectum, or has spread to lymph nodes, nearby organs, or other places in the body).
Whether the tumor has spread into or through the bowel wall.
Where the cancer is found in the rectum.
Whether the bowel is blocked or has a hole in it.
Whether all of the tumor can be removed by surgery.
The patient’s general health.
Whether the cancer has just been diagnosed or has recurred (come back).
Source: National Cancer Institute (NCI)
Fecal Occult Blood Test
Fecal Occult Blood Test
Also called: FOBT, Stool Hemoccult, Hemoccult Test, Guaiac Fecal Occult Blood Test, Fecal Immunochemical Test, FIT Test
A fecal occult blood test looks for blood in the stool. Occult blood means that you can't see it with the naked eye. And fecal means that it is in your stool. Blood in stool may indicate hemorrhoids, colorectal cancer, or another condition.
Fecal Occult Blood Test
Also called: FOBT, Stool Hemoccult, Hemoccult Test, Guaiac Fecal Occult Blood Test, Fecal Immunochemical Test, FIT Test
A fecal occult blood test looks for blood in the stool. Occult blood means that you can't see it with the naked eye. And fecal means that it is in your stool. Blood in stool may indicate hemorrhoids, colorectal cancer, or another condition.
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Your result is Negative.
A negative test result means that there is no blood in the stool.
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Your result is Negative.
A negative or normal result means the test did not detect any blood in the stool. However, because cancers in the colon may not always bleed, you may need to do the test a few times to confirm that there is no blood in your stool.
Related conditions
A fecal occult blood test (FOBT) looks at a sample of your stool (poop) to check for blood. Occult blood means that you can't see it with the naked eye. And fecal means that it is in your stool.
Blood in your stool means there is bleeding in the digestive tract. The bleeding may be caused by a variety of conditions, including:
Polyps, abnormal growths on the lining of the colon or rectum
Hemorrhoids, swollen veins in your anus or rectum
Diverticulosis, a condition with small pouches in the inside wall of the colon
Ulcers, sores in the lining of the digestive tract
Colitis, a type of inflammatory bowel disease
Colorectal cancer, a type of cancer that starts in the colon or rectum
Colorectal cancer is one of the most common types of cancer in the United States. A fecal occult blood test can screen for colorectal cancer to help find the disease early when treatment may be most effective.
Other names: FOBT, stool occult blood, occult blood test, Hemoccult test, guaiac smear test, gFOBT, immunochemical FOBT, iFOBT; FIT
A fecal occult blood test is commonly used as a screening test to help find colorectal cancer before you have symptoms. The test also has other uses. It may be done when there is concern about bleeding in the digestive tract from other conditions.
In certain cases, the test is used to help find the cause of anemia. And it can help tell the difference between irritable bowel syndrome (IBS), which usually doesn't cause bleeding, and inflammatory bowel disease (IBD), which is likely to cause bleeding.
But a fecal occult blood test alone cannot diagnose any condition. If your test results show blood in your stool, you will likely need other tests to diagnose the exact cause.
Your health care provider may order a fecal occult blood test if you have symptoms of a condition that could involve bleeding in your digestive tract. Or you may have the test to screen for colorectal cancer when you don't have any symptoms.
Expert medical groups strongly recommend that people get regular screening tests for colorectal cancer. Most medical groups recommend that you start screening tests at age 45 or 50 if you have an average risk of developing colorectal cancer. They recommend regular testing until at least age 75. Talk with your provider about your risk for colorectal cancer and when you should get a screening test.
A fecal occult blood test is one or several types of colorectal screening tests. Other tests include:
A stool DNA test. This test checks your stool for blood and cells with genetic changes that may be a sign of cancer.
Colonoscopy or sigmoidoscopy. Both tests use a thin tube with a camera to look inside your colon. A colonoscopy allows your provider to see your entire colon. A sigmoidoscopy shows only the lower part of your colon.
CT colonography, also called "virtual colonoscopy." For this test, you usually drink a dye before having a CT scan that uses x-rays to take detailed 3-dimensional pictures of your entire colon and rectum.
There are pros and cons of each type of test. Your provider can help you figure out which test is right for you.
Usually, your provider will give you a kit to collect samples of your stool (poop) at home. The kit will include instructions on how to do the test.
There are two main types of fecal occult blood tests:
The guaiac fecal occult blood test (gFOBT) uses a chemical (guaiac) to find blood in stool. It usually requires stool samples from two or three separate bowel movements.
The fecal immunochemical test (iFOBT or FIT) uses antibodies to find blood in stool. Research shows that FIT testing is better at finding colorectal cancers than gFOBT testing. A FIT test requires stool samples from one to three separate bowel movements, depending on the brand of the test.
Different test kits have different instructions, so it's very important to follow the specific instructions that come with your kit. The typical process for gathering a stool sample usually includes these general steps:
Collecting a bowel movement. Your kit may include a special paper to place over your toilet to catch your bowel movement. Or you may use plastic wrap or a clean, dry container. If you are doing a guaiac test, be careful not to let any urine mix in with your stool.
Taking a stool sample from the bowel movement. Your kit will include a wooden stick or applicator brush for scraping the stool sample from your bowel movement. Follow the instructions for where to gather the sample from the stool.
Preparing the stool sample. You will either smear the stool on a special test card or insert the applicator with the stool sample into a tube that came with your kit.
Labeling and sealing the sample as directed.
Repeating the test on your next bowel movement as directed if more than one sample is needed.
Returning the samples as directed. This might be mailing them or taking them to your provider's office or a lab.
You do not need any special preparations for many fecal occult blood tests. But for some guaiac fecal occult blood tests (gFOBTs), certain foods, supplements, and medicines may affect the results of the test. If you are having one of these tests, your provider will tell you what you need to avoid and for how long. For example, you might need to avoid:
Nonsteroidal, anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, and aspirin. If you take aspirin for heart problems, talk with your provider before stopping your medicine. You may be able to take acetaminophen during this time but check with your provider before taking it.
Vitamin C in amounts over 250 mg a day. This includes vitamin C from supplements, fruit juices, or fruit.
Red meat, such as beef, lamb, and pork. Traces of blood from these meats may show up in your stool.
Certain raw fruits and vegetables.
There is no known risk to having a fecal occult blood test.
If your results from a fecal occult blood test show that you have blood in your stool, it means you likely have bleeding somewhere in your digestive tract. But that doesn't always mean you have cancer. Other conditions that may cause blood in your stool include ulcers, hemorrhoids, polyps, and benign (not cancer) tumors.
If you have blood in your stool, your provider will likely recommend more tests to figure out the exact location and cause of your bleeding. The most common follow-up test is a colonoscopy. If you have questions about your test results, talk with your provider.
Learn more about laboratory tests, reference ranges, and understanding results.
Regular colorectal cancer screenings, such as fecal occult blood tests, are an important tool in the fight against cancer. Studies show that screening tests can help find cancer early and may reduce deaths from the disease.
If you decide to use fecal occult blood testing for your colorectal cancer screening, you will need to do the test every year.
You can buy gFOBT and FIT stool collection kits without a prescription. Most of these tests require you to send a sample of your stool to a lab. But some tests can be done completely at home for quick results. If you're considering buying your own test, ask your provider which one is best for you.
Fecal Occult Blood Test (FOBT): MedlinePlus Lab Test Information [accessed on Dec 28, 2018]
Tests to Detect Colorectal Cancer and Polyps - National Cancer Institute [accessed on Dec 28, 2018]
Additional Materials (4)
Colorectal Cancer Types of Surgery
Surgery is the main treatment for colorectal cancer. Polyps and very early stage cancers (Stage 0 and some early Stage I tumors) can be removed during a colonoscopy, using a variety of techniques. In late Stage I and in Stage II and III cancer, the cancerous part of the colon is removed surgically. The surgeon may perform a resection, consisting of a partial colectomy (removing the cancer and a small amount of healthy tissue around it) and an anastomosis (sewing the parts of the colon back together). Nearby lymph nodes may also be removed and biopsied. If it isn't possible to perform a resection (for instance, if the cancer is at the outlet of the rectum), a colostomy may be performed. In a colostomy, a portion of the large intestine is brought through the abdominal wall to carry stool out of the body, where it empties into a special bag. The colostomy may be temporary in order to allow the colon or rectum time to heal after surgery, or it may be permanent.
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Colorectal Cancer Screening & Diagnosis
Colorectal cancer includes cancer of both the colon and rectum. It is the fourth most common cancer in the United States and the second leading cause of cancer-related deaths affecting both men and women equally. The CDC recommends that everyone age 50 or over be screened. When diagnosed early, patients have a 90% 5-year survival rate.
Video by TheVisualMD
Screening and Diagnosis Fecal Occult Blood Test
A fecal occult blood test (FOBT) finds blood in the stool by placing a stool sample on a chemically treated card, pad, or cloth wipe. A fecal occult blood test may be used to check for colorectal cancer, but it is never used to diagnose the condition.
Image by TheVisualMD
Fecal impaction
Fecal impaction : Plain abdominal X-ray showing a huge fecal impaction extending from the pelvis upwards to the left subphrenic space and from the left towards the right flank, measuring over 40 cm in length and 33 cm in width.
Image by Di Saverio S, Tugnoli G, Orlandi PE, Casali M, Catena F, et al.
Colorectal Cancer Types of Surgery
TheVisualMD
4:12
Colorectal Cancer Screening & Diagnosis
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Screening and Diagnosis Fecal Occult Blood Test
TheVisualMD
Fecal impaction
Di Saverio S, Tugnoli G, Orlandi PE, Casali M, Catena F, et al.
A KRAS genetic test is most often used to guide treatment for certain cancers, particularly colon and non-small cell lung cancer. Some medicines are especially effective in cancer patients with KRAS mutations.
A KRAS genetic test is most often used to guide treatment for certain cancers, particularly colon and non-small cell lung cancer. Some medicines are especially effective in cancer patients with KRAS mutations.
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This person may respond to anti-EGFR therapy.
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Non-small Cell Lung Cancer
Colon cancer
KRAS gene provides instructions for making a protein called K-Ras. These proteins play important roles in cell division, cell differentiation, and the self-destruction of cells (apoptosis). KRAS gene belongs to a class of genes known as oncogenes. When there is a gene mutation, oncogenes can turn normal cells into cancerous cells.
KRAS genetic test is used to detect the most common KRAS mutations in the DNA cells and help to guide cancer treatment.
It is ordered to evaluate the response to a therapy with anti-epidermal growth factor receptor (anti-EGFR) drug therapy in patients with colon cancer and non-small cell lung cancer.
A doctor may perform this test after an individual has been diagnosed with colon cancer or non-small cell lung cancer, to test for drug sensitivity with epidermal growth factor receptor-targeted therapies.
After using anesthesia, a biopsy procedure (taking a small piece of the affected tissue) is performed to collect a tumor sample, which then will be evaluated by a pathologist.
You may be asked to refrain from eating, but usually, no preparations are needed. Follow the instructions provided by your health-care practitioner.
Risks of a biopsy depend on size, place of biopsy and type of procedure, among several other variables. There is a risk of infection, bleeding and accidental injury to a nearby tissue/organ where the biopsy was taken. There is also a risk of spreading the cancer cells.
If the biopsy result of the cancer tissue evaluated is:
Positive for KRAS mutation: this person is not eligible for treatment with anti-EGFR drug therapy.
Negative for KRAS mutation: this person may respond to anti-EGFR therapy.
However, there can be false negatives.
According to the American Society of Clinical Oncology, their guidelines suggest doing KRAS genetic test to evaluate drug therapy response, before treatment with epidermal growth factor receptor-targeted therapies.
KRAS Mutation [accessed on Oct 03, 2018]
Medscape: Medscape Access [accessed on Oct 03, 2018]
KRASC - Clinical: KRAS Mutation Analysis, 7 Mutation Panel, Colorectal [accessed on Oct 03, 2018]
KRASO - Clinical: KRAS Mutation Analysis, 7 Mutation Panel, Other (Non-Colorectal) [accessed on Oct 03, 2018]
481075: KRAS Gene Mutation Analysis, Extended | LabCorp [accessed on Oct 03, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Barium Enema
Barium Enema
Also called: Lower GI Series
A barium enema, also called a lower GI series, is an x-ray exam used to help diagnose problems of the large intestine. To make the large intestine more visible on x-ray, the intestine is filled with a chalky liquid called barium.
Barium Enema
Also called: Lower GI Series
A barium enema, also called a lower GI series, is an x-ray exam used to help diagnose problems of the large intestine. To make the large intestine more visible on x-ray, the intestine is filled with a chalky liquid called barium.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
A negative result means that there were no abnormalities found. Barium filled the colon evenly, showing normal bowel shape and position and no blockages.
Related conditions
A barium enema is an x-ray exam in which a liquid that contains barium sulfate is put through the anus into the rectum and colon. Barium sulfate is a silver-white metallic compound that helps show pictures of the colon, rectum, and anus on an x-ray.
https://www.niddk.nih.gov/health-information/diagnostic-tests/lower-gi-series [accessed on Sep 19, 2019]
https://medlineplus.gov/ency/article/003817.htm [accessed on Sep 19, 2019]
https://www.radiologyinfo.org/en/info.cfm?pg=lowergi [accessed on Sep 19, 2019]
https://www.healthline.com/health/barium-enema [accessed on Sep 19, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (11)
Screening and Diagnosis Barium Enema
A barium enema is an X-ray examination of the colon. To make the intestine visible on X-ray, a white liquid called barium is inserted into the colon through a tube placed in the anus. The barium blocks X-rays, causing the outline of the barium-filled colon to show up clearly on the X-ray image.
Image by TheVisualMD
Barium Enema
Double Contrast Barium Enema - Using Positive and Negative Contrast
Image by The original uploader was Glitzy queen00 at English Wikipedia
A barium swallow exam taken via fluoroscopy.
A barium swallow exam taken via fluoroscopy.
Image by Normaler_Schluck-00.jpg (and others): Hellerhoff
Upper gastrointestinal series
X-ray of the stomach with both positive (bariumsulphate) and negative (CO2)contrastmedia.
Image by Lucien Monfils
Hernia
X-rays image: Double Contrast Barium Enema depicting gas filled loop of colon trapped outside the normal peritoneal confines. This marks the entrance or exit of transdiafragmatic, colonic herniation.
Image by Nevit Dilmen (talk)
Peutz-Jeghers syndrome
Note multiple polyps (mostly pedunculated) and at least one large mass at the hepatic flexure coated with contrast.
Image by robhengxr
Upper gastrointestinal series
Barium follow though showing the small bowel.
Image by Glitzy queen00 at en.wikipedia
Diverticulosis and Diverticulitis
Representation of the rectum, colon and descending colon sigmoideums in double contrast in an X-ray contrast enema. In the distal descending colon and sigmoid, individual small protuberances indicate which are called diverticula.
Image by Bragel
Gastroesophageal reflux disease - Treatment for GER and GERD
Gastroesophageal reflux barium X-ray : X-ray of the abdomen and chest in a patient with a gastrostomy. Radio-contrast was injected into the stomach and quickly seen migrating upwards through the entire esophagus. The patient had severe reflux esophagitis.
Image by Steven Fruitsmaak
Double Contrast Barium Enema - Using Positive and Negative Contrast
Double Contrast Barium Enema - Using Positive and Negative Contrast
Image by Glitzy queen00
Lower GI Series
A lower GI series, also called a barium
enema, is an x-ray exam used to help
diagnose problems of the large intestine. An
x ray is a picture created by using radiation
and recorded on film or on a computer. To
make the large intestine more visible on x ray,
a health care provider will fill the person’s
intestine with a chalky liquid called barium.
Document by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Screening and Diagnosis Barium Enema
TheVisualMD
Barium Enema
The original uploader was Glitzy queen00 at English Wikipedia
A barium swallow exam taken via fluoroscopy.
Normaler_Schluck-00.jpg (and others): Hellerhoff
Upper gastrointestinal series
Lucien Monfils
Hernia
Nevit Dilmen (talk)
Peutz-Jeghers syndrome
robhengxr
Upper gastrointestinal series
Glitzy queen00 at en.wikipedia
Diverticulosis and Diverticulitis
Bragel
Gastroesophageal reflux disease - Treatment for GER and GERD
Steven Fruitsmaak
Double Contrast Barium Enema - Using Positive and Negative Contrast
Glitzy queen00
Lower GI Series
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Colonoscopy
Colonoscopy
Also called: Coloscopy
Colonoscopy is an exam in which a doctor uses a colonoscope, to look inside your rectum and colon. Colonoscopy can show irritated and swollen tissue, ulcers, polyps, and cancer.
Colonoscopy
Also called: Coloscopy
Colonoscopy is an exam in which a doctor uses a colonoscope, to look inside your rectum and colon. Colonoscopy can show irritated and swollen tissue, ulcers, polyps, and cancer.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
Normal findings are healthy intestinal tissues. If no abnormalities are discovered, an adult at average risk of colon cancer is generally advised to have a repeat colonoscopy 10 years until age 75.
Related conditions
Colonoscopy is a exam in which a doctor uses a flexible tube with a camera on one end, called a colonoscope or scope, to look inside your rectum and colon. The rectum and colon make up most of your large intestine.
Colonoscopy can show irritated and swollen tissue, ulcers, polyps, and cancer.
A colonoscopy is used:
to look for early signs of cancer in the colon and rectum. It may be part of a routine screening, which usually starts at age 45.
to look for causes of unexplained changes in bowel habits
to evaluate symptoms like abdominal pain, rectal bleeding, and weight loss
Your doctor can also remove polyps from your colon during the procedure.
You may need a colonoscopy to find the cause of unexplained symptoms such as:
Bleeding from your anus (the opening of the rectum through which stool passes out of your body)
Changes in your bowel activity, such as diarrhea
Pain in your abdomen (belly)
Unexplained weight loss
Doctors also use the procedure to screen for colon polyps and cancer. Screening is testing for diseases when you have no symptoms. It may find diseases at an early stage, when they are easier to treat. If aren't at higher risk for colorectal cancer, your health care provider will likely recommend you start getting screenings at age 45. If you at higher risk, you may need to start getting screened for colorectal cancer earlier.
There are also other tests to screen for colorectal cancer, including stool tests. Talk with your provider about which test is right for you and when and how often you should get it.
This test allows a provider to view your entire colon and rectum. It is often done in an outpatient department of a hospital or medical center. Before the test, you will need to empty out your colon (large bowel) in a procedure called bowel prep. During the test:
You will lie on an exam table.
You will be given medicine called a sedative to help you relax. It also prevents you from feeling pain during the procedure. You may be awake for the test, but you probably won't remember anything.
A colonoscope, a thin, lighted tube with a camera attached, will be inserted into your rectum and up into your colon.
Your provider will look for colorectal polyps or other abnormal areas.
Your provider may remove polyps or tissue samples using special tools inserted through the scope.
Polyps or samples may be sent to a lab for testing.
The sedative you are given may make you drowsy for several hours. You should arrange for someone to drive you home.
For a colonoscopy, you will need to do a bowel prep. Your provider will give you specific instructions on how to do your bowel prep, but steps for bowel prep may include:
Following a liquid diet for one to three days before the test.
Drinking plenty of clear liquids one to three days before the test. Clear liquids include water, black coffee or tea, fat-free broth, and sports drinks without added color.
Drinking a strong liquid laxative and/or using an enema on the evening before your test.
The laxative or enema will help you empty your bowels. You should prepare to spend a lot of time in the bathroom. Bowel prep can be inconvenient and uncomfortable, but if the colon is not thoroughly cleaned out, your provider may not be able to get a full picture of your colon and rectum. Polyps and other abnormal areas may not be seen.
Serious risks of colonoscopy are rare but can include:
Tears in the colon or rectum wall
Bleeding
Reaction to the sedative
Normal findings are healthy intestinal tissues. Abnormal results may include the following:
Colorectal polyps or abnormal tissue were found and removed.
Samples were sent to a lab for testing.
Most polyps aren't cancerous but can turn into cancer if not removed. Depending on the size and number of polyps, your provider may recommend more frequent colonoscopies.
If you have questions about your results, talk to your health care provider.
You may feel cramping in your abdomen or bloating during the first hour after the colonoscopy. If the doctor removed polyps or performed a biopsy, you may have light bleeding from your anus. This bleeding is normal.
Colorectal Cancer Screening Tests: MedlinePlus Medical Test [accessed on Feb 10, 2024]
Colonoscopy - NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases. Feb 10, 2024 [accessed on Feb 10, 2024]
Colonoscopy | MedlinePlus. National Library of Medicine. Dec 5, 2022 [accessed on Feb 10, 2024]
Colonoscopy: MedlinePlus Medical Encyclopedia [accessed on Feb 10, 2024]
Robert H. Shmerling, MD. Understanding the results of your colonoscopy - Harvard Health. Oct 14, 2020 [accessed on Feb 10, 2024]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (40)
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Colorectal Cancer Clip 6
Colorectal Cancer Clip 6
Video by TheVisualMD
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Colorectal Cancer Clip 4
Colorectal Cancer Clip 4
Video by TheVisualMD
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Colorectal Cancer Clip 3
Colorectal Cancer Clip 3
Video by TheVisualMD
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Colorectal Cancer Screening
Colorectal cancer is one of the few preventable forms of cancer thanks to effective screening. For many people, screening for colorectal cancer is an unpleasant thought, but knowing your options and taking a pro-active approach especially if you're over 50 can save your life. In this video, you can learn the "ins and outs" of colonoscopy, as well as learn about a new technique called virtual colonoscopy, which uses high-tech CT scans to screen the colon.
Video by TheVisualMD
This browser does not support the video element.
Colorectal Cancer Screening & Diagnosis
Colorectal cancer includes cancer of both the colon and rectum. It is the fourth most common cancer in the United States and the second leading cause of cancer-related deaths affecting both men and women equally. The CDC recommends that everyone age 50 or over be screened. When diagnosed early, patients have a 90% 5-year survival rate.
Video by TheVisualMD
Preparing for a Colonoscopy
Video by Dartmouth-Hitchcock/YouTube
Why No One Should Be Afraid of a Colonoscopy
Video by Stanford Health Care/YouTube
What are Colonoscopy Risks? • Risks of Colonoscopy | Colonoscopy Center of Excellence
Video by La Peer/YouTube
Having a colonoscopy
Video by Cancer Research UK/YouTube
The Importance of Good Bowel Preparation During Colonoscopy
Video by Johns Hopkins Medicine/YouTube
What is a colonoscopy and how do I prepare for it?
Video by You and Colonoscopy/YouTube
Virtual Colonoscopy Q&A | Dr. Karen Horton
Video by Johns Hopkins Medicine/YouTube
What to expect during a colonoscopy
Video by MD Anderson Cancer Center/YouTube
6 Reasons to Get a Colonoscopy
Video by Cleveland Clinic/YouTube
Colonoscopy Video Tour: Removal of a Colon Polyp (Polypectomy)
Video by AmCollege Gastro/YouTube
What happens during and after a colonoscopy?
Video by You and Colonoscopy/YouTube
How to prepare for a colonoscopy
Video by MD Anderson Cancer Center/YouTube
Colonoscopy and Flexible Sigmoidoscopy
Video by Gastro Pros/YouTube
Virtual Colonoscopy: A Kinder Gentler Way to Prevent Colon Cancer
Video by University of California Television (UCTV)/YouTube
Screening for Colorectal Cancer
Video by Dartmouth-Hitchcock/YouTube
What is Colorectal Cancer?
Video by Stanford Health Care/YouTube
Rectal Cancer | Q&A
Video by Johns Hopkins Medicine/YouTube
5 Things to Know About Colonoscopy - The Nebraska Medical Center
Video by Nebraska Medicine Nebraska Medical Center/YouTube
Video by PreOp.com Patient Engagement - Patient Education/YouTube
UCSF Radiology: How is Virtual Colonoscopy Performed?
Video by UCSF Imaging/YouTube
Sensitive content
This media may include sensitive content
Diagram showing a colonoscopy
Diagram showing a colonoscopy.
Image by Cancer Research UK / Wikimedia Commons
Virtual Colonoscopy 3D Model
With virtual colonoscopy, a computed tomography scanner takes cross-sectional images of the patient's colon, after the colon has been inflated with gas. A three-dimensional model is then created from the CT slices and evaluated by a radiologist for abnormalities.
Image by TheVisualMD
Virtual Colonoscopy Slice of CT Data
Virtual colonoscopy is a new imaging technology that uses computed tomography (CT) images to look for polyps and cancer in the colon. A computed tomography scanner takes cross-sectional images of the patient's colon, after the colon has been inflated with gas. A three-dimensional model is created from the CT slices and evaluated by a radiologist for abnormalities.
Image by TheVisualMD
Colonoscopy or sigmoidoscopy testing
Drawing of a woman being tested for colon polyps. The woman is lying on her left side with her head on a pillow. In the background is a TV screen showing images of the colon.
Image by NIDDK Image Library
Colorectal Cancer Types of Surgery
Surgery is the main treatment for colorectal cancer. Polyps and very early stage cancers (Stage 0 and some early Stage I tumors) can be removed during a colonoscopy, using a variety of techniques. In late Stage I and in Stage II and III cancer, the cancerous part of the colon is removed surgically. The surgeon may perform a resection, consisting of a partial colectomy (removing the cancer and a small amount of healthy tissue around it) and an anastomosis (sewing the parts of the colon back together). Nearby lymph nodes may also be removed and biopsied. If it isn't possible to perform a resection (for instance, if the cancer is at the outlet of the rectum), a colostomy may be performed. In a colostomy, a portion of the large intestine is brought through the abdominal wall to carry stool out of the body, where it empties into a special bag. The colostomy may be temporary in order to allow the colon or rectum time to heal after surgery, or it may be permanent.
Image by TheVisualMD
Sensitive content
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Capsule endoscopy
Image of the colon acquired by capsule endoscopy
Image by Dr.HH.Krause
All Views
Inside
Outside
Unfurled
1
2
3
4
Virtual Colonoscopy
Virtual colonoscopy is a new technology that uses computerized tomography (CT) images to look for polyps and cancer in the colon. The result is a computer-generated, animated, three-dimensional view of the interior of the colon. The preparation for the procedure is similar to that for a colonoscopy, but the procedure itself takes only about 10 minutes, and no sedation is required. If abnormalities are found, a conventional colonoscopy is performed for removal or biopsy of the growth.
Interactive by TheVisualMD
Virtual Colonoscopy open colon section view
After the image-taking procedure is complete, the cross-sectional pictures are processed by the computer to create animated, three-dimensional images of the large intestine. They are examined by a radiologist to identify any abnormal growths. If abnormalities are found, a conventional colonoscopy will be performed so that the abnormal growths can be removed or biopsied.
Image by TheVisualMD
Screening and Diagnosis Colonoscopy
A colonoscopy is an examination of the interior of the colon. It is often used as a screening tool for early detection of colorectal cancer. During a colonoscopy, a long flexible tube with a video camera at one end, called a colonoscope, is inserted first into the anus and then into the colon. The doctor can view the inside of the colon along its entire length on a video monitor.
Image by TheVisualMD
A Less Invasive Look
Virtual colonoscopy is a new technology that uses computed tomography (CT), or, less often, magnetic resonance imaging (MRI) images to look for polyps, cancer, or other diseases of the colon when an abnormality is suspected. A computer program assembles the images to create an animated, three-dimensional view of the interior of the colon. The preparation for the procedure is similar to that for a colonoscopy, but the procedure itself takes only about 10 minutes, and no sedation is required. If abnormalities are found, a conventional colonoscopy will need to be performed for removal or biopsy of the growth.
Image by TheVisualMD
Screening and Diagnosis Colonoscope
A colonoscopy is an examination of the interior of the colon. It is often used as a screening tool for early detection of colorectal cancer. During a colonoscopy, a long flexible tube with a video camera at one end, called a colonoscope, is inserted first into the anus and then into the colon. The doctor can view the inside of the colon along its entire length on a video monitor.
Image by TheVisualMD
Capsule endoscopy
Picture of a capsule
Image by Euchiasmus
Preparing for a colonoscopy
Video by AmerGastroAssn/YouTube
0:05
Colorectal Cancer Clip 6
TheVisualMD
0:15
Colorectal Cancer Clip 4
TheVisualMD
0:49
Colorectal Cancer Clip 3
TheVisualMD
4:13
Colorectal Cancer Screening
TheVisualMD
4:12
Colorectal Cancer Screening & Diagnosis
TheVisualMD
14:55
Preparing for a Colonoscopy
Dartmouth-Hitchcock/YouTube
3:35
Why No One Should Be Afraid of a Colonoscopy
Stanford Health Care/YouTube
2:56
What are Colonoscopy Risks? • Risks of Colonoscopy | Colonoscopy Center of Excellence
La Peer/YouTube
1:37
Having a colonoscopy
Cancer Research UK/YouTube
1:23
The Importance of Good Bowel Preparation During Colonoscopy
Johns Hopkins Medicine/YouTube
6:30
What is a colonoscopy and how do I prepare for it?
You and Colonoscopy/YouTube
8:26
Virtual Colonoscopy Q&A | Dr. Karen Horton
Johns Hopkins Medicine/YouTube
1:16
What to expect during a colonoscopy
MD Anderson Cancer Center/YouTube
3:17
6 Reasons to Get a Colonoscopy
Cleveland Clinic/YouTube
2:45
Colonoscopy Video Tour: Removal of a Colon Polyp (Polypectomy)
AmCollege Gastro/YouTube
5:15
What happens during and after a colonoscopy?
You and Colonoscopy/YouTube
8:08
How to prepare for a colonoscopy
MD Anderson Cancer Center/YouTube
2:49
Colonoscopy and Flexible Sigmoidoscopy
Gastro Pros/YouTube
1:26:06
Virtual Colonoscopy: A Kinder Gentler Way to Prevent Colon Cancer
University of California Television (UCTV)/YouTube
4:06
Screening for Colorectal Cancer
Dartmouth-Hitchcock/YouTube
3:47
What is Colorectal Cancer?
Stanford Health Care/YouTube
8:46
Rectal Cancer | Q&A
Johns Hopkins Medicine/YouTube
4:18
5 Things to Know About Colonoscopy - The Nebraska Medical Center
UCSF Radiology: How is Virtual Colonoscopy Performed?
UCSF Imaging/YouTube
Sensitive content
This media may include sensitive content
Diagram showing a colonoscopy
Cancer Research UK / Wikimedia Commons
Virtual Colonoscopy 3D Model
TheVisualMD
Virtual Colonoscopy Slice of CT Data
TheVisualMD
Colonoscopy or sigmoidoscopy testing
NIDDK Image Library
Colorectal Cancer Types of Surgery
TheVisualMD
Sensitive content
This media may include sensitive content
Capsule endoscopy
Dr.HH.Krause
Virtual Colonoscopy
TheVisualMD
Virtual Colonoscopy open colon section view
TheVisualMD
Screening and Diagnosis Colonoscopy
TheVisualMD
A Less Invasive Look
TheVisualMD
Screening and Diagnosis Colonoscope
TheVisualMD
Capsule endoscopy
Euchiasmus
1:15
Preparing for a colonoscopy
AmerGastroAssn/YouTube
Digital Rectal Examination
Digital Rectal Examination
Also called: DRE, Digital Rectal Exam
A digital rectal examination (DRE) is a test in which a doctor inserts a lubricated, gloved finger into your rectum to assess your pelvic organs. It is commonly used to check the prostate gland in men, but it can also be used to evaluate the uterus and ovaries in women.
Digital Rectal Examination
Also called: DRE, Digital Rectal Exam
A digital rectal examination (DRE) is a test in which a doctor inserts a lubricated, gloved finger into your rectum to assess your pelvic organs. It is commonly used to check the prostate gland in men, but it can also be used to evaluate the uterus and ovaries in women.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
A normal result means that your doctor didn't feel any abnormalities during the exam, such as a growth or an organ enlargement.
Related conditions
Digital rectal examination (DRE) is a test in which a doctor inserts a lubricated, gloved finger into your rectum to search for certain abnormalities in the pelvic organs. This test is usually performed in men to check for abnormalities in their prostate gland, but it can also be used to evaluate a woman's uterus or ovaries.
Many doctors perform a DRE as part of a routine physical exam for men age 50 or older, some even at age 40, whether or not the man has urinary problems.
Your doctor may want to perform this test in the following situations:
If you are bleeding through your rectum
If you have pelvic pain
If you have recently had an unexplained change in your bowel habits
To collect a stool sample to check for occult (hidden) blood; this is usually done as part of the screening for rectal or colon cancer
If you are a man who has symptoms of enlarged prostate or prostate infection
Routinely to check for the size of the prostate and to look for bumps or other prostate abnormalities in men over 50 years old
First, you will need to undress below the waist; then, your doctor will ask you to lie on your side with your knees bent towards your chest, as this is the easiest and comfortable position for the test to be done. In some cases, men can also be examined while bending over the exam table; and women can also be examined during a pelvic exam, with their feet raised and placed on stirrups.
Then, the doctor will slide a lubricated, gloved finger in your rectum. At this point, he or she may want to press your abdomen with their free hand to help them feel any masses or abnormalities. You may also be asked to squeeze your rectum around their finger, so they can evaluate how well your muscles are working.
If an infection is suspected, your doctor might massage the prostate during the DRE to obtain fluid to examine with a microscope. This exam is usually done first.
No special preparations are needed for a DRE. But you should tell your doctor if you have hemorrhoids or anal fissures. The DRE may make them worse.
Most people can feel a little bit uncomfortable, but the test shouldn't be painful.
Some men can feel the urge to pee when their prostate is being examined.
In very rare cases, a vasovagal response can occur. If this happens, you can have symptoms like lightheadedness, dizziness, blurred vision, nausea, sweating, and sometimes fainting.
A normal result means that your doctor did not find any abnormalities during the exam; however, this doesn’t mean that you don’t have a problem. Your doctor may want to order further testing.
If your result was abnormal, it means that your doctor found something during the test. This may happen for several reasons, such as:
Bleeding in the digestive tract
Anal fissure (small tear in the lining of the anus)
Abscess (pus collection) in the rectum or anus
Hemorrhoids (swollen veins in the rectum or anus)
Cancer of the colon or rectum
Enlargement or abnormal growths of an organ, such as the rectum, bladder, prostate in men, or cervix, uterus, or ovaries in women.
If the DRE test indicates a problem may exist, your doctor may order additional tests.
Digital rectal exam: MedlinePlus Medical Encyclopedia [accessed on Dec 21, 2018]
Prostate Tests | NIDDK [accessed on Dec 21, 2018]
https://www.nhs.uk/conditions/rectal-examination/ [accessed on Apr 17, 2019]
https://www.webmd.com/colorectal-cancer/digital-rectal-examination [accessed on Apr 17, 2019]
https://www.verywellhealth.com/the-digital-rectal-exam-2782260 [accessed on Apr 17, 2019]
https://www.verywellhealth.com/vasovagal-reflex-1945072 [accessed on Apr 17, 2019]
https://www.cancer.net/navigating-cancer-care/diagnosing-cancer/tests-and-procedures/digital-rectal-exam-dre [accessed on Sep 16, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (5)
Sensitive content
This media may include sensitive content
Digital Rectal Exam
The prostate gland is a small gland that sits below the bladder and encircles the urethra; the gland lies close to the wall of the rectum, which allows it to be felt in a digital rectal exam, or DRE, which is performed to determine the gland is enlarged.
Image by TheVisualMD
Active Surveillance & Watchful Waiting
Not all prostate cancer treatment is radical. Active surveillance and watchful waiting are two approaches to treatment that seek to avoid the often severe side effects of curative prostate treatment. They do this by actively monitoring signs and symptoms and taking action only when necessary. Active surveillance is for men with early prostate cancer who don't have symptoms. It monitors progression of cancer through PSA and DRE testing, and includes curative treatment, such as radiation therapy, if PSA levels rise rapidly. Watchful waiting is for older men who have slow-growing cancers or men with health problems that prevent them from having surgery. This approach includes regular PSA and DRE testing, and may include hormone therapy or other palliative treatment if symptoms, such as urinary retention or pain, become acute.
Image by TheVisualMD
Cross-section diagram of a digital rectal examination showing the physician's index finger inserted into the patient's rectum to feel the size and shape of the prostate
Digital rectal exam; drawing shows a side view of the male reproductive and urinary anatomy, including the prostate, rectum, and bladder; also shows a gloved and lubricated finger inserted into the rectum to feel the prostate.
Digital rectal exam (DRE). The doctor inserts a gloved, lubricated finger into the rectum and feels the prostate to check for anything abnormal.
Image by National Cancer Institute / National Cancer Institute
Sensitive content
This media may include sensitive content
Digital Rectal Exam
TheVisualMD
Active Surveillance & Watchful Waiting
TheVisualMD
Cross-section diagram of a digital rectal examination showing the physician's index finger inserted into the patient's rectum to feel the size and shape of the prostate
National Cancer Institute / National Cancer Institute
CEA Test
CEA Test
Also called: Carcinoembryonic Antigen, CEA Assay, CEA Tumor Marker
A CEA (carcinoembryonic antigen) test measures CEA in a sample of blood or other body fluid. It helps check if treatment for certain cancers is working. The test is most commonly used in colorectal cancer.
CEA Test
Also called: Carcinoembryonic Antigen, CEA Assay, CEA Tumor Marker
A CEA (carcinoembryonic antigen) test measures CEA in a sample of blood or other body fluid. It helps check if treatment for certain cancers is working. The test is most commonly used in colorectal cancer.
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Use the slider below to see how your results affect your
health.
ng/mL
3
5
20
Your result is Normal.
Related conditions
CEA stands for carcinoembryonic antigen. CEA is a protein that is a type of "tumor marker." Tumor markers are substances that are often made by cancer cells or by normal cells in response to cancer.
High levels of CEA are normal in healthy, unborn babies. After birth, CEA levels become very low or disappear completely. So, healthy adults should have little or no CEA in their bodies.
Cancers that may cause high levels of CEA include cancers of the:
Colon and rectum (colorectal or bowel cancer)
Prostate
Ovary
Lung
Thyroid
Liver
Pancreas
Breast
If you've been diagnosed with a cancer that can cause high CEA levels, CEA testing may help your health care provider learn more about your cancer and chance of recovery. The test is often used with other tests to check if cancer treatment is working.
CEA tests are not used to screen for or diagnose cancer. That's because:
Cancers that often cause high CEA levels don't always cause high levels. You can have normal CEA test results even though you have one of these cancers.
Many other health problems that aren't cancer can make CEA levels rise, including certain conditions that affect your liver, digestion, or breathing.
Most CEA tests use a sample of your blood to measure your CEA level. Sometimes the test uses a sample of fluid from your spine, chest, or abdomen (belly), but this is less common.
A CEA test is mostly used in people who have been diagnosed with cancers that often increase CEA levels. It's most commonly used in colorectal cancer. A provider may order a CEA test along with other tests to:
Learn more about a cancer soon after it has been diagnosed. CEA levels can help predict the likelihood of recovery and/or the chance that cancer will come back after treatment.
Check how well cancer treatment is working.
See if cancer has returned after treatment.
If you've been diagnosed with a type of cancer that can cause high CEA levels, you may need CEA testing:
Before treatment to:
Help understand how serious your cancer is.
Help guide treatment decisions.
Get a measurement of your CEA level before treatment to compare with CEA levels after treatment.
During cancer treatment to see if the treatment working.
After treatment to check whether cancer has come back. You may need to have tests on a regular schedule.
CEA is usually measured with a blood sample. During a CEA blood test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
Sometimes, CEA is tested in other body fluids. For these tests, your provider will remove a small sample of fluid using a thin needle.
For a CEA blood test, you usually don't need to prepare. If you smoke, you may need to stop for a while before your test. That's because smoking increases CEA levels.
A CEA blood test has very little risk. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
To understand your CEA test results, your provider will consider the results of other tests and exams. Ask your provider to explain what your test results mean for your health and treatment.
If you had a test before starting cancer treatment, in general:
A low level of CEAmay mean your tumor is small and the cancer has not spread to other parts of your body. But some cancers don't make much CEA, so your provider may use other tests to learn more about how much cancer you have and if it's spread.
A high level of CEAmay mean you have a larger tumor and/or your cancer has spread. You'll need other tests to confirm how serious your cancer is.
If you had a test to monitor your cancer during or after treatment, your provider will compare your current CEA test results with your past test results. In general:
Decreases in CEA over time often mean that treatment is working.
Increases in CEA or high levels that stay highmay mean that treatment isn't working. For example, if you had surgery for colorectal cancer, these levels may mean that the entire tumor wasn't removed or the cancer is growing back.
Decreases in CEA after treatment followed by increasesmay mean cancer has come back.
CEA levels that remain high or increase after treatment don't always mean that treatment isn't working, or cancer is growing. So, if your CEA levels don't come down, your provider will likely order other tests to find out why.
If you have questions about your results, talk with your provider.
Labs use different methods to measure CEA. The test method can affect your results. So, its best to have your tests done the same way, and usually in the same lab. This allows your provider to compare your results over time. If you have questions about how your tests are done, ask your provider.
CEA Test: MedlinePlus Medical Test [accessed on Mar 09, 2023]
https://www.cancer.gov/about-cancer/diagnosis-staging/diagnosis/tumor-markers-fact-sheet [accessed on Mar 13, 2019]
https://www.labcorp.com/test-menu/21906/carcinoembryonic-antigen-cea [accessed on Oct 03, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (20)
Carcinoembryonic Antigen (CEA): CEA in Colorectal Cancer Staging and Treatment
CEA tests are not used to screen for colorectal cancer, but they're frequently performed after the cancer has been diagnosed. CEA is useful in staging--performing tests to determine if the cancer has spread within the intestine or to distant parts of the body. CEA may also be used for treatment planning, as elevated levels may indicate a poorer prognosis. After surgery, CEA levels may be measured periodically to see if the cancer has spread. It is important to note that CEA is not a perfect predictor of how a patient will respond to treatment, nor is it conclusive in determining if cancer has spread. The American Society of Clinical Oncologists (ASCO) states that CEA should not be used as the sole basis for decision-making in colorectal cancer.
Image by TheVisualMD
Carcinoembryonic Antigen (CEA): CEA Testing During Chemotherapy
Whether CEA is tested during systemic treatment for colorectal cancer depends on the stage of the cancer. After surgery, the American Society of Clinical Oncologists (ASCO) recommends that patients with stage II or stage III cancer have a CEA test every 3 months, for a minimum of 3 years. However, if the patient is receiving chemotherapy, CEA testing should be delayed until after chemotherapy is completed. On the other hand, CEA is the marker of choice for monitoring stage IV (metastatic) colorectal cancer during systemic treatment. Patients with metastatic cancer, in which the cancer has spread to distant parts of the body, should have a CEA test every 1-3 months during chemotherapy to see if the treatment is working and whether the cancer is still spreading. ASCO recommends other tests be done in conjunction with the CEA tests.
Image by TheVisualMD
The Importance of Good Bowel Preparation During Colonoscopy
Video by Johns Hopkins Medicine/YouTube
Colon cancer: Essential facts
Video by Institute for Cancer Genetics and Informatics/YouTube
The Colon and Colon Cancer
Video by Armando Hasudungan/YouTube
Colon Cancer: Don't Ignore Your Symptoms
Video by American Cancer Society/YouTube
Colorectal Cancer Screening
Video by Mechanisms in Medicine/YouTube
This browser does not support the video element.
Treating Colon Cancer
This animation explains how colon cancer forms and how it can be treated through chemotherapy and surgery.
Video by TheVisualMD
This browser does not support the video element.
Colorectal Cancer Screening
Colorectal cancer is one of the few preventable forms of cancer thanks to effective screening. For many people, screening for colorectal cancer is an unpleasant thought, but knowing your options and taking a pro-active approach especially if you're over 50 can save your life. In this video, you can learn the "ins and outs" of colonoscopy, as well as learn about a new technique called virtual colonoscopy, which uses high-tech CT scans to screen the colon.
Video by TheVisualMD
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Colorectal Cancer Clip 6
Colorectal Cancer Clip 6
Video by TheVisualMD
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Dr. O'Kieffe and patient on preparing for a colonoscopy
A recent colonoscopy patient and gastroenterologist Dr. Donald O'Kieffe of Metro Gastroenterology, Chevy Chase, MD, explain what's involved in the preparation for your screening.
Video by TheVisualMD
This browser does not support the video element.
Dr. Klein on who should be screened
Dr. Mark Klein, a radiologist and colorectal cancer screening specialist at Washington Radiology Associates in Washington, DC, discusses who should be screened for colorectal cancer, and when.
Video by TheVisualMD
Colon cancer staging
Colon cancer staging : After colon cancer has been diagnosed, the next step is to perform tests to determine if the cancer has spread within the intestine or to distant parts of the body. This is called staging. Staging helps the doctor to decide the most appropriate treatment for the cancer at its current stage.
Image by TheVisualMD
Colorectal Cancer Types of Surgery
Surgery is the main treatment for colorectal cancer. Polyps and very early stage cancers (Stage 0 and some early Stage I tumors) can be removed during a colonoscopy, using a variety of techniques. In late Stage I and in Stage II and III cancer, the cancerous part of the colon is removed surgically. The surgeon may perform a resection, consisting of a partial colectomy (removing the cancer and a small amount of healthy tissue around it) and an anastomosis (sewing the parts of the colon back together). Nearby lymph nodes may also be removed and biopsied. If it isn't possible to perform a resection (for instance, if the cancer is at the outlet of the rectum), a colostomy may be performed. In a colostomy, a portion of the large intestine is brought through the abdominal wall to carry stool out of the body, where it empties into a special bag. The colostomy may be temporary in order to allow the colon or rectum time to heal after surgery, or it may be permanent.
Image by TheVisualMD
Colon Anatomy & Function
Image by TheVisualMD
Colostomy
Colostomy Illustration
Image by Blausen.com staff. \"Blausen gallery 2014\". Wikiversity Journal of Medicine. DOI:10.15347/wjm/2014.010. ISSN 20018762
Colorectal Cancer
Colorectal cancer refers to cancer of the colon and cancer of the rectum. The colon is the longest part of the large intestine, and the rectum is the last several inches of the large intestine, closest to the anus.
Image by TheVisualMD
What Is Colorectal Cancer?
The process of cell growth in the body is normally an orderly one. Cells grow and divide as necessary to produce more cells as they are needed. Cells that are old or damaged die, and are replaced with new cells.
Image by TheVisualMD
Treating Colorectal Cancer
There are three main treatment options for colorectal cancer:
Image by TheVisualMD
Colorectal Cancer Spread to Body Stage 4
Cancer spreads in three ways: by invading surrounding tissue, by invading the lymph system and traveling through lymph vessels to other places in the body, and by invading veins and capillaries and traveling through the bloodstream to other places in the body. Stage IV: Cancer may have spread to nearby lymph nodes and has spread to other parts of the body, such as the liver or lungs. Stage IV colorectal cancer is not considered curable. Image 5 of 5.
Image by TheVisualMD
Carcinoembryonic Antigen (CEA): CEA in Colorectal Cancer Staging and Treatment
TheVisualMD
Carcinoembryonic Antigen (CEA): CEA Testing During Chemotherapy
TheVisualMD
1:23
The Importance of Good Bowel Preparation During Colonoscopy
Johns Hopkins Medicine/YouTube
2:49
Colon cancer: Essential facts
Institute for Cancer Genetics and Informatics/YouTube
10:05
The Colon and Colon Cancer
Armando Hasudungan/YouTube
6:06
Colon Cancer: Don't Ignore Your Symptoms
American Cancer Society/YouTube
2:42
Colorectal Cancer Screening
Mechanisms in Medicine/YouTube
3:45
Treating Colon Cancer
TheVisualMD
4:13
Colorectal Cancer Screening
TheVisualMD
0:05
Colorectal Cancer Clip 6
TheVisualMD
0:48
Dr. O'Kieffe and patient on preparing for a colonoscopy
Also called: Flexible Sigmoidoscopy, Flex Sig, Rigid Sigmoidoscopy, Proctoscopy, Proctosigmoidoscopy
A sigmoidoscopy is a diagnostic test used to check the sigmoid colon, which is the lower part of your colon or large intestine. It is used to help diagnose bowel problems and detect colon polyps that can become colon cancer.
Sigmoidoscopy
Also called: Flexible Sigmoidoscopy, Flex Sig, Rigid Sigmoidoscopy, Proctoscopy, Proctosigmoidoscopy
A sigmoidoscopy is a diagnostic test used to check the sigmoid colon, which is the lower part of your colon or large intestine. It is used to help diagnose bowel problems and detect colon polyps that can become colon cancer.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
A negative result means that no abnormalities were found in the colon. If you're at average risk of colon cancer, meaning you have no colon cancer risk factors other than age, your doctor may recommend repeating the exam in five years.
Related conditions
{"label":"Proctoscopy reference range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"The lining of the colon appears smooth and pink, with numerous folds. No abnormal growths, pouches, bleeding, or inflammation is seen.","conditions":[]},{"flag":"abnormal","label":{"short":"Abnormal","long":"Abnormal","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"A proctoscopy can reveal various issues. An abnormal result may require further testing, such as a biopsy, or determine appropriate treatment for your condition.","conditions":["Hemorrhoids","Colon polyps","Colon cancer","Ulcer","Diverticulosis","Colitis"]}],"value":0.5}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
Your result is Normal.
The lining of the colon appears smooth and pink, with numerous folds. No abnormal growths, pouches, bleeding, or inflammation is seen.
Related conditions
Sigmoidoscopy is a test in which the rectum and sigmoid colon are examined using a sigmoidoscope, a flexible lighted tube with a lens for viewing and a tool for removing tissue. This instrument is inserted through the anus into the rectum and sigmoid colon as air is pumped into the colon to expand it so the doctor can see the colon lining more clearly.
A sigmoidoscope is of two types:
Rigid sigmoidoscope: This sigmoidoscope is 25 cm long, and it allows examination of up to about 20 cm of the rectum and colon.
Flexible sigmoidoscope: It is made of a flexible fiber-optic tube and can be up to 60 cm long. It allows examination of the descending colon.
During sigmoidoscopy, abnormal growths in the rectum and sigmoid colon can be removed for analysis (biopsied). The lower colon must be cleared of stool before sigmoidoscopy, but the preparation is not very extensive. People are usually not sedated for this test.
You may need a sigmoidoscopy to find the cause of unexplained symptoms such as:
Bleeding from your anus (the opening of the rectum through which stool passes out of your body)
Changes in your bowel activity, such as diarrhea
Pain in your abdomen (belly)
Unexplained weight loss
Doctors also use the procedure to screen for colon polyps and cancer. Screening is testing for diseases when you have no symptoms. It may find diseases at an early stage, when they are easier to treat. If aren't at higher risk for colorectal cancer, your health care provider will likely recommend you start getting screenings at age 45. If you at higher risk, you may need to start getting screened for colorectal cancer earlier.
There are also other tests to screen for colorectal cancer, including stool tests. Talk with your provider about which test is right for you and when and how often you should get it.
This test allows your provider to look at the lower part of the colon. During the test:
You will lie on an exam table with your knees drawn up to your chest.
A sigmoidoscope, a flexible, lighted tube with a camera, will be inserted into the rectum and up into the lower part of the colon.
Air will be pumped through the sigmoidoscope to make the colon bigger and easier to see.
The air may make you feel like you need to have a bowel movement or pass gas.
Your provider may remove polyps or tissue samples using special tools inserted through the scope.
Polyps or samples may be sent to a lab for testing.
For a sigmoidoscopy, before the test, you may need to:
Follow a clear liquid diet one or more days before the procedure. This isn't always required, so be sure to talk to your provider before the test.
You may be asked to fast (not eat or drink) on the morning of the procedure.
Use an enema to empty your bowels about one hour before the procedure. A second enema is sometimes needed.
There are fewer risks to sigmoidoscopy than with a colonoscopy. Tears in the colon and bleeding can happen, but they are even less common than with a colonoscopy.
Normal findings are healthy intestinal tissues. Abnormal results may include the following:
Colorectal polyps or abnormal tissue were found. They may or may not be removed depending on their location.
Whether or not your polyps were removed, you will probably need a colonoscopy so your provider can view your entire colon and rectum.
If you have questions about your results, talk to your health care provider.
Tests to Detect Colorectal Cancer and Polyps - National Cancer Institute [accessed on Dec 28, 2018]
Colorectal Cancer Screening | Cancer Trends Progress Report [accessed on Dec 28, 2018]
Colorectal Cancer Screening (PDQ®)—Patient Version - National Cancer Institute [accessed on Dec 28, 2018]
Rigid and Flexible Sigmoidoscopy. MedicineNet [accessed on Feb 09, 2024]
Colorectal Cancer Screening Tests: MedlinePlus Medical Test [accessed on Feb 10, 2024]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (24)
Colorectal Cancer Screening
Video by Mechanisms in Medicine/YouTube
Testing for bowel cancer
Video by Cancer Research UK/YouTube
Screening for Cancer
Common Screening Tests and American Cancer Society Recommendations
Image by TheVisualMD
Screening & Diagnosis
Image by TheVisualMD
This browser does not support the video element.
Colorectal Cancer Clip 1
Colorectal Cancer Clip 1
Video by TheVisualMD
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Colorectal Cancer Clip 6
Colorectal Cancer Clip 6
Video by TheVisualMD
Colonoscopy or sigmoidoscopy testing
Drawing of a woman being tested for colon polyps. The woman is lying on her left side with her head on a pillow. In the background is a TV screen showing images of the colon.
Image by NIDDK Image Library
Drawing of the digestive system with sigmoid colon, rectum, and anus highlighted and parts labeled: esophagus, stomach, liver, gallbladder, duodenum, pancreas, small intestine, colon, sigmoid colon, rectum, and anus
The digestive system focusing on the sigmoid colon, rectum, and anus.
Image by NIDDK Image Library
colonoscopy
SAN DIEGO (April 5, 2011) Hospitalman Urian D. Thompson, left, Lt. Cmdr. Eric A. Lavery and Registered Nurse Steven Cherry review the monitor while Lavery uses a colonoscope on a patient during a colonoscopy at Naval Medical Center San Diego. (U.S. Navy photo by Mass Communication Specialist 2nd Class Chad A. Bascom/Released)
Image by U.S. Navy photo by Mass Communication Specialist 2nd Class Chad A. Bascom
Sensitive content
This media may include sensitive content
Diagram showing a colonoscopy
Diagram showing a colonoscopy.
Image by Cancer Research UK / Wikimedia Commons
Sensitive content
This media may include sensitive content
normal rectum colonoscopy
normal rectum 70y.o. Japanese / colonoscopy
Image by melvil
Familial adenomatous polyposis as seen on sigmoidoscopy
Familial adenomatous polyposis as seen on sigmoidoscopy
Image by Samir
Proctoscopy
Two proctoscopes
Image by Ralf Lotys (Sicherlich)
An anoscope, a proctoscope and a rectoscope, with approximate lengths
An anoscope, a proctoscope and a rectoscope, with approximate lengths
Image by Mikael Häggström
This browser does not support the video element.
Sigmoidoscopy: NCI B-roll [video]
NCI B-roll of a patient receiving a sigmoidoscopy. This video is silent. A version of this video with audio can be found in the video NCI Detection B-roll. Downloadable video files are 1280x720 at 30 fps. This image is part of the NCI B-Roll Videos collection.
View video using embedded player on this page or at youtube.com.
Video by National Cancer Institute (NCI)
Lower GI Series
A lower GI series, also called a barium
enema, is an x-ray exam used to help
diagnose problems of the large intestine. An
x ray is a picture created by using radiation
and recorded on film or on a computer. To
make the large intestine more visible on x ray,
a health care provider will fill the person’s
intestine with a chalky liquid called barium.
Document by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Drawing of the digestive system with sigmoid colon, rectum, and anus highlighted
The digestive system focusing on the sigmoid colon and stomach.
Image by NIDDK Image Library
Benign Tumor
Image of en:familial adenomatous polyposis as seen on en:sigmoidoscopy.
Image by Samir at English Wikipedia
What is a flexible sigmoidoscopy?
Video by You and Colonoscopy/YouTube
Colon Cancer Screening Tests: Flexible Sigmoidoscopy
Video by American Cancer Society/YouTube
Colon cancer: Essential facts
Video by Institute for Cancer Genetics and Informatics/YouTube
Screening for Colorectal Cancer
Video by Dartmouth-Hitchcock/YouTube
What to expect during a colonoscopy
Video by MD Anderson Cancer Center/YouTube
6 Reasons to Get a Colonoscopy
Video by Cleveland Clinic/YouTube
2:42
Colorectal Cancer Screening
Mechanisms in Medicine/YouTube
1:37
Testing for bowel cancer
Cancer Research UK/YouTube
Screening for Cancer
TheVisualMD
Screening & Diagnosis
TheVisualMD
0:15
Colorectal Cancer Clip 1
TheVisualMD
0:05
Colorectal Cancer Clip 6
TheVisualMD
Colonoscopy or sigmoidoscopy testing
NIDDK Image Library
Drawing of the digestive system with sigmoid colon, rectum, and anus highlighted and parts labeled: esophagus, stomach, liver, gallbladder, duodenum, pancreas, small intestine, colon, sigmoid colon, rectum, and anus
NIDDK Image Library
colonoscopy
U.S. Navy photo by Mass Communication Specialist 2nd Class Chad A. Bascom
Sensitive content
This media may include sensitive content
Diagram showing a colonoscopy
Cancer Research UK / Wikimedia Commons
Sensitive content
This media may include sensitive content
normal rectum colonoscopy
melvil
Familial adenomatous polyposis as seen on sigmoidoscopy
Samir
Proctoscopy
Ralf Lotys (Sicherlich)
An anoscope, a proctoscope and a rectoscope, with approximate lengths
Mikael Häggström
1:17
Sigmoidoscopy: NCI B-roll [video]
National Cancer Institute (NCI)
Lower GI Series
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Drawing of the digestive system with sigmoid colon, rectum, and anus highlighted
NIDDK Image Library
Benign Tumor
Samir at English Wikipedia
1:55
What is a flexible sigmoidoscopy?
You and Colonoscopy/YouTube
2:49
Colon Cancer Screening Tests: Flexible Sigmoidoscopy
American Cancer Society/YouTube
2:49
Colon cancer: Essential facts
Institute for Cancer Genetics and Informatics/YouTube
PCR (polymerase chain reaction) tests identify genetic material in a sample to diagnose an infectious disease or a genetic condition. PCR tests are also used to detect cancer and monitor response to treatment. The tests are fast and highly accurate.
PCR (polymerase chain reaction) tests identify genetic material in a sample to diagnose an infectious disease or a genetic condition. PCR tests are also used to detect cancer and monitor response to treatment. The tests are fast and highly accurate.
{"label":"PCR Reference Range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"negative","label":{"short":"Negative","long":"Negative","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"A negative PCR result means that the DNA or RNA of the pathogen (disease-causing organism) or abnormal cells where not found in your sample.","conditions":[]},{"flag":"positive","label":{"short":"Positive","long":"Positive","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"A positive PCR result means that the DNA or RNA of the pathogen (disease-causing organism) or abnormal cells where found in your sample.","conditions":["COVID-19","Lyme disease","Pertussis","HPV","CMV","Gonorrhea","Chlamydia","Cancer"]}],"value":0.5}[{"negative":0},{"positive":0}]
Use the slider below to see how your results affect your
health.
Your result is Negative.
A negative PCR result means that the DNA or RNA of the pathogen (disease-causing organism) or abnormal cells where not found in your sample.
Related conditions
PCR (polymerase chain reaction) tests are a fast, highly accurate way to diagnose certain infectious diseases and genetic changes. The tests work by finding the DNA or RNA of a pathogen (disease-causing organism) or abnormal cells in a sample.
DNA is the genetic material that contains instructions and information for all living things.
RNA is another type of genetic material. It contains information that has been copied from DNA and is involved in making proteins.
Most viruses and other pathogens contain DNA or RNA.
Unlike many other tests, PCR tests can find evidence of disease in the earliest stages of infection. Other tests may miss early signs of disease because there aren't enough viruses, bacteria, or other pathogens in the sample, or your body hasn't had enough time to develop an antibody response. Antibodies are proteins made by your immune system to attack foreign substances, such as viruses and bacteria. PCR tests can detect disease when there is only a very small amount of pathogens in your body.
During a PCR test, a small amount of genetic material in a sample is copied multiple times. The copying process is known as amplification. If there are pathogens in the sample, amplification will make them much easier to see.
PCR tests are used to:
Diagnose certain infectious diseases
Identify a genetic change that can cause disease
Find small amounts of cancer cells that might be missed in other types of tests
PCR tests work by:
Taking a sample of blood, saliva, mucus, or tissue
The sample will contain your own DNA and possibly the DNA of a pathogen or cancer cell.
The sample is put in a special machine. An enzyme called polymerase is added to the sample. This causes the sample to produce copies.
The copying process is repeated multiple times. After about an hour, billions of copies are made. If a virus or pathogen is present, it will be indicated on the machine.
Certain viruses, including COVID-19, are made up of RNA rather than DNA. For these viruses, the RNA must be changed into DNA before copying. This process is called reverse transcription PCR (rtPCR).
PCR and rtPCR check for the presence of a pathogen. Another type of PCR known as quantitative PCR (qPCR) measures the amount of pathogens in the sample. qPCR can be done at the same time as PCR or rtPCR.
There are different ways to get a sample for a PCR test. Common methods include blood tests and nasal swabs.
During a blood test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
A nasal swab may be taken from the front part of your nostrils (anterior nares). It also may be taken from the back of your nostrils, in a procedure known as a nasal mid-turbinate (NMT) swab, or from the nasopharynx, the uppermost part of your nose and throat. In some cases, a health care provider will ask you to do an anterior nares test or an NMT swab yourself.
During an anterior nares test, you will start by tilting your head back. Then you or the provider will:
Gently insert a swab inside your nostril
Rotate the swab and leave it in place for 10 to 15 seconds
Remove the swab and insert it into your second nostril
Swab the second nostril using the same technique
Remove the swab
During an NMT swab, you will start by tilting your head back. Then you or your provider will:
Gently insert a swab onto the bottom of the nostril, pushing it until you feel it stopping
Rotate the swab for 15 seconds
Remove the swab and insert it into your second nostril
Swab the second nostril using the same technique
Remove the swab
During a nasopharyngeal swab:
You will tip your head back.
Your health care provider will insert a swab into your nostril until it reaches your nasopharynx (the upper part of your throat).
Your provider will rotate the swab and remove it.
You don't need any special preparations for a PCR test.
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
A nasal swab may tickle your throat or cause you to cough. A nasopharyngeal swab may be uncomfortable and cause coughing or gagging. All these effects are temporary.
PCR tests are an accurate and reliable method for identifying many infectious diseases. And because they are often able to make diagnoses before symptoms of infection occur, PCR tests play a crucial role in preventing the spread of diseases.
PCR Tests: MedlinePlus Medical Test [accessed on Jan 05, 2022]
NCI Dictionary of Cancer Terms [accessed on Jan 05, 2022]
Laboratory Methods - Testing.com [accessed on Feb 18, 2022]
Blood Work | How This Provides Clues On Your Health | Leukemia & Lymphoma Society® (LLS) [accessed on Jan 05, 2022]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (31)
Polymerase Chain Reaction (PCR)
Polymerase chain reaction (PCR) is a technique used to "amplify" small segments of DNA.
Image by National Human Genome Research Institute (NHGRI)
Biotechnology
Polymerase chain reaction, or PCR, is used to amplify a specific sequence of DNA. Primers—short pieces of DNA complementary to each end of the target sequence—are combined with genomic DNA, Taq polymerase, and deoxynucleotides. Taq polymerase is a DNA polymerase isolated from the thermostable bacterium Thermus aquaticus that is able to withstand the high temperatures used in PCR. Thermus aquaticus grows in the Lower Geyser Basin of Yellowstone National Park. Reverse transcriptase PCR (RT-PCR) is similar to PCR, but cDNA is made from an RNA template before PCR begins.
Image by CNX Openstax
Antigenic Shift
Illustration of antigenic shift. NIAID illustration of potential influenza genetic reassortment
Image by National Institute of Allergy and Infectious Diseases (NIAID)
Laboratory Researcher
Chanelle Case Borden, Ph.D., a postdoctoral fellow in the National Cancer Institute's Experimental Immunology Branch, pipetting DNA samples into a tube for polymerase chain reaction, or PCR, a laboratory technique used to make multiple copies of a segment of DNA.
Image by National Cancer Institute (NCI) / Daniel Sone (photographer)
Laboratory Researcher
Chanelle Case Borden, Ph.D., a postdoctoral fellow in the National Cancer Institute's Experimental Immunology Branch, pipetting DNA samples into a tube for polymerase chain reaction, or PCR, a laboratory technique used to make multiple copies of a segment of DNA.
Image by National Cancer Institute (NCI) / Daniel Sone (photographer)
Laboratory Researcher
Chanelle Case Borden, Ph.D., a postdoctoral fellow in the National Cancer Institute's Experimental Immunology Branch, pipetting DNA samples into a tube for polymerase chain reaction, or PCR, a laboratory technique used to make multiple copies of a segment of DNA.
Image by National Cancer Institute (NCI) / Daniel Sone (photographer)
Laboratory
Microcentrifuge tubes in a rack. Some of them are DNA samples while the remainder of them are primers to be used in polymerase chain reaction, or PCR, a laboratory technique used to make multiple copies of a segment of DNA.
Image by National Cancer Institute (NCI) / Daniel Sone (photographer)
Laboratory Pipette
National Cancer Institute researcher pipetting DNA samples into a tube for polymerase chain reaction, or PCR, a laboratory technique used to make multiple copies of a segment of DNA.
Image by National Cancer Institute (NCI) / Daniel Sone (photographer)
Laboratory Researcher
Chanelle Case Borden, Ph.D., a postdoctoral fellow in the National Cancer Institute's Experimental Immunology Branch, pipetting DNA samples into a tube for polymerase chain reaction, or PCR, a laboratory technique used to make multiple copies of a segment of DNA.
Image by National Cancer Institute (NCI) / Daniel Sone (photographer)
Polymerase chain reaction (PCR)
Video by khanacademymedicine/YouTube
Polymerase Chain Reaction (PCR)
Video by DNA Learning Center/YouTube
PCR tubes
Photo of a strip of PCR tubes, each tube contains a 1000uL (1mL) reaction.
Image by Madprime
What is Polymerase Chain Reaction? | PCR Explained
Video by 2 Minute Classroom/YouTube
Laboratory Researcher
Chanelle Case Borden, Ph.D., a postdoctoral fellow in the National Cancer Institute's Experimental Immunology Branch, pipetting DNA samples into a tube for polymerase chain reaction, or PCR, a laboratory technique used to make multiple copies of a segment of DNA.
Image by National Cancer Institute (NCI) / Daniel Sone (photographer)
DNA Genotyping and Sequencing
A technician loads samples into a digital PCR machine at the Cancer Genomics Research Laboratory, part of the National Cancer Institute's Division of Cancer Epidemiology and Genetics (DCEG). Polymerase chain reaction (PCR) is a technique that greatly amplifies small pieces of DNA, generating many thousands of copies of a particular DNA sequence.
See also https://dceg.cancer.gov/about/organization/programs-hgp/cgr.
Image by National Cancer Institute (NCI) / Daniel Sone (photographer)
Laboratory Researcher
National Cancer Institute researcher setting up genetic samples and primers for polymerase chain reaction, or PCR, a laboratory technique used to make multiple copies of a segment of DNA.
Image by National Cancer Institute (NCI) / Daniel Sone (photographer)
Biotechnology
Southern blotting is used to find a particular sequence in a sample of DNA. DNA fragments are separated on a gel, transferred to a nylon membrane, and incubated with a DNA probe complementary to the sequence of interest. Northern blotting is similar to Southern blotting, but RNA is run on the gel instead of DNA. In western blotting, proteins are run on a gel and detected using antibodies.
Image by CNX Openstax
simple sequence repeat (SSR, a.k.a. microsatellite) locus
A number of DNA samples from specimens of Littorina plena amplified using polymerase chain reaction with primers targeting a variable simple sequence repeat (SSR, a.k.a. microsatellite) locus. Samples have been run on a 5% polyacrylamide gel and visualized using silver staining.
Image by ParinoidMarvin/Wikimedia
Biotechnology
This diagram shows the steps involved in molecular cloning.
Image by CNX Openstax
Gene therapy
Gene therapy using an adenovirus vector can be used to cure certain genetic diseases in which a person has a defective gene. (credit: NIH)
Image by U.S. National Library of Medicine
Testing for Ebola
Technicians set up polymerase chain reaction, or PCR, assay for Ebola in a containment laboratory. Assay components are assembled in the PCR hood to prevent contamination that could interfere with test results.
Image by U.S. Army photo by Dr. Randal J. Schoepp
reverse transcription polymerase chain reaction test
Microbiologist Erica Spackman reviews results of a reverse transcription polymerase chain reaction test to determine whether there is virus in a sample and to generate material for gene sequencing.
Image by USDA Agricultural Research Service/Photo by Suzanne Deblois.
How to Perform a Polymerase Chain Reaction | William Armour & Laura Towns
Oxford Academic (Oxford University Press)/YouTube
8:08
Gel Electrophoresis
Amoeba Sisters/YouTube
9:34
Polymerase chain reaction
Osmosis/YouTube
Polymerase Chain Reaction (PCR)
National Human Genome Research Institute (NHGRI)
Primer
National Human Genome Research Institute (NHGRI)
PDL1 (Immunotherapy) Tests
PDL1 (Immunotherapy) Tests
Also called: Programmed Death-Ligand 1, PDL1, PD-LI, PDL1 Testing, PD-L1 Test
A PD-L1 test measures a protein on cancer cells that stops your immune system from attacking cancer. The test can guide immunotherapy choices. There are many types of PD-L1 tests.
PDL1 (Immunotherapy) Tests
Also called: Programmed Death-Ligand 1, PDL1, PD-LI, PDL1 Testing, PD-L1 Test
A PD-L1 test measures a protein on cancer cells that stops your immune system from attacking cancer. The test can guide immunotherapy choices. There are many types of PD-L1 tests.
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Use the slider below to see how your results affect your
health.
Your result is High.
Having high levels of PDL1 indicates you may be started on immunotherapy.
Related conditions
A PD-L1 test uses a sample of cancerous tumor tissue to measure how much of a protein called PD-L1 is found on the cancer cells. If you have certain types of cancer, PD-L1 testing can check whether you may benefit from a type of cancer treatment called immunotherapy. Immunotherapy helps your own immune system fight cancer.
Normally, PD-L1 is found on certain healthy cells. It acts as a kind of "brake" to stop cells in your immune system, called T cells, from attacking healthy cells in your body. If cancer cells have high amounts of PD-L1, they can turn your T cells off so they can't attack the cancer cells.
If high amounts of PD-L1 are found on cancer cells, immunotherapy medicines called "immune checkpoint inhibitors" may be used. These medicines prevent the PD-L1 protein from putting the brakes on T cells. This frees your T cells to fight cancer.
Immunotherapy can help stop or slow the growth of many types of cancers that have PD-L1. Immunotherapy has fewer side effects than cancer chemotherapy. But it can cause serious side effects in some people, and not everyone benefits from it.
There are many types of PD-L1 tests. The test your health care provider orders will depend on:
The type of cancer you have
The specific immunotherapy medicine that your provider is considering for you
PD-L1 testing is used to look for the PD-L1 protein on cancer cells in a sample of tumor tissue. The test also measures the amount of PD-L1 in the tissue. This information helps find out if immunotherapy medicines could help control your cancer.
If you've been diagnosed with cancer, you may need PD-L1 testing to find out if immunotherapy could help you. Many types of cancer have immunotherapy treatments related to PD-L1. These cancers include:
Non-small cell lung cancer
Melanoma
Hodgkin lymphoma
Bladder cancer
Kidney cancer
Breast cancer
Head and neck cancer (squamous cell carcinoma)
Cancer of the esophagus (squamous cell carcinoma)
Stomach cancer (adenocarcinoma)
Cervical cancer
PD-L1 tests are done on a tissue sample from a tumor. If you're having surgery to remove a tumor, a sample will be taken for testing.
If you aren't having the tumor removed, you may have a biopsy, which is a procedure to remove a small amount of tissue for testing. If you already had a biopsy to diagnose your cancer, the same tissue sample may be used to test for PD-L1.
There are many ways to do a biopsy. The type of biopsy you have depends on the type of cancer you have and where the tumor is located. In general, a biopsy may be done using:
A hollow needle inserted through your skin. Imaging tests, such as ultrasound, may be used to guide the needle:
A fine needle aspiration biopsy uses a very thin needle to remove a sample of cells and/or fluid.
A core needle biopsy uses a larger needle to remove a sample.
Surgery. Surgery may be done to remove a sample of tissue (an incisional biopsy). In certain cases, the entire tumor will be removed (an excisional biopsy).
A scope. Scopes are tools for looking inside your body. They may be inserted through an opening in your body or through a small incision (cut). Special tools may be used with a scope to remove a tissue sample. Examples of scope procedures include bronchoscopy, laparoscopy, colposcopy, and cystoscopy (to examine the inside of the bladder).
Preparations for your test depend on how your tissue sample will be taken. Ask your provider how to prepare for your test.
Risks depend on how your tissue sample is taken. In general, if you are having a biopsy, you may have a little bruising or bleeding where the tissue was removed. Ask your provider to explain any risks from the test you're having.
Your test results will show whether you have enough PD-L1 protein in your tumor for you to benefit from a specific immunotherapy medicine. Some immunotherapy medicines will not be helpful if a small percentage of your cancer cells have PD-L1.
If your test results show that:
Your tumor cells have enough PD-L1 for you to use immunotherapy medicine, you may be able to start that medicine. This may be called a "positive" test result.
Your tumor cells don't have enough PD-L1, then the immunotherapy is not likely to help you. This may be called a "negative" test result. Your provider will consider another type of cancer treatment.
Your provider may also use other tests to help decide on the best treatment for you. If you have questions about your results, talk with your provider.
Immunotherapy is a quickly changing area of medicine. For some immunotherapy medicines, PD-L1 testing is required to see if you are a good match for that treatment. For other medicines, testing is only recommended. But new research may change how tests are used to choose treatments. So, check with your provider to find out how PD-L1 testing may affect your treatment plan.
PDL1 (Immunotherapy) Tests: MedlinePlus Medical Test [accessed on Dec 20, 2022]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (14)
Detecting Abnormal Cells in the Cervix - CD3 (yellow); CD8 (red); PD1 (pink) and PDL1 (green).
This image of cellular infiltrate in mucous membrane cells of the cervix visualizes a panel of biomarkers indicating abnormal expansion or a growth. The biomarkers detected include CD3 (yellow); CD8 (red); PD1 (pink) and PDL1 (green). The blue color represents the cell nucleus. The intensity of each fluorescent signal can be measured and interpreted as the amount of that particular protein present in the tissue sample. This image indicates the presence of different inflammatory cells and immune regulatory cells present in the cellular infiltrate.
Image by National Cancer Institute \ Tisch Cancer Institute at the Mount Sinai School of Medicine / Tin Htwe Thin
Sensitive content
This media may include sensitive content
Metastatic Melanoma Cells
The ability of cancer cells to move and spread depends on actin-rich core structures such as the podosomes (yellow) shown here in melanoma cells. Cell nuclei (blue), actin (red), and an actin regulator (green) are also shown.
Image by Julio C. Valencia / NCI Center for Cancer Research
Cancer therapy by inhibition of negative immune regulation (CTLA4, PD1)
Image by Brennick CA, George MM, Corwin WL, Srivastava PK, Ebrahimi-Nik H/Wikimedia
PD-L1 positive lung adenocarcinoma -- high mag
Micrograph showing a PD-L1 positive lung adenocarcinoma. PD-L1 immunostain.
Image by https://commons.wikimedia.org/wiki/File:PD-L1_positive_lung_adenocarcinoma_--_high_mag.jpg
B7 family ligands and CD28 family receptors
This diagram shows binding of costimulatory molecules on APCs and T cells. It shows B7 family ligands and their interactions with CD28 family receptors.
Image by The Immunologist/Wikimedia
Cancer immunotherapy | The PD-L1 pathway
Video by Roche/YouTube
PD-L1 – Immunotherapy: Unleashing the body to fight cancer | Dana-Farber Cancer Institute
Video by Dana-Farber Cancer Institute/YouTube
What is PD-1? Ask a Scientist
Video by Cancer Research Institute/YouTube
How Does Anti-PD-1 Therapy Help Fight Cancer?
Video by Johns Hopkins Medicine/YouTube
PD-L1 Testing and Developmental Process for Companion Diagnostic Tests
Video by RocheDiagnosticsUSA/YouTube
PD-L1 Biomarker Testing
Video by OncLiveTV/YouTube
Tumour immunology and immunotherapy
Video by nature video/YouTube
Immunotherapy: Moving beyond PD1 and PDL1 inhibitors
Video by ImedexCME/YouTube
Detecting Abnormal Cells in the Cervix - CD3 (yellow); CD8 (red); PD1 (pink) and PDL1 (green).
National Cancer Institute \ Tisch Cancer Institute at the Mount Sinai School of Medicine / Tin Htwe Thin
Sensitive content
This media may include sensitive content
Metastatic Melanoma Cells
Julio C. Valencia / NCI Center for Cancer Research
Cancer therapy by inhibition of negative immune regulation (CTLA4, PD1)
Guido4
Neoepitope
Brennick CA, George MM, Corwin WL, Srivastava PK, Ebrahimi-Nik H/Wikimedia
PD-L1 – Immunotherapy: Unleashing the body to fight cancer | Dana-Farber Cancer Institute
Dana-Farber Cancer Institute/YouTube
2:01
What is PD-1? Ask a Scientist
Cancer Research Institute/YouTube
1:07
How Does Anti-PD-1 Therapy Help Fight Cancer?
Johns Hopkins Medicine/YouTube
12:39
PD-L1 Testing and Developmental Process for Companion Diagnostic Tests
RocheDiagnosticsUSA/YouTube
4:47
PD-L1 Biomarker Testing
OncLiveTV/YouTube
5:04
Tumour immunology and immunotherapy
nature video/YouTube
23:02
Immunotherapy: Moving beyond PD1 and PDL1 inhibitors
ImedexCME/YouTube
Virtual Colonoscopy
Virtual Colonoscopy
Also called: CT Colonography, Computed Tomographic Colonography
Virtual colonoscopy is a non-invasive imaging method that uses computed tomographic data combined with specialized imaging software to examine the colon. It produces three-dimensional images of the colon which are examined for colorectal cancer and precancerous polyps.
Virtual Colonoscopy
Also called: CT Colonography, Computed Tomographic Colonography
Virtual colonoscopy is a non-invasive imaging method that uses computed tomographic data combined with specialized imaging software to examine the colon. It produces three-dimensional images of the colon which are examined for colorectal cancer and precancerous polyps.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
No abnormalities were detected in the colon. If you're at average risk of colon cancer, meaning you have no colon cancer risk factors other than age, your doctor may recommend repeating the exam in five years.
Related conditions
A method to examine the inside of the colon by taking a series of x-rays. A computer is used to make 2-dimensional (2-D) and 3-D pictures of the colon from these x-rays. The pictures can be saved, changed to give better viewing angles, and reviewed after the procedure, even years later.
Also called computed tomographic colonography, computed tomography colonography, CT colonography, and CTC.
You may need a virtual colonoscopy to find the cause of unexplained symptoms such as:
Bleeding from your anus (the opening of the rectum through which stool passes out of your body)
Changes in your bowel activity, such as diarrhea
Pain in your abdomen (belly)
Unexplained weight loss
Doctors also use the procedure to screen for colon polyps and cancer. Screening is testing for diseases when you have no symptoms. It may find diseases at an early stage, when they are easier to treat. If aren't at higher risk for colorectal cancer, your health care provider will likely recommend you start getting screenings at age 45. If you at higher risk, you may need to start getting screened for colorectal cancer earlier.
There are also other tests to screen for colorectal cancer, including stool tests. Talk with your provider about which test is right for you and when and how often you should get it.
This is a type of x-ray that uses a CT scan (computed tomography) to take detailed, 3-dimensional pictures of the entire colon and rectum. It is usually done in a radiology department of a hospital or medical center. This procedure also requires bowel prep beforehand. During the test:
You will lie on a narrow table.
You may be asked to drink a liquid containing contrast dye. Contrast dye is a substance that makes parts of your body show up more clearly on an x-ray.
A provider will insert a small tube into the rectum.
Air will be pumped through the tube to make the colon bigger and easier to see.
The table will slide into the CT machine.
A series of images will be taken.
For a virtual colonoscopy, you will need to do a bowel prep. Your provider will give you specific instructions on how to do your bowel prep, but steps for bowel prep may include:
Following a liquid diet for one to three days before the test.
Drinking plenty of clear liquids one to three days before the test. Clear liquids include water, black coffee or tea, fat-free broth, and sports drinks without added color.
Drinking a strong liquid laxative and/or using an enema on the evening before your test.
The laxative or enema will help you empty your bowels. You should prepare to spend a lot of time in the bathroom. Bowel prep can be inconvenient and uncomfortable, but if the colon is not thoroughly cleaned out, your provider may not be able to get a full picture of your colon and rectum. Polyps and other abnormal areas may not be seen.
In a virtual colonoscopy, risks include:
Exposure to a small dose of radiation from the scan.
Rarely, a tear in the colon or rectum can happen when it is inflated with air.
Normal findings are healthy intestinal tissues. Abnormal results may include the following:
Colorectal polyps or abnormal tissue were seen on the CT scan.
You will probably need a traditional colonoscopy so your provider can get a tissue sample. Sometimes this procedure can be done on the same day as your virtual colonoscopy.
If you have questions about your results, talk to your health care provider.
Colorectal Cancer Screening Tests: MedlinePlus Medical Test [accessed on Feb 12, 2024]
Colonoscopy | MedlinePlus. National Library of Medicine. Dec 5, 2022 [accessed on Feb 12, 2024]
Virtual Colonoscopy | NIDDK [accessed on Dec 28, 2018]
Tests to Detect Colorectal Cancer and Polyps - National Cancer Institute [accessed on Dec 28, 2018]
Colorectal Cancer Screening | Cancer Trends Progress Report [accessed on Dec 28, 2018]
CT Colonography [accessed on Dec 28, 2018]
Virtual colonoscopy - Mayo Clinic [accessed on Dec 28, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (14)
Virtual Colonoscopy 3D Model
With virtual colonoscopy, a computed tomography scanner takes cross-sectional images of the patient's colon, after the colon has been inflated with gas. A three-dimensional model is then created from the CT slices and evaluated by a radiologist for abnormalities.
Image by TheVisualMD
Virtual Colonoscopy open colon section view
After the image-taking procedure is complete, the cross-sectional pictures are processed by the computer to create animated, three-dimensional images of the large intestine. They are examined by a radiologist to identify any abnormal growths. If abnormalities are found, a conventional colonoscopy will be performed so that the abnormal growths can be removed or biopsied.
Image by TheVisualMD
A Less Invasive Look
Virtual colonoscopy is a new technology that uses computed tomography (CT), or, less often, magnetic resonance imaging (MRI) images to look for polyps, cancer, or other diseases of the colon when an abnormality is suspected. A computer program assembles the images to create an animated, three-dimensional view of the interior of the colon. The preparation for the procedure is similar to that for a colonoscopy, but the procedure itself takes only about 10 minutes, and no sedation is required. If abnormalities are found, a conventional colonoscopy will need to be performed for removal or biopsy of the growth.
Image by TheVisualMD
This browser does not support the video element.
Colon unfurling
Virtual colonoscopy is a new technology that uses computed tomography (CT), or, less often, magnetic resonance imaging (MRI) images to look for polyps, cancer, or other diseases of the colon when an abnormality is suspected. A computer program assembles the images to create an animated, three-dimensional view of the interior of the colon. The preparation for the procedure is similar to that for a colonoscopy, but the procedure itself takes only about 10 minutes, and no sedation is required. If abnormalities are found, a conventional colonoscopy will need to be performed for removal or biopsy of the growth.
Video by TheVisualMD
This browser does not support the video element.
Colorectal Cancer Clip 3
Colorectal Cancer Clip 3
Video by TheVisualMD
This browser does not support the video element.
Colorectal Cancer Clip 4
Colorectal Cancer Clip 4
Video by TheVisualMD
Spectrum of Medical Imaging
This composite image was created in recognition of The Society of Photo-Optical Instrumentation Engineers (SPIE) designation of 2015 as the “International Year of Light.” Medical imaging scientists and engineers contribute to the quest for the improved human condition by providing imaging that spans the entire usable electro-magnetic spectrum (seen at bottom). From the humblest of beginnings with simple magnification of objects and focusing with lenses, to the biological observation of cells with rudimentary microscopes in the visible spectrum, medical imaging today has both extended away from the visible spectrum towards longer and shorter wavelengths (low and high energies) and exploited the hyperspectral nature of the visible which was once considered “commonplace” or rudimentary. Considering yet a different cross-section through the various imaging modalities across the spectrum, the medically useful information gained spans anatomic, physiologic, and molecular regimes. Systems and algorithms have been developed as single-modality acquisition systems, and also as multiple-modalities with conjoint reconstruction, each informing the other in the quest to optimize image quality and information content. In addition, the role of light-based technologies in enabling advanced computations in tomographic reconstructions, computer-aided diagnosis, machine learning (neural networks, deep learning, etc.) , and 3D visualizations as well as in data-enriched storage of medical images has further extended the potential knowledge “seen” through imaging. The breadth of the electromagnetic spectrum offers limitless opportunities for improvement and inquiry, in our quest to answer human life’s difficult questions. This montage was first published on the cover of the SPIE’s Journal of Medical Imaging (July-Sept. 2015, vol. 3, no. 3) and is but a small tribute to the multitude of medical imaging scientists who have contributed to the wealth of new knowledge as we interrogate the human condition. The gray-scale whole body images (from Left to Right) are acquired from longer wavelength modalities to shorter wavelength modalities spanning the (currently) usable electromagnetic spectrum. The background images include: a coronal Magnetic Resonance Image (MRI) T2 weighted image slice, a posterior surface Infra Red (IR) heat map, a coronal non-contrast Computed Tomography (CT) slice, and a coronal 18F-fluoro-deoxyglucose Positron Emission Tomography (FDG-PET) slice. The selection of color inset images includes (from Top-to-Bottom, then Left to Right): [1] diffusion tensor magnetic resonance imaging (MRI) used to image long white matter tracts within and around the human brain illustrating neuronal connectivity (coloring refers to bluish=vertical direction; green=horizontal A-P direction; red=horizontal lateral direction) (courtesy of Arthur Toga, PhD); [2] registered and superimposed coronal proton-MRI (gray-scale) and a hyper polarized 129Xe ventilation MRI scan (color scale) within the same patient’s lungs, prior to their receiving a bronchial stent (courtesy of Bastiaan Driehuys, PhD); [3] coronal slice through a microwave-based image reconstruction of the Debye parameter ε (epsilon) in a heterogeneously dense human breast phantom (courtesy of Susan Hagness, PhD); [4] juxtaposed optical image of the retina and vertical and horizontal Optical Coherence Tomograph (OCT) slices showing pigmentosa retinopathy (courtesy of Jean-Michel Muratet, MD); [5] functional 3-D photoacoustic imaging of melanoma (gray scale) in vivo, surrounded by highly optically absorptive blood vessels (red) (courtesy of Lihong Wang, PhD); [6] optical micrograph of HeLa cells stained for microtubules (blue) and co-stained with DAPI for actin visualization (red); HeLa cells are the world's first stem cell line, originally derived from the aggressive cervical cancer cells of Henrietta Lacks (courtesy Tom Deerinck/NCMIR); [7] visualization of the pelvis highlighting the colon, which is imaged with contrast x-ray computed tomography (CT), and after digital surface rendering can be used in virtual colonoscopy, thus avoiding a physical visible light-based colonoscopy; [8] registered and fused sagittal 99mTc-sestamibi dedicated molecular single photon emission computed tomography (SPECT, heat color scale) and low-dose CT slice (gray scale) of a patient’s uncompressed, pendant breast containing two surgically confirmed DCIS loci in the posterior breast (courtesy of Martin Tornai, PhD); [9] classic, early x-radiograph of Wilhelm Röntgen’s wife’s hand (adapted from http://en.wikipedia.org/wiki/100_Photographs_that_Changed_the_World); [10] transverse pelvic CT (gray scale) with multiple superimposed simulated x-ray photon radiotherapy beams, and their cumulative 20Gy (red) deposited dose isocontours at the focus of a tumor (courtesy of Paul Read, MD, PhD); [11] false-colored scanning electron micrograph of human immunodeficiency virus (HIV) particles (yellow) infecting a human H9 T-cell (turquoise) (adapted from http://biosingularity.com/category/infection/); [12] transverse 18F-dopa positron emission tomography (PET) slice through a Parkinson patient’s brain showing decreased in vivo quantitative uptake in the right caudate and putamen (courtesy of Christaan Schiepers, MD, PhD); [13] registered and fused transverse head CT (gray scale) and registered superimposed PET image (color) of a patient immediately after radio-therapeutic proton irradiation showing endogenously created 15O-positron emitter (2 min half-life) within the nasopharyngeal tumor focus (courtesy of Kira Grogg, PhD). [14] transverse (long axis) cardiac 99mTc-sestamibi SPECT slice illustrating thinned myocardial apical wall in a procedure performed thousands of times daily around the world (adapted from www.medscape.com). These images are but a small sampling of the breadth of the spectrum of light that is currently being investigated the world over by passionate scientists and engineers on a quest for the betterment of the human condition. All contributors for these images used herein have given their permission for their use, and are graciously thanked.
Image by Martin Tornai
Virtual Colonoscopy: A Kinder Gentler Way to Prevent Colon Cancer
Video by University of California Television (UCTV)/YouTube
Virtual Colonoscopy Q&A | Dr. Karen Horton
Video by Johns Hopkins Medicine/YouTube
All Views
Inside
Outside
Unfurled
1
2
3
4
Virtual Colonoscopy
Virtual colonoscopy is a new technology that uses computerized tomography (CT) images to look for polyps and cancer in the colon. The result is a computer-generated, animated, three-dimensional view of the interior of the colon. The preparation for the procedure is similar to that for a colonoscopy, but the procedure itself takes only about 10 minutes, and no sedation is required. If abnormalities are found, a conventional colonoscopy is performed for removal or biopsy of the growth.
Interactive by TheVisualMD
UCSF Radiology: How is Virtual Colonoscopy Performed?
Video by UCSF Imaging/YouTube
Virtual Colonoscopy - Lexington Diagnostic Center
Video by Lexington Diagnostic Center/YouTube
Virtual Colonoscopy-Mayo Clinic
Video by Mayo Clinic/YouTube
3D Visualization of Colon and Virtual Colonoscopy
3D Visualization of Colon and Virtual Colonoscopy
Image by TheVisualMD
Virtual Colonoscopy 3D Model
TheVisualMD
Virtual Colonoscopy open colon section view
TheVisualMD
A Less Invasive Look
TheVisualMD
0:13
Colon unfurling
TheVisualMD
0:49
Colorectal Cancer Clip 3
TheVisualMD
0:15
Colorectal Cancer Clip 4
TheVisualMD
Spectrum of Medical Imaging
Martin Tornai
1:26:06
Virtual Colonoscopy: A Kinder Gentler Way to Prevent Colon Cancer
University of California Television (UCTV)/YouTube
8:26
Virtual Colonoscopy Q&A | Dr. Karen Horton
Johns Hopkins Medicine/YouTube
Virtual Colonoscopy
TheVisualMD
2:33
UCSF Radiology: How is Virtual Colonoscopy Performed?
UCSF Imaging/YouTube
2:24
Virtual Colonoscopy - Lexington Diagnostic Center
Lexington Diagnostic Center/YouTube
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Virtual Colonoscopy-Mayo Clinic
Mayo Clinic/YouTube
3D Visualization of Colon and Virtual Colonoscopy
TheVisualMD
Staging
Diagram showing Dukes A bowel cancer
Diagram showing Dukes' B bowel cancer
Diagram showing Dukes' C bowel cancer
Diagram showing Dukes' D bowel cancer
Rectal Cancer - Stages
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Dukes A Bowel Cancer Staging
Interactive by Cancer Research UK / Wikimedia Commons
Diagram showing Dukes A bowel cancer
Diagram showing Dukes' B bowel cancer
Diagram showing Dukes' C bowel cancer
Diagram showing Dukes' D bowel cancer
Rectal Cancer - Stages
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Dukes A Bowel Cancer Staging
Interactive by Cancer Research UK / Wikimedia Commons
What Are the Stages of Rectal Cancer?
There are three ways that cancer spreads in the body.
Cancer can spread through tissue, the lymph system, and the blood:
Tissue. The cancer spreads from where it began by growing into nearby areas.
Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.
Cancer may spread from where it began to other parts of the body.
When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood.
Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body.
Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.
The metastatic tumor is the same type of cancer as the primary tumor. For example, if rectal cancer spreads to the lung, the cancer cells in the lung are actually rectal cancer cells. The disease is metastatic rectal cancer, not lung cancer.
The following stages are used for rectal cancer:
Stage 0 (Carcinoma in Situ)
Stage 0 (rectal carcinoma in situ). Abnormal cells are shown in the mucosa of the rectum wall.
In stage 0 rectal cancer, abnormal cells are found in the mucosa (innermost layer) of the rectum wall. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.
Stage I
Stage I rectal cancer. Cancer has spread from the mucosa of the rectum wall to the submucosa or to the muscle layer.
In stage I rectal cancer, cancer has formed in the mucosa (innermost layer) of the rectum wall and has spread to the submucosa (layer of tissue next to the mucosa) or to the muscle layer of the rectum wall.
Stage II
Stage II rectal cancer. In stage IIA, cancer has spread through the muscle layer of the rectum wall to the serosa. In stage IIB, cancer has spread through the serosa but has not spread to nearby organs. In stage IIC, cancer has spread through the serosa to nearby organs.
Stage II rectal cancer is divided into stages IIA, IIB, and IIC.
Stage IIA: Cancer has spread through the muscle layer of the rectum wall to the serosa (outermost layer) of the rectum wall.
Stage IIB: Cancer has spread through the serosa (outermost layer) of the rectum wall to the tissue that lines the organs in the abdomen (visceral peritoneum).
Stage IIC: Cancer has spread through the serosa (outermost layer) of the rectum wall to nearby organs.
Stage III
Stage III rectal cancer is divided into stages IIIA, IIIB, and IIIC.
Stage IIIA rectal cancer. Cancer has spread through the mucosa of the rectum wall to the submucosa and may have spread to the muscle layer, and has spread to one to three nearby lymph nodes or tissues near the lymph nodes. OR, cancer has spread through the mucosa to the submucosa and four to six nearby lymph nodes.
In stage IIIA, cancer has spread:
through the mucosa (innermost layer) of the rectum wall to the submucosa (layer of tissue next to the mucosa) or to the muscle layer of the rectum wall. Cancer has spread to one to three nearby lymph nodes or cancer cells have formed in tissue near the lymph nodes; or
through the mucosa (innermost layer) of the rectum wall to the submucosa (layer of tissue next to the mucosa). Cancer has spread to four to six nearby lymph nodes.
Stage IIIB rectal cancer. Cancer has spread through the muscle layer of the rectum wall to the serosa or has spread through the serosa but not to nearby organs; cancer has spread to one to three nearby lymph nodes or to tissues near the lymph nodes. OR, cancer has spread to the muscle layer or to the serosa, and to four to six nearby lymph nodes. OR, cancer has spread through the mucosa to the submucosa and may have spread to the muscle layer; cancer has spread to seven or more nearby lymph nodes.
In stage IIIB, cancer has spread:
through the muscle layer of the rectum wall to the serosa (outermost layer) of the rectum wall or has spread through the serosa to the tissue that lines the organs in the abdomen (visceral peritoneum). Cancer has spread to one to three nearby lymph nodes or cancer cells have formed in tissue near the lymph nodes; or
to the muscle layer or to the serosa (outermost layer) of the rectum wall. Cancer has spread to four to six nearby lymph nodes; or
through the mucosa (innermost layer) of the rectum wall to the submucosa (layer of tissue next to the mucosa) or to the muscle layer of the rectum wall. Cancer has spread to seven or more nearby lymph nodes.
Stage IIIC rectal cancer. Cancer has spread through the serosa of the rectum wall but not to nearby organs; cancer has spread to four to six nearby lymph nodes. OR, cancer has spread through the muscle layer to the serosa or has spread through the serosa but not to nearby organs; cancer has spread to seven or more nearby lymph nodes. OR, cancer has spread through the serosa to nearby organs and to one or more nearby lymph nodes or to tissues near the lymph nodes.
In stage IIIC, cancer has spread:
through the serosa (outermost layer) of the rectum wall to the tissue that lines the organs in the abdomen (visceral peritoneum). Cancer has spread to four to six nearby lymph nodes; or
through the muscle layer of the rectum wall to the serosa (outermost layer) of the rectum wall or has spread through the serosa to the tissue that lines the organs in the abdomen (visceral peritoneum). Cancer has spread to seven or more nearby lymph nodes; or
through the serosa (outermost layer) of the rectum wall to nearby organs. Cancer has spread to one or more nearby lymph nodes or cancer cells have formed in tissue near the lymph nodes.
Stage IV
Stage IV rectal cancer is divided into stages IVA, IVB, and IVC.
Stage IV rectal cancer. The cancer has spread through the blood and lymph nodes to other parts of the body, such as the lung, liver, abdominal wall, or ovary.
Stage IVA: Cancer has spread to one area or organ that is not near the rectum, such as the liver, lung, ovary, or a distant lymph node.
Stage IVB: Cancer has spread to more than one area or organ that is not near the rectum, such as the liver, lung, ovary, or a distant lymph node.
Stage IVC: Cancer has spread to the tissue that lines the wall of the abdomen and may have spread to other areas or organs.
Rectal cancer can recur (come back) after it has been treated.
The cancer may come back in the rectum or in other parts of the body, such as the colon, pelvis, liver, or lungs.
Cancer spreads in three ways: by invading surrounding tissue, by invading the lymph system and traveling through lymph vessels to other places in the body, and by invading veins and capillaries and traveling through the bloodstream to other places in the body. Stage III: Cancer has spread to nearby tissues or organs and lymph nodes, but not to distant parts of the body.
Interactive by TheVisualMD
Mandard tumor regression grade (TRG) in rectal cancer
Mandard tumor regression grade (TRG), in this case showing rectal cancer.
Image by Marisa D. Santos, Cristina Silva, Anabela Rocha, Carlos Nogueira,
Fernando Castro-Poças, António Araujo, Eduarda Matos, Carina Pereira,
Rui Medeiros, Carlos Lopes/Wikimedia
PET/CT
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PET/CT Scans of Colorectal Cancer 1) Pet/CT scan 2) CT Scan 3) Pet Scan
PET scans can often detect a tumor that can't be seen on CT scans or regular X-rays. Cancer tumors grow rapidly and so actively metabolize glucose. In a PET scan, the patient is injected with glucose containing a radioactive tracer. The PET scan image shows areas of the body that utilize the glucose. The brain, heart, and bladder all metabolize glucose and appear black in the image, along with any cancer tumors that are present.
Interactive by TheVisualMD
Colon cancer staging
Colon cancer staging
Colon cancer staging
Colon cancer staging
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Stages of Colorectal Cancer
Interactive by TheVisualMD
Colorectal Cancer Staging In Situ
Colorectal Cancer Staging Localized
Colorectal Cancer Staging Regional
Colorectal Cancer Staging Regional
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Colorectal Cancer Staging
After colon cancer has been diagnosed, the next step is to perform tests to determine if the cancer has spread within the intestine or to distant parts of the body. This is called staging. Staging helps the doctor to decide the most appropriate treatment for the cancer at its current stage. Regional means the cancer has spread to nearby lymph nodes or tissues, often through the hepatic portal system.
Interactive by TheVisualMD
Rectal Cancer Staging In PET/CT
Hg6996
Image by PET/CT of a staging exam of colon carcinoma. Besides the primary tumor a lot of lesions can be seen. On cursor position: lung nodule. Imaging parameters: Patient: 69kg, 186cm. Scanned 45 minutes after injection. Injected dose: 300mBq FDG, total acquisition time: 6 minutes. Device: GE PET/CT Discovery 600
Colon or rectal cancer diagnosis: should I get a second opinion?
Video by Swedish/YouTube
Colorectal Cancer Staging
After colon cancer has been diagnosed, the next step is to perform tests to determine if the cancer has spread within the intestine or to distant parts of the body. This is called staging. Staging helps the doctor to decide the most appropriate treatment for the cancer at its current stage.
Image by TheVisualMD
Cancer staging
Staging Cancer : Staging is the process of finding out the amount of cancer in the body and if it has spread. Most tumorous cancers are staged using the TNM system. In the TNM system, T = extent of the primary tumor, N = extent of spread to lymph nodes, M = presence of metastasis. After the TNM description has been decided, the cancer can be designated as Stage 0-IV. Stage 0 =carcinoma in situ. In Stage I, Stage II, and Stage III, higher numbers indicate more extensive disease, ie, greater tumor size, and/or spread of the cancer to nearby lymph nodes, and/or organs adjacent to the primary tumor. In Stage IV, the cancer has spread to another organ.
Image by TheVisualMD
Staging Cancer
Cancer staging, that is, determining the extent and spread of cancer in the body, is used by doctors to plan treatment and to arrive at a prognosis (estimate of future course and outcome) for the disease.
Image by TheVisualMD
Staging Cancer
Cancer staging, that is, determining the extent and spread of cancer in the body, is used by doctors to plan treatment and to arrive at a prognosis (estimate of future course and outcome) for the disease.
Image by TheVisualMD
Staging Cancer
Cancer staging, that is, determining the extent and spread of cancer in the body, is used by doctors to plan treatment and to arrive at a prognosis (estimate of future course and outcome) for the disease.
Image by TheVisualMD
Staging Cancer
Cancer staging, that is, determining the extent and spread of cancer in the body, is used by doctors to plan treatment and to arrive at a prognosis (estimate of future course and outcome) for the disease.
Image by TheVisualMD
Staging Cancer
Cancer staging, that is, determining the extent and spread of cancer in the body, is used by doctors to plan treatment and to arrive at a prognosis (estimate of future course and outcome) for the disease.
Image by TheVisualMD
Tumor Sizing
Cancer staging, that is, determining the extent and spread of cancer in the body, is used by doctors to plan treatment and to arrive at a prognosis (estimate of future course and outcome) for the disease. For most cancers, staging is done using the TNM (Tumor, Node, Metastasis) system, developed by the American Joint Committee on Cancer (AJCC) and the International Union Against Cancer (UICC). A T1 tumor may be the size of a pea (less than 2cm); a T3 tumor could be the size of a lime (up to 5 cm).
Mandard tumor regression grade (TRG) in rectal cancer
Marisa D. Santos, Cristina Silva, Anabela Rocha, Carlos Nogueira,
Fernando Castro-Poças, António Araujo, Eduarda Matos, Carina Pereira,
Rui Medeiros, Carlos Lopes/Wikimedia
PET/CT Scans of Colorectal Cancer 1) Pet/CT scan 2) CT Scan 3) Pet Scan
TheVisualMD
Stages of Colorectal Cancer
TheVisualMD
Colorectal Cancer Staging
TheVisualMD
Rectal Cancer Staging In PET/CT
PET/CT of a staging exam of colon carcinoma. Besides the primary tumor a lot of lesions can be seen. On cursor position: lung nodule. Imaging parameters: Patient: 69kg, 186cm. Scanned 45 minutes after injection. Injected dose: 300mBq FDG, total acquisition time: 6 minutes. Device: GE PET/CT Discovery 600
2:40
Colon or rectal cancer diagnosis: should I get a second opinion?
Three-panel drawing showing rectal cancer surgery with anastomosis; the first panel shows area of rectum with cancer, the middle panel shows cancer and nearby tissue removed, and the last panel shows the colon and anus joined.
Resection of the rectum with anastomosis. The rectum and part of the colon are removed, and then the colon and anus are joined.
There are different types of treatment for patients with rectal cancer.
Six types of standard treatment are used:
Surgery
Radiation therapy
Chemotherapy
Active surveillance
Targeted therapy
Immunotherapy
Other types of treatment are being tested in clinical trials.
Treatment for rectal cancer may cause side effects.
Patients may want to think about taking part in a clinical trial.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Follow-up tests may be needed.
There are different types of treatment for patients with rectal cancer.
Different types of treatment are available for patients with rectal cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Six types of standard treatment are used:
Surgery
Surgery is the most common treatment for all stages of rectal cancer. The cancer is removed using one of the following types of surgery:
Polypectomy: If the cancer is found in a polyp (a small piece of bulging tissue), the polyp is often removed during a colonoscopy.
Local excision: If the cancer is found on the inside surface of the rectum and has not spread into the wall of the rectum, the cancer and a small amount of surrounding healthy tissue is removed.
Resection: If the cancer has spread into the wall of the rectum, the section of the rectum with cancer and nearby healthy tissue is removed. Sometimes the tissue between the rectum and the abdominal wall is also removed. The lymph nodes near the rectum are removed and checked under a microscope for signs of cancer.
Radiofrequency ablation: The use of a special probe with tiny electrodes that kill cancer cells. Sometimes the probe is inserted directly through the skin and only local anesthesia is needed. In other cases, the probe is inserted through an incision in the abdomen. This is done in the hospital with general anesthesia.
Cryosurgery: A treatment that uses an instrument to freeze and destroy abnormal tissue. This type of treatment is also called cryotherapy.
Pelvic exenteration: If the cancer has spread to other organs near the rectum, the lower colon, rectum, and bladder are removed. In women, the cervix, vagina, ovaries, and nearby lymph nodes may be removed. In men, the prostate may be removed. Artificial openings (stoma) are made for urine and stool to flow from the body to a collection bag.
After the cancer is removed, the surgeon will either:
do an anastomosis (sew the healthy parts of the rectum together, sew the remaining rectum to the colon, or sew the colon to the anus); or
make a stoma (an opening) from the rectum to the outside of the body for waste to pass through. This procedure is done if the cancer is too close to the anus and is called a colostomy. A bag is placed around the stoma to collect the waste. Sometimes the colostomy is needed only until the rectum has healed, and then it can be reversed. If the entire rectum is removed, however, the colostomy may be permanent.
Radiation therapy and/or chemotherapy may be given before surgery to shrink the tumor, make it easier to remove the cancer, and help with bowel control after surgery. Treatment given before surgery is called neoadjuvant therapy. After all the cancer that can be seen at the time of the surgery is removed, some patients may be given radiation therapy and/or chemotherapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy.
Resection of the rectum with anastomosis. The rectum and part of the colon are removed, and then the colon and anus are joined.
Radiation therapy
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy:
External radiation therapy uses a machine outside the body to send radiation toward the cancer.
Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.
The way the radiation therapy is given depends on the type and stage of the cancer being treated. External radiation therapy is used to treat rectal cancer.
Short-course preoperative radiation therapy is used in some types of rectal cancer. This treatment uses fewer and lower doses of radiation than standard treatment, followed by surgery several days after the last dose.
Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly in the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy).
Chemoembolization of the hepatic artery is a type of regional chemotherapy that may be used to treat cancer that has spread to the liver. This is done by blocking the hepatic artery (the main artery that supplies blood to the liver) and injecting anticancer drugs between the blockage and the liver. The liver’s arteries then carry the drugs into the liver. Only a small amount of the drug reaches other parts of the body. The blockage may be temporary or permanent, depending on what is used to block the artery. The liver continues to receive some blood from the hepatic portal vein, which carries blood from the stomach and intestine.
The way the chemotherapy is given depends on the type and stage of the cancer being treated.
Active surveillance
Active surveillance is closely following a patient's condition without giving any treatment unless there are changes in test results. It is used to find early signs that the condition is getting worse. In active surveillance, patients are given certain exams and tests to check if the cancer is growing. When the cancer begins to grow, treatment is given to cure the cancer. Tests include the following:
Digital rectal exam.
MRI.
Endoscopy.
Sigmoidoscopy.
CT scan.
Carcinoembryonic antigen (CEA) assay.
Targeted therapy
Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells. Targeted therapies usually cause less harm to normal cells than chemotherapy or radiation therapy do.
Types of targeted therapies used in the treatment of rectal cancer include the following:
Monoclonal antibodies: Monoclonal antibodies are immune system proteins made in the laboratory to treat many diseases, including cancer. As a cancer treatment, these antibodies can attach to a specific target on cancer cells or other cells that may help cancer cells grow. The antibodies are able to then kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by infusion. They may be used alone or to carry drugs, toxins, or radioactive material directly to cancer cells.
There are different types of monoclonal antibody therapy:
Vascular endothelial growth factor (VEGF) inhibitor therapy: Cancer cells make a substance called VEGF, which causes new blood vessels to form (angiogenesis) and helps the cancer grow. VEGF inhibitors block VEGF and stop new blood vessels from forming. This may kill cancer cells because they need new blood vessels to grow. Bevacizumab and ramucirumab are VEGF inhibitors and angiogenesis inhibitors.
Epidermal growth factor receptor (EGFR) inhibitor therapy: EGFRs are proteins found on the surface of certain cells, including cancer cells. Epidermal growth factor attaches to the EGFR on the surface of the cell and causes the cells to grow and divide. EGFR inhibitors block the receptor and stop the epidermal growth factor from attaching to the cancer cell. This stops the cancer cell from growing and dividing. Cetuximab and panitumumab are EGFR inhibitors.
Angiogenesis inhibitors: Angiogenesis inhibitors stop the growth of new blood vessels that tumors need to grow.
Ziv-aflibercept is a vascular endothelial growth factor trap that blocks an enzyme needed for the growth of new blood vessels in tumors.
Regorafenib is used to treat colorectal cancer that has spread to other parts of the body and has not gotten better with other treatment. It blocks the action of certain proteins, including vascular endothelial growth factor. This may help keep cancer cells from growing and may kill them. It may also prevent the growth of new blood vessels that tumors need to grow.
Protein kinase inhibitor therapy: This treatment blocks a protein needed for cancer cells to divide. Protein kinase inhibitors include:
BRAF inhibitors that block the activity of proteins made by mutant BRAF genes. Encorafenib is a BRAF inhibitor.
Immunotherapy
Immunotherapy is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. This cancer treatment is a type of biologic therapy.
Immune checkpoint inhibitor therapy: Immune checkpoint inhibitors block proteins called checkpoints that are made by some types of immune system cells, such as T cells, and some cancer cells. These checkpoints help keep immune responses from being too strong and sometimes can keep T cells from killing cancer cells. When these checkpoints are blocked, T cells can kill cancer cells better. They are used to treat some patients with metastatic colorectal cancer.
There are two types of immune checkpoint inhibitor therapy:
CTLA-4 inhibitor therapy: CTLA-4 is a protein on the surface of T cells that helps keep the body’s immune responses in check. When CTLA-4 attaches to another protein called B7 on a cancer cell, it stops the T cell from killing the cancer cell. CTLA-4 inhibitors attach to CTLA-4 and allow the T cells to kill cancer cells. Ipilimumab is a type of CTLA-4 inhibitor.Immune checkpoint inhibitor. Checkpoint proteins, such as B7-1/B7-2 on antigen-presenting cells (APC) and CTLA-4 on T cells, help keep the body’s immune responses in check. When the T-cell receptor (TCR) binds to antigen and major histocompatibility complex (MHC) proteins on the APC and CD28 binds to B7-1/B7-2 on the APC, the T cell can be activated. However, the binding of B7-1/B7-2 to CTLA-4 keeps the T cells in the inactive state so they are not able to kill tumor cells in the body (left panel). Blocking the binding of B7-1/B7-2 to CTLA-4 with an immune checkpoint inhibitor (anti-CTLA-4 antibody) allows the T cells to be active and to kill tumor cells (right panel).
PD-1 and PD-L1 inhibitor therapy: PD-1 is a protein on the surface of T cells that helps keep the body’s immune responses in check. PD-L1 is a protein found on some types of cancer cells. When PD-1 attaches to PD-L1, it stops the T cell from killing the cancer cell. PD-1 and PD-L1 inhibitors keep PD-1 and PD-L1 proteins from attaching to each other. This allows the T cells to kill cancer cells. Pembrolizumab and nivolumab are types of PD-1 inhibitors.
Immune checkpoint inhibitor. Checkpoint proteins, such as PD-L1 on tumor cells and PD-1 on T cells, help keep immune responses in check. The binding of PD-L1 to PD-1 keeps T cells from killing tumor cells in the body (left panel). Blocking the binding of PD-L1 to PD-1 with an immune checkpoint inhibitor (anti-PD-L1 or anti-PD-1) allows the T cells to kill tumor cells (right panel).
Other types of treatment are being tested in clinical trials.
Treatment for rectal cancer may cause side effects.
Patients may want to think about taking part in a clinical trial.
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.
Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCI’s clinical trials search webpage.
Follow-up tests may be needed.
Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.
After treatment for rectal cancer, a blood test to measure amounts of carcinoembryonic antigen (a substance in the blood that may be increased when cancer is present) may be done to see if the cancer has come back.
Source: National Cancer Institute (NCI)
Additional Materials (2)
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Permanent Colostomy Illustration
Line drawing showing a permanent colostomy for rectal cancer.
Image by National Cancer Institute / Unknown Illustrator
Anal and Rectal Cancer Care and Treatment
Video by ChristianaCare/YouTube
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Permanent Colostomy Illustration
National Cancer Institute / Unknown Illustrator
4:59
Anal and Rectal Cancer Care and Treatment
ChristianaCare/YouTube
active surveillance
active surveillance
Image by Mohamed_hassan/Pixabay
active surveillance
Watchful Waiting
Clinical management approach wherein immediate therapy is not provided but there is a period of observation during which periodic tests monitor patient and the progression of the illness.
Image by Mohamed_hassan/Pixabay
active surveillance
Closely watching a patient’s condition but not giving any treatment unless there are changes in test results that show the condition is getting worse. Active surveillance may be used to avoid or delay the need for treatments such as radiation therapy or surgery, which can cause side effects or other problems. During active surveillance, certain exams and tests, such as blood tests, imaging tests, and biopsies, are done on a regular schedule to monitor the condition. Active surveillance may be used in certain types of prostate cancer and in some other types of cancer. It is a type of expectant management.
Source: National Cancer Institute (NCI)
Additional Materials (11)
When Is Active Surveillance Appropriate for Cancer Patients?
Video by Michigan Medicine/YouTube
What is Active Surveillance for Prostate Cancer?
Video by Roswell Park Comprehensive Cancer Center/YouTube
What's New in Active Surveillance for Prostate Cancer
Video by Memorial Sloan Kettering Cancer Center/YouTube
Active Surveillance of Thyroid Cancer | James Wu, MD | UCLAMDChat
Video by UCLA Health/YouTube
Active Surveillance for Prostate Cancer
Video by MassGeneralHospital/YouTube
Mount Sinai's Active Surveillance Program for Prostate Cancer
Video by Mount Sinai Health System/YouTube
Active Surveillance for Prostate Cancer | Charlie's Story
Video by Johns Hopkins Medicine/YouTube
Active Surveillance for Prostate Cancer
Video by UAB Medicine/YouTube
Study finds active monitoring as effective as invasive treatments for some prostate cancer patients
Video by NBC News/YouTube
Active Surveillance of Prostate Cancer with Yushen Qian, MD
Video by Stanford Health Care/YouTube
Prostate Cancer Active Surveillance
Video by University of California Television (UCTV)/YouTube
1:36
When Is Active Surveillance Appropriate for Cancer Patients?
Michigan Medicine/YouTube
3:14
What is Active Surveillance for Prostate Cancer?
Roswell Park Comprehensive Cancer Center/YouTube
47:03
What's New in Active Surveillance for Prostate Cancer
Memorial Sloan Kettering Cancer Center/YouTube
29:58
Active Surveillance of Thyroid Cancer | James Wu, MD | UCLAMDChat
UCLA Health/YouTube
3:32
Active Surveillance for Prostate Cancer
MassGeneralHospital/YouTube
3:03
Mount Sinai's Active Surveillance Program for Prostate Cancer
Mount Sinai Health System/YouTube
2:38
Active Surveillance for Prostate Cancer | Charlie's Story
Johns Hopkins Medicine/YouTube
14:22
Active Surveillance for Prostate Cancer
UAB Medicine/YouTube
2:04
Study finds active monitoring as effective as invasive treatments for some prostate cancer patients
NBC News/YouTube
34:34
Active Surveillance of Prostate Cancer with Yushen Qian, MD
Stanford Health Care/YouTube
15:05
Prostate Cancer Active Surveillance
University of California Television (UCTV)/YouTube
Rectal Cancer Treatment Options by Stage
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Rectal Cancer - Recurrent
Image by Cancer Research UK / Wikimedia Commons
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Rectal Cancer - Recurrent
Diagram showing the area removed for a rectal cancer.
Image by Cancer Research UK / Wikimedia Commons
Rectal Cancer Treatment Options by Stage
Treatment of Stage 0 (Carcinoma in Situ)
Treatment of stage 0 may include the following:
Simple polypectomy.
Local excision.
Resection (when the tumor is too large to remove by local excision).
Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done.
Treatment of Stage I Rectal Cancer
Treatment of stage I rectal cancer may include the following:
Local excision.
Resection.
Resection with radiation therapy and chemotherapy after surgery.
Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done.
Treatment of Stages II and III Rectal Cancer
Treatment of stage II and stage III rectal cancer may include the following:
Surgery.
Chemotherapy combined with radiation therapy, followed by surgery.
Short-course radiation therapy followed by surgery and chemotherapy.
Resection followed by chemotherapy combined with radiation therapy.
Chemotherapy combined with radiation therapy, followed by active surveillance. Surgery may be done if the cancer recurs (comes back).
A clinical trial of a new treatment.
Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done.
Treatment of Stage IV and Recurrent Rectal Cancer
Treatment of stage IV and recurrent rectal cancer may include the following:
Surgery with or without chemotherapy or radiation therapy.
Systemic chemotherapy with or without targeted therapy (angiogenesis inhibitor).
Systemic chemotherapy with or without immunotherapy (immune checkpoint inhibitor therapy).
Chemotherapy to control the growth of the tumor.
Radiation therapy, chemotherapy, or a combination of both, as palliative therapy to relieve symptoms and improve the quality of life.
Placement of a stent to help keep the rectum open if it is partly blocked by the tumor, as palliative therapy to relieve symptoms and improve the quality of life.
Targeted therapy with a protein kinase inhibitor and a monoclonal antibody in patients with a certain change in the BRAF gene.
Immunotherapy.
Clinical trials of chemotherapy and/or targeted therapy.
Treatment of rectal cancer that has spread to other organs depends on where the cancer has spread.
Treatment for areas of cancer that have spread to the liver includes the following:
Surgery to remove the tumor. Chemotherapy may be given before surgery, to shrink the tumor.
Cryosurgery or radiofrequency ablation.
Chemoembolization and/or systemic chemotherapy.
A clinical trial of chemoembolization combined with radiation therapy to the tumors in the liver.
Source: National Cancer Institute (NCI)
Additional Materials (3)
Colectomy Treatment for Colorectal Cancer
Treating Colorectal Cancer with Surgery
Colostomy Treatment for Colorectal Cancer
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Colectomy Treatment for Colorectal Cancer
In late Stage I and in Stage II and III cancer, the cancerous part of the colon is removed surgically. The surgeon may perform a resection, consisting of a partial colectomy (removing the cancer and a small amount of healthy tissue around it) and an anastomosis (sewing the parts of the colon back together). Nearby lymph nodes may also be removed and biopsied.
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Rectal Cancer - Stages
The T stages of bowel cancer.
Image by Cancer Research UK / Wikimedia Commons
Scott’s Story: Rectal Cancer, Stage II Treated with da Vinci Robot Surgery
Video by Franciscan Health/YouTube
Colectomy Treatment for Colorectal Cancer
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Rectal Cancer - Stages
Cancer Research UK / Wikimedia Commons
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Scott’s Story: Rectal Cancer, Stage II Treated with da Vinci Robot Surgery
Description: Peripherally inserted central catheter (PICC); drawing of a PICC line that goes from a vein in the upper right arm to a large vein above the right side of the heart called the superior vena cava. An inset shows a PICC line in the arm with a clear plastic dressing over it. An intravenous line attached to the PICC is also shown.
Peripherally inserted central catheter (PICC). A PICC is a thin, flexible tube that is inserted into a vein in the upper arm and guided (threaded) into a large vein above the right side of the heart called the superior vena cava. It is used to give intravenous fluids, blood transfusions, chemotherapy, and other drugs. It is also used for taking blood samples. A PICC line may stay in place for weeks or months and helps avoid the need for repeated needle sticks.
This page lists cancer drugs approved by the Food and Drug Administration (FDA) for colon and rectal cancer. The list includes generic and brand names. This page also lists common drug combinations used in colon and rectal cancer. The individual drugs in the combinations are FDA-approved. However, the drug combinations themselves usually are not approved, although they are widely used.
The drug names link to NCI's Cancer Drug Information summaries. There may be drugs used in colon cancer and rectal cancer that are not listed here.
Drugs Approved for Colon Cancer
Alymsys (Bevacizumab)
Avastin (Bevacizumab)
Bevacizumab
Camptosar (Irinotecan Hydrochloride)
Capecitabine
Cetuximab
Cyramza (Ramucirumab)
Eloxatin (Oxaliplatin)
Erbitux (Cetuximab)
5-FU (Fluorouracil Injection)
Fluorouracil Injection
Fruquintinib
Fruzaqla (Fruquintinib)
Ipilimumab
Irinotecan Hydrochloride
Keytruda (Pembrolizumab)
Leucovorin Calcium
Lonsurf (Trifluridine and Tipiracil Hydrochloride)
Mvasi (Bevacizumab)
Nivolumab
Opdivo (Nivolumab)
Oxaliplatin
Panitumumab
Pembrolizumab
Ramucirumab
Regorafenib
Stivarga (Regorafenib)
Trifluridine and Tipiracil Hydrochloride
Tucatinib
Tukysa (Tucatinib)
Vectibix (Panitumumab)
Xeloda (Capecitabine)
Yervoy (Ipilimumab)
Zaltrap (Ziv-Aflibercept)
Zirabev (Bevacizumab)
Ziv-Aflibercept
Drug Combinations Used in Colon Cancer
CAPOX
FOLFIRI
FOLFIRI-BEVACIZUMAB
FOLFIRI-CETUXIMAB
FOLFOX
FU-LV
XELIRI
XELOX
Drugs Approved for Rectal Cancer
Alymsys (Bevacizumab)
Avastin (Bevacizumab)
Bevacizumab
Camptosar (Irinotecan Hydrochloride)
Capecitabine
Cetuximab
Cyramza (Ramucirumab)
Eloxatin (Oxaliplatin)
Erbitux (Cetuximab)
5-FU (Fluorouracil Injection)
Fluorouracil Injection
Fruquintinib
Fruzaqla (Fruquintinib)
Ipilimumab
Irinotecan Hydrochloride
Keytruda (Pembrolizumab)
Leucovorin Calcium
Lonsurf (Trifluridine and Tipiracil Hydrochloride)
Mvasi (Bevacizumab)
Nivolumab
Opdivo (Nivolumab)
Oxaliplatin
Panitumumab
Pembrolizumab
Ramucirumab
Regorafenib
Stivarga (Regorafenib)
Trifluridine and Tipiracil Hydrochloride
Tucatinib
Tukysa (Tucatinib)
Vectibix (Panitumumab)
Xeloda (Capecitabine)
Yervoy (Ipilimumab)
Zaltrap (Ziv-Aflibercept)
Zirabev (Bevacizumab)
Ziv-Aflibercept
Drug Combinations Used in Rectal Cancer
CAPOX
FOLFIRI
FOLFIRI-BEVACIZUMAB
FOLFIRI-CETUXIMAB
FOLFOX
FU-LV
XELIRI
XELOX
Drugs Approved for Gastroenteropancreatic Neuroendocrine Tumors
Afinitor (Everolimus)
Everolimus
Lanreotide Acetate
Somatuline Depot (Lanreotide Acetate)
Source: National Cancer Institute (NCI)
Additional Materials (3)
Central Venous Catheter
Central venous catheter; drawing of a central venous catheter that goes from a vein below the right collarbone to a large vein above the right side of the heart called the superior vena cava. An inset shows a central venous catheter in the right side of the chest with a clear plastic dressing over it.
Central venous catheter. A central venous catheter is a thin, flexible tube that is inserted into a vein, usually below the right collarbone, and guided (threaded) into a large vein above the right side of the heart called the superior vena cava. It is used to give intravenous fluids, blood transfusions, chemotherapy, and other drugs. The catheter is also used for taking blood samples. It may stay in place for weeks or months and helps avoid the need for repeated needle sticks.
Central venous catheter; drawing of a central venous catheter that goes from a vein below the right collarbone to a large vein above the right side of the heart called the superior vena cava. An inset shows a central venous catheter in the right side of the chest with a clear plastic dressing over it.
Central venous catheter. A central venous catheter is a thin, flexible tube that is inserted into a vein, usually below the right collarbone, and guided (threaded) into a large vein above the right side of the heart called the superior vena cava. It is used to give intravenous fluids, blood transfusions, chemotherapy, and other drugs. The catheter is also used for taking blood samples. It may stay in place for weeks or months and helps avoid the need for repeated needle sticks.
Description: Peripheral venous catheter; drawing of a peripheral venous catheter in a vein in the lower part of the arm with the catheter tubing clamped and capped off at the end.
Peripheral venous catheter. A peripheral venous catheter is a thin, flexible tube that is inserted into a vein. It is usually inserted into the lower part of the arm or the back of the hand. It is used to give intravenous fluids, blood transfusions, chemotherapy, and other drugs.
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Rectal Cancer
Rectal cancer is a disease in which malignant (cancer) cells form in the tissues of the rectum, the last several inches of the large intestine closest to the anus. Learn about symptoms, risk factors, tests, and treatments.