Each patient with rectal cancer presents a triple problem: recognition of disease, selection of appropriate treatment, and actual administration or carrying out of the treatment decided on.
The task of recognizing the disease usually rests with the family physician. Patients seldom seek surgical advice until a definite diagnosis has been determined. While the favorable influence of early recognition on results of treatment is well known, a comparatively small percentage of cases is referred for treatment in the early stages. There is a double explanation for this unsatisfactory state of affairs: first, the neglect of the patient to seek medical advice at the onset of illness and, second, failure of the clinician to recognize malignant disease.
The early symptoms of rectal cancer are mild and indefinite. They mimic symptoms commonly associated with nonmalignant pathologic conditions of the colon and rectum. With the exception of constipation, gas, flatulence and occasional showing of