Sokha, a Cambodian national, was diagnosed with rectal cancer metastasized to the liver last May and underwent surgery at a hospital in Ho Chi Minh City. After the surgery, she traveled between Cambodia and Vietnam for chemotherapy and disease monitoring.

Recently, she experienced severe abdominal pain, fatigue, poor appetite, and abdominal distension, prompting her to visit Tam Anh General Hospital, Ho Chi Minh City, for examination. Doctors noted a large tumor causing abdominal tension, a weakened general condition, and mild anemia. Ultrasound, CT, and X-ray results revealed multiple secondary lesions, including two large suspected metastatic tumors in both ovaries, multifocal liver lesions, numerous fuzzy nodules in the right lung, mild hydronephrosis in the left kidney due to tumor compression, and moderate multi-membrane effusion.

Doctor Huynh Ba Tan, from the Department of Surgical Oncology, and his team decided on surgery. The goal was to reduce intra-abdominal pressure, manage the metastatic ovaries, alleviate symptoms, and stabilize the patient's condition prior to further chemo-radiation therapy.

The medical team performing surgery on patient Sokha. *Photo: Tam Anh General Hospital*

During the abdominal surgery, doctor Tan found two tumors that nearly filled the entire cavity. They were widespread, adhering to the abdominal wall, the underside of the liver, and infiltrating fatty tissue in the right hypochondrium. The liver showed multiple metastatic foci, with minimal fluid and no bleeding in the abdominal cavity. The surgical team carefully dissected and managed the metastatic adnexa, avoiding damage to surrounding structures, reducing compression on the left ureter, cleaning the abdominal cavity, and assessing the invasion extent.

The team successively removed the two cancer-invaded ovaries, which together weighed over 5 kg, relieving pressure in the abdominal cavity. According to doctor Tan, a typical adult woman's ovary measures about 2x3x4 cm and weighs approximately 5-8 grams. Cancer cells metastasizing to the ovaries caused Sokha's ovaries to enlarge 15 times their normal size. Post-surgery, Sokha was alert, her abdomen was soft and no longer distended, she resumed normal eating, slept well, and could sit up and walk gently.

Doctor Tan explained that distant metastatic rectal cancer, as seen in Sokha's case, can progress silently with few specific symptoms. Tumors can compress multiple organs. Untimely intervention for metastatic sites, like the ovaries, risks prolonged pain, tumor rupture, and severe infection, which can be life-threatening.

Doctor Tan examining patient Sokha. *Photo: Tam Anh General Hospital*

According to Globocan's 2022 statistics, rectal cancer is among the three most common cancers globally. In Vietnam, it also ranks among cancers with a high incidence rate in both men and women.

A sedentary lifestyle, a diet high in red meat and fat, low fiber intake, and some genetic factors increase the risk of rectal cancer in young people.

Doctors recommend annual health check-ups. Individuals experiencing abnormal signs such as prolonged digestive disorders, changes in bowel habits, unexplained weight loss, or persistent anemia should seek medical examination for timely screening and diagnosis. Cancer detected and treated in its early stages has a better prognosis than in late stages.

Minh Tam

*Patient's name has been changed