Materiały źródłowe

• #1 Rectal Cancer Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/colorectal/hp/rectal-treatment-pdq

  Treatment Option Overview for Rectal Cancer […] The management of rectal cancer varies somewhat from that of colon cancer because of the increased risk of local recurrence and a poorer overall prognosis. Differences include surgical technique, the use of radiation therapy, and the method of chemotherapy administration. In addition to determining the intent of rectal cancer surgery (i.e., curative or palliative), it is important to consider therapeutic issues related to the maintenance or restoration of normal anal sphincter, genitourinary function, and sexual function. […] The approach to the management of rectal cancer is multimodal and involves a multidisciplinary team of cancer specialists with expertise in gastroenterology, medical oncology, surgical oncology, radiation oncology, and radiology.

• #2 Rectal Cancer Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/colorectal/hp/rectal-treatment-pdq

  Immunotherapy […] Among patients with rectal adenocarcinomas, 5% to 10% of the tumors have mismatch repair deficiency or high microsatellite instability. Immune checkpoint inhibitors are efficacious as a first-line therapy for metastatic colorectal cancers, with overall response rates of 30% to 60%. These responses proved durable, and prolonged overall survival (OS) was demonstrated in these settings. […] Primary Surgical Therapy […] The primary treatment for patients with rectal cancer is surgical resection of the primary tumor. The surgical approach to treatment varies according to: […] – Tumor location. […] – Stage of disease. […] – Presence or absence of high-risk features (i.e., positive margins, lymphovascular invasion, perineural invasion, and poorly differentiated histology).

• #3 Rectal Cancer Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/colorectal/hp/rectal-treatment-pdq

  Types of surgical resection include: […] – Polypectomy for select T1 cancers. […] – Transanal local excision and transanal endoscopic microsurgery for select clinically staged T1/T2, N0 rectal cancers. […] – Total mesorectal excision with autonomic nerve preservation techniques via low-anterior resection. […] – Total mesorectal excision via abdominoperineal resection for patients who are not candidates for sphincter-preservation, leaving patients with a permanent end-colostomy. […] Chemoradiation Therapy […] Preoperative chemoradiation therapy has become the standard of care for patients with clinically staged T3T4 or node-positive disease (stages II/III), based on the results of several studies: […] – Tumor regression and downstaging of the tumor. […] – Improved tumor resectability.

• #4 Rectal Cancer Treatment, by Stage | How to Treat Rectal Cancer | American Cancer Society

  https://www.cancer.org/cancer/types/colon-rectal-cancer/treating/by-stage-rectum.html

  Treatment for rectal cancer is based mainly on the stage (extent) of the cancer, but other factors can also be important. […] People with rectal cancers that have not spread to distant sites are usually treated with surgery. Treatment with radiation and chemotherapy (chemo) may also be given before or after surgery. […] Removing or destroying the cancer is typically all that’s needed. You can usually be treated with surgery, such as a polypectomy (removing the polyp), local excision, or transanal resection. […] For other stage I cancers, surgery is usually the main treatment. Some small stage I cancers can be removed through the anus without cutting the abdomen (belly), using transanal resection or transanal endoscopic microsurgery (TEM). […] For treatment of stage II rectal cancer that is pMMR or MSS, chemotherapy, radiation therapy, and surgery are usually given, although the order of these treatments might be different for some people.

• #5 Rectal cancer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rectal-cancer/diagnosis-treatment/drc-20352889

  Rectal cancer treatment may begin with surgery to remove the cancer. If the cancer grows larger or spreads to other parts of the body, treatment might start with medicine and radiation instead. Your healthcare team considers many factors when creating a treatment plan. These factors may include your overall health, the type and stage of your cancer, and your preferences. […] Surgery to remove the cancer can be used alone or in combination with other treatments. […] Procedures used for rectal cancer may include: Removing very small cancers from the inside of the rectum. Very small rectal cancers may be removed using a colonoscope or another specialized type of scope inserted through the anus. This procedure is called transanal local excision. […] Removing all or part of the rectum. Larger rectal cancers that are far enough away from the anus might be removed in a procedure that removes all or part of the rectum. This procedure is called low anterior resection.

• #6 Rectal Cancer Overview: Causes, Symptoms, and Treatment Options at TGH

  https://www.tgh.org/institutes-and-services/conditions/rectal-cancer

  Rectal cancer treatment can vary depending on the location, size and stage of the tumor. In some cases, benign rectal polyps and early-stage rectal tumors can be removed through the anus. Known as transanal minimally invasive surgery (TAMIS), this procedure is typically performed through a TAMIS port, a specialized device inserted into the anus. The TAMIS port provides a stable and controlled channel for the surgeon to access the rectum. To better visualize the targeted tissue, the surgeon may use an endoscope, a flexible tube with a light source and miniature camera attached to the end. To remove abnormal tissue, the surgeon can insert specialized surgical instruments through the port. […] If a rectal tumor cannot be removed through the anus, a traditional open procedure may be considered, such as: Anterior resection To remove a tumor in the upper rectum, the surgeon will remove the section containing the tumor and then reattach the colon to the remaining part of the rectum. Low anterior resection To remove a tumor in the middle or lower rectum, the surgeon will remove the entire rectum, then perform a coloanal anastomosis to attach the colon to the anus and create a small pouch in the colon to collect stool. Abdominoperineal resection (APR) To remove a tumor in the lower rectum, the surgeon will remove the lower (sigmoid) colon, rectum, anus and sphincter muscles. During APR surgery, the surgeon will create a stoma to bring the lower end of the colon outside the body through the skin in the lower belly, where a colostomy pouch will be worn to collect stool. […] Chemotherapy or radiation therapy may be administered before or after rectal cancer surgery, depending on the stage of the tumor and other factors.

• #7 Rectal cancer treatment – La Crosse – Mayo Clinic Health System

  https://www.mayoclinichealthsystem.org/locations/la-crosse/services-and-treatments/colon-and-rectal-surgery/conditions-and-treatments/rectal-cancer

  Operations used to treat rectal cancer include: Removing very small cancers from the inside of the rectum Very small rectal cancers may be removed using a colonoscope or another specialized type of scope inserted through the anus (transanal local excision). Surgical tools can be passed through the scope to cut away cancer and some of the healthy tissue around it. This procedure might be an option if your cancer is small and unlikely to spread to nearby lymph nodes. If a lab analysis finds that your cancer cells are aggressive or more likely to spread to the lymph nodes, your doctor may recommend additional surgery. […] Removing all or part of the rectum Larger rectal cancers that are far enough away from the anal canal might be removed in a procedure that removes all or part of the rectum. Nearby tissue and lymph nodes also are removed. This procedure preserves the anus so waste can leave the body normally. How the procedure is performed depends on the cancer’s location. If cancer affects the upper portion of the rectum, that part of the rectum is removed and the colon is attached to the remaining rectum. All of the rectum may be removed if the cancer is located in the lower portion of the rectum. Then the colon is shaped into a pouch and attached to the anus.

• #8 Rectal cancer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rectal-cancer/diagnosis-treatment/drc-20352889

  Removing the rectum and anus. For rectal cancers that are located near the anus, it might not be possible to remove the cancer completely without hurting the muscles that control bowel movements. In these situations, surgeons may recommend an operation called abdominoperineal resection, also known as APR. […] Chemotherapy treats cancer with strong medicines. Chemotherapy medicines are typically used before or after surgery in people with rectal cancer. Chemotherapy is often combined with radiation therapy and used before an operation to shrink a large cancer so that it’s easier to remove with surgery. […] Radiation therapy treats cancer with powerful energy beams. […] Combining chemotherapy and radiation therapy may enhance the effectiveness of each treatment. […] Targeted therapy for cancer is a treatment that uses medicines that attack specific chemicals in the cancer cells.

• #9 Rectal cancer treatment – La Crosse – Mayo Clinic Health System

  https://www.mayoclinichealthsystem.org/locations/la-crosse/services-and-treatments/colon-and-rectal-surgery/conditions-and-treatments/rectal-cancer

  Removing the rectum and anus For rectal cancers that are located near the anus, it might not be possible to remove the cancer completely without damaging the muscles that control bowel movements. In these situations, surgeons may recommend an operation called abdominoperineal resection (APR) to remove the rectum, anus and some of the colon, as well as nearby tissue and lymph nodes. The surgeon creates an opening in the abdomen and attaches the remaining colon, also called a colostomy. Waste leaves your body through the opening and collects in a bag that attaches to your abdomen.

• #10 Stage III Rectal Cancer

  https://www.texasoncology.com/types-of-cancer/rectal-cancer/stage-iii-rectal-cancer

  The progress that has been made in the treatment of rectal cancer has resulted from improved surgical techniques, the development of adjuvant and neoadjuvant chemotherapy and radiation therapy treatments and participation in clinical trials. […] Several new chemotherapy drugs show promising activity for the treatment of advanced or recurrent rectal cancer. […] Laparoscopic surgery is used for many types of surgery with the short-term advantages of less pain, fewer wound complications, quicker post-operative recovery, and shorter hospital stays. […] As the technology for radiation therapy has evolved, important advances have been made in the ability of physicians to precisely target the area of the cancer. […] Targeted therapies are anticancer drugs that interfere with specific pathways involved in cancer cell growth or survival. […] Techniques designed to prevent or control the side effects of cancer and its treatments are called supportive care.

• #11 8 Things To Know About Surgery for Rectal Cancer > News > Yale Medicine

  https://www.yalemedicine.org/news/8-things-to-know-about-rectal-cancer-surgery

  Colorectal surgeons use MRI to enhance surgery. […] An MRI can help colorectal surgeons see how much cancer has invaded the rectal wall, and even the lymph nodes and the fat around the rectum, which are also removed in surgery, says Dr. Mongiu. […] Robotic surgery has been a game-changer for us, says Dr. Reddy, and while there are still some open and laparoscopic operations, almost all rectal surgeries performed at Yale are now robotic ones, he adds. […] Rectal surgery recurrence rates have fallen from roughly 20% of cases before 1990 to less than 5% today, says Vikram Reddy, MD, PhD, MBA, chief of colon and rectal surgery for Yale Medicine. […] Permanent stomas are less common than they used to be. […] Robotic surgery is helping even in some situations where preserving the anus was once impossible, says Dr. Mongiu.

• #12 Treatment for bowel (rectal) cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/bowel-cancer/treatment/treatment-rectal

  This section is about treatment for rectal cancer that hasn’t spread to another part of the body. […] The main treatments are surgery, radiotherapy, chemotherapy and chemoradiotherapy. […] The type of surgery you have for cancer of the back passage (rectum) depends on the position and stage of your cancer. […] You might have chemotherapy on its own or with radiotherapy. Fluorouracil, capecitabine, oxaliplatin and irinotecan are drugs used for rectal cancer. […] Treatment with chemotherapy and radiotherapy together is called chemoradiotherapy. You might have this treatment for cancer of the back passage (rectal cancer). […] Radiotherapy uses high energy waves similar to x-rays to kill bowel cancer cells. It is a treatment for cancer of the back passage (rectal cancer).

• #13 Rectal Cancer Treatment & Management: Approach Considerations, Neoadjuvant Therapy, Transanal Excision

  https://emedicine.medscape.com/article/281237-treatment

  Preoperative radiation therapy (RT) has many potential advantages, including tumor down-staging, an increase in resectability, and a decrease in tumor viability, which may decrease the risk of local recurrence. […] Preoperative RT decreases the risk of tumor recurrence in patients with stage II or III disease; however, this does not translate into a decrease in distant metastases or an increase in survival rate. […] Neoadjuvant long-course RT plus radiation sensitization with a fluoropyrimidine, followed by a treatment break of approximately 8 weeks before surgical excision and concluding with adjuvant chemotherapy, has been a standard of care in rectal cancer. […] Neoadjuvant chemoradiotherapy is not usually beneficial for tumors of the upper rectum; those should typically be treated with initial surgical resection.

• #14 Rectal Cancer Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/colorectal/hp/rectal-treatment-pdq

  – Higher rate of local control. […] – Improved toxicity profile of chemoradiation therapy. […] – Higher rate of sphincter preservation. […] Complete pathological response rates of 10% to 25% may be achieved with preoperative chemoradiation therapy. However, preoperative radiation therapy is associated with increased complications compared with surgery alone. Some patients with cancers at a lower risk of local recurrence might be adequately treated with surgery and adjuvant chemotherapy. […] Postoperative chemoradiation therapy is the current standard of care for stages II and III rectal cancer. However, before 1990, the following studies noted an increase in both disease-free survival (DFS) and OS with the use of postoperative combined-modality therapy: […] – The Gastrointestinal Tumor Study Group trial (GITSG-7175).

• #15 Treatment of locally advanced rectal cancer: Controversies and questions

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3482638/

  The Gastrointestinal tumor study group and National surgical adjuvant breast and bowel project trials demonstrated that chemoradiotherapy following surgical resection could reduce local recurrence from 55% to 33%, with significantly prolonged disease-free survival (DFS). […] We will outline current trends and controversies in the treatment of locally advanced rectal cancer. The topics to be covered include staging, neoadjuvant therapies, surgery, and adjuvant therapy. […] Pre-treatment evaluation, including accurate staging, is critical when planning treatment for rectal cancer patients. […] The addition of chemotherapy at some point in the treatment regimen, either preoperatively or postoperatively, conferred a significant benefit in terms of local control. […] The above data indicate that both preoperative long-course and short-course radiotherapy followed by proper TME provide excellent local control.

• #16 Rectal cancer: Treatment may reduce recurrence risk without surgery

  https://www.medicalnewstoday.com/articles/new-rectal-cancer-treatment-may-reduce-risk-recurrence-avoid-surgery

  A new treatment for locally advanced rectal cancer (LARC) has proved successful enough to avoid surgery and reduce the risk of recurrence, according to a new study. […] Total neoadjuvant treatment (TNT) involves bouts of short-course radiotherapy followed by different rounds of chemotherapy. […] Researchers in Sweden found that the treatment reduced the existence of tumors by twice the amount as previous approaches. […] The treatment could reduce the need for complicated bowel surgery and the subsequent complications that ensue. […] If the tumor disappears completely during treatment, surgery is not required. This means that the rectum is preserved and the need for a stoma and a new rectum is eliminated, Dr. Glimelius said. […] Total Neoadjuvant Therapy (TNT) refers to giving a full regimen of chemotherapy (FOLFOX, FOLFOXIRI, FOLFIRINOX, or CAPEOX most commonly) and chemoradiotherapy (radiation therapy in combination with Capecitabine) used in the treatment of rectal cancer prior to surgery.

• #17 Treatment for Rectal Cancer | Fred Hutchinson Cancer Center

  https://www.fredhutch.org/en/diseases/rectal-cancer/treatment.html

  We view treatment as a collaborative effort. Your Fred Hutch Physicians will explain all your options and recommend a treatment plan to get you the best results based on the stage, size and location of your cancer and your overall health. […] During and after treatment, your team continues to provide follow-up care on a schedule tailored to you. […] Treatment looks different for different people depending on your diagnosis. We tailor your treatment plan to you. […] People with rectal cancer often have radiation therapy along with chemotherapy to shrink their tumor before surgery. This makes the tumor easier to remove from the small space in and around the rectum, and it decreases the chance that the cancer will return. […] External-beam radiation therapy (EBRT) aims high-energy X-rays or other types of radiation at your body to kill cancer cells.

• #18 Colorectal Cancer Treatment

  https://www.radiologyinfo.org/en/info/colorect

  Your doctor may use radiation to shrink a tumor before surgery or destroy any remaining cancer cells afterward. […] Doctors are developing new drugs that enhance the tumor-killing ability of radiation therapy and chemotherapy. […] Intensity modulated radiation therapy (IMRT) and proton therapy may allow for treatment with a reduced chance of long-term bowel complications. […] Immunotherapy enhances the body’s immune system and increases the likelihood that the cancer cells will be killed. […] Gene therapy involves altering genetic material. Doctors either introduce a new gene to enhance the body’s ability to kill cancer cells or administer a gene directly to the cancer cells, causing them to die.

• #19 Colon and Rectal Cancer Treatments | Northwestern Medicine

  https://www.nm.org/conditions-and-care-areas/cancer-care/gastrointestinal-cancers/colorectal-cancer/treatments

  Treatment for colon and rectal cancer may include a single treatment or a combination of surgery, chemotherapy, radiation therapy or targeted therapies. […] The primary treatment for colorectal cancer is often surgical removal (called resection) of the cancerous portion and surrounding lymph nodes, along with a length of normal tissue on either side of the cancer. […] Medicines are administered either through the veins or by mouth to interfere with the cancer cells reproduction. […] Chemotherapy after surgery can increase the survival rate for patients with some stages of colorectal cancer. […] Your radiation oncologist will talk to you about the best options for your diagnosis. […] Radiation therapy options include: […] For some tumors, proton therapy can be a precise treatment that limits the radiation exposure to healthy tissues around the targeted tumor.

• #20 7 Innovative Rectal Cancer Treatment Options | MD Anderson Cancer Center

  https://www.mdanderson.org/cancer-types/rectal-cancer/rectal-cancer-treatment.html

  Surgery is the most common treatment for rectal cancer, especially if it has not spread. […] At MD Anderson, most rectal cancer surgeries can be performed using minimally invasive techniques, such as robotic or laparoscopic surgery. […] The type of surgery rectal cancer patients undergo depends on the stage and location of the tumor and they include: […] Proctectomy: This is the most common type of surgery for rectal cancer. […] Pelvic exenteration: Sometimes rectal cancers can grow into surrounding structures within the pelvis. […] Intraoperative Radiation Therapy (IORT): Radiation therapy is sometimes given during surgery in cases of rectal cancers that have grown beyond the rectum and into surrounding structures. […] Chemotherapy drugs kill cancer cells, control their growth or relieve disease-related symptoms.

• #21 7 Innovative Rectal Cancer Treatment Options | MD Anderson Cancer Center

  https://www.mdanderson.org/cancer-types/rectal-cancer/rectal-cancer-treatment.html

  Treatment at MD Andersons Gastrointestinal Center combines the latest technology and research with a multidisciplinary team approach tailored to your unique needs. […] Rectal cancer may be treated with surgery alone; a combination of surgery and chemotherapy; or with surgery, chemotherapy and radiation therapy together. […] Patients with early-stage rectal cancer may only need surgery. If the cancer is more advanced, they may receive chemotherapy and radiation therapy before surgery. In some cases, these treatments are so effective that surgery is no longer needed. […] Other times, patients receive chemotherapy after surgery. This is meant to kill cancer cells that might have escaped the primary tumor and moved to other parts of the body, as well as to prevent cancer from recurring. […] If rectal cancer has spread, or metastasized, to distant parts of the body, some patients can still be cured. With new treatments, rectal cancer that has spread can often be managed like a chronic condition and care is meant to prolong and preserve quality of life. Treatments for all patients with metastatic rectal cancer can include surgery, radiation therapy, cryotherapy, microwave treatment, and cancer drugs like chemotherapy, targeted therapy and immunotherapy.

• #22 Treatment of locally advanced rectal cancer: Controversies and questions

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3482638/

  The advantages of long-course chemoradiotherapy include tumor downsizing and downstaging, which may alter the surgical treatment plan in favor of a sphincter-preserving procedure. […] Currently, preoperative chemotherapy remains the standard of treatment for T3N0 patients based on the principle that overtreatment is less harmful than undertreatment. […] The pathologic response of tumor to treatment is one of the most significant prognostic factors in rectal cancer. […] Given that most of the patients in EORTC 22921 did not receive adequate doses of adjuvant chemotherapy, we cannot assume from this study that adjuvant chemotherapy is definitely not beneficial to patients receiving neoadjuvant chemoradiation. […] At this time, surgery remains the standard of care for rectal cancer patients following neoadjuvant chemoradiation. Observational management is still investigational but may be used in carefully selected high-risk patients, ideally in the setting of a clinical trial.

• #23 How We Treat Rectal Cancer | Dana-Farber Cancer Institute

  https://www.dana-farber.org/cancer-care/types/rectal-cancer/treatment

  Even if the doctor removes all the cancer possible during an operation, you may be given chemotherapy with or without radiation therapy to eliminate any remaining cancer cells. This treatment aims to lower the risk that the cancer will come back. It is called adjuvant therapy. […] When indicated, our medical oncologists use chemotherapy, a cancer treatment that uses drugs to stop the growth of cancer cells, either by eliminating the cells or by stopping them from dividing. […] Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. […] Our specialists are actively involved in research, and apply the latest knowledge to your care. Our many targeted therapies through clinical trials are a significant part of our treatment approach and provide you with the most innovative treatment options, which may not be available elsewhere.

• #24 Rectal Cancer Treatment | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/rectal/treatment

  Rectal Cancer Treatment […] The most effective way to treat rectal cancer is often a combination of treatments. […] Our areas of expertise include surgery, chemotherapy, radiation therapy, rehabilitation, follow-up care, and quality-of-life issues. […] Surgery is the most common treatment for some stages of rectal cancer. […] We may combine it with other therapies, such as radiation and chemotherapy, to shrink the tumor. […] Total neoadjuvant therapy uses a precise combination of chemotherapy and radiation therapy to make tumors as small as possible before surgery. […] MSK has helped pioneer watch-and-wait therapy (also known as nonoperative management) for rectal cancer. […] Chemotherapy may be used in combination with radiation before surgery to shrink a tumor or after surgery to kill any remaining cancer cells.

• #25 Rectal Cancer Treatment (PDQ®) – PDQ Cancer Information Summaries – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK65940/

  This PDQ cancer information summary has current information about the treatment of rectal cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care. […] There are different types of treatment for people with rectal cancer. […] The following types of treatment are used: Surgery, Radiation therapy, Chemotherapy, Chemoradiation therapy, Active surveillance, Targeted therapy, Immunotherapy. […] Surgery is the most common treatment for all stages of rectal cancer. […] 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.

• #26 Bowel cancer

  https://www.cancervic.org.au/cancer-information/types-of-cancer/bowel_cancer/treatment_for_early_bowel_cancer.html

  Surgery is the main treatment for early rectal cancer. […] If the cancer has spread beyond the rectal wall and/or into nearby lymph nodes, it is common to have chemotherapy combined with radiation therapy (chemoradiation). Most often this takes place before surgery. This is called neoadjuvant treatment. […] After surgery you may have further chemotherapy. […] Radiation therapy may be recommended for rectal cancer but is rarely used to treat colon cancer. […] Radiation therapy is used before surgery to shrink the tumour. This makes it easier for the surgeon to remove the cancer and reduces the risk of the cancer coming back. […] Some people with rectal cancer have chemotherapy before surgery to shrink it so it’s easier to remove. You may have only chemotherapy or with radiation therapy (chemoradiation). […] Chemotherapy after surgery for colon or rectal cancer aims to destroy any remaining cancer cells and reduce the chance of the cancer coming back.

• #27 Rectal Cancer Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/colorectal/hp/rectal-treatment-pdq

  – The Mayo/North Central Cancer Treatment Group trial (NCCTG-794751). […] – The National Surgical Adjuvant Breast and Bowel Project trial (NSABP-R-01). […] The efficacy of postoperative radiation therapy and 5-FU-based chemotherapy for stages II and III rectal cancer was established by a series of prospective, randomized clinical trials. […] Treatment of Stage IV and Recurrent Rectal Cancer […] Treatment options for stage IV and recurrent rectal cancer include: […] – Surgery with or without chemotherapy or radiation therapy. […] – Systemic therapy. […] – Second-line chemotherapy. […] – Immunotherapy. […] – Palliative therapy. […] For patients with locally recurrent, liver-only, or lung-only metastatic disease, surgical resection, if feasible, is the only potentially curative treatment. Patients with limited pulmonary metastasis, and patients with both pulmonary and hepatic metastasis, may also be considered for surgical resection, with 5-year survival possible in highly selected patients.

• #28 Rectal Cancer Medication: Antineoplastic agents, Antineoplastics, KRAS Inhibitors

  https://emedicine.medscape.com/article/281237-medication

  Pharmacotherapy in rectal cancer involves the use of multiple chemotherapy agents in combination regimens, often given together with radiation therapy. Chemotherapy is given before surgery to down-stage the tumor and help induce remission, and after surgery to prevent recurrences. […] As with colon cancer, standard chemotherapy for rectal cancer is with 5-fluorouracil (5-FU), or the 5-FU prodrug capecitabine, in combination with adjuncts such as levamisole and leucovorin. […] In unresectable and metastatic rectal cancer, biologic agents are used in combination with chemotherapy. Biologic agents used in both first-line and second-line therapy include bevacizumab and encorafenib. Bevacizumab, a vascular endothelial growth factor (VEGF) inhibitor, in combination with chemotherapy is indicated in patients with positive or negative resectable synchronous metastases, as well as those with unresectable synchronous metastases. Encorafenib, a BRAF inhibitor, is used in combination with cetuximab and mFOLFOX6 for first-line treatment of BRAF V600E mutation-positive metastatic rectal cancer. Other biologic agents are used in second-line therapy.

• #29 Colon & Rectal Cancer Treatment Options – Virginia Oncology Associates

  https://www.virginiacancer.com/colon-rectal/treatment-options/

  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. […] Radiation therapy is usually given before surgery to shrink a tumor to make it easier to remove. […] Your colorectal cancer treatment plan may include systemic treatments to destroy cancer cells throughout the body. […] A combination of chemotherapy drugs called FOLFOX and FOLFIRI are commonly given to colorectal cancer patients. […] Targeted therapy is a category of cancer treatment focused on a specific genetic change to stop the growth of cancer cells. […] Side effects of targeted therapy are less intense for most patients compared to chemotherapy. […] Immunotherapy uses your body’s natural defenses to fight cancer by improving your immune systems ability to attack cancer cells. […] Clinical trials have already brought many new drugs to patients with colon and rectal cancers. […] Virginia Oncology Associates offers a comprehensive approach to providing patients with the best possible care during their colorectal cancer journey.

• #30 Colorectal Cancer Treatment & Pharmacologic Management

  https://www.cancertherapyadvisor.com/ddi/colorectal-cancer-pharmacologic-management/

  Targeted therapy is designed to destroy cancer cells by acting on specific genetic and molecular pathways. […] Many of the pharmacotherapeutic best practices for colon and rectal cancers involve combinations of therapies. […] For both colon and rectal cancers, stage 0 tumors are exclusively treated by surgically removing the tumor. […] However, in rectal cancer, if the tumor is high risk, adjuvant treatment may be recommended. […] For T3-4, N0, M0 rectal cancer, either radiation with capecitabine/fluorouracil followed by chemotherapy with CAPEOX/FOLFOX as adjuvant therapy is recommended. […] In rectal cancer, chemoradiation is administered before surgery, and adjuvant CAPEOX, FOLFOX, or FU-LV follow surgery. […] In patients with locally recurrent rectal cancer, tumors are surgically removed if possible. […] In patients with locally recurrent colon cancer, surgery, often followed by chemotherapy, can extend life or even be curative.

• #31 Rectal Cancer Treatment – NCI

  https://www.cancer.gov/types/colorectal/patient/rectal-treatment-pdq

  Chemoradiation therapy combines chemotherapy and radiation therapy to increase the effects of both. […] Treatment of stage 0 may include the following types of surgery: simple polypectomy, local excision, resection (when the tumor is too large to remove by local excision). […] Treatment of stage I rectal cancer may include: local excision, resection, resection with radiation therapy and chemotherapy after surgery. […] Treatment of stage II and stage III rectal cancer may include: chemoradiation followed by surgery, chemotherapy alone followed by surgery, for people with lower-risk disease, short-course radiation therapy followed by surgery and chemotherapy, surgery followed by chemoradiation, surgery, chemoradiation followed by active surveillance and possibly surgery if the cancer recurs (comes back), immunotherapy with dostarlimab (for treatment of tumors that may have a defect in genes involved in DNA repair).

• #31 Rectal Cancer Treatment – NCI

  https://www.cancer.gov/types/colorectal/patient/rectal-treatment-pdq

  Rectal cancer is a type of cancer that forms in the tissues of the rectum. […] After rectal cancer has been diagnosed, imaging tests are done to find out if cancer cells have spread within the rectum or to other parts of the body. […] Certain factors affect prognosis (chance of recovery) and treatment options. […] There are different types of treatment for people with rectal cancer. […] The following types of treatment are used: Surgery, Radiation therapy, Chemotherapy, Chemoradiation therapy, Active surveillance, Targeted therapy, Immunotherapy. […] Surgery is the most common treatment for all stages of rectal cancer. […] Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. […] Chemotherapy (also called chemo) uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing.

• #32 Treatment decisions for rectal cancer | Bowel cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/bowel-cancer/treatment/treatment-rectal/treatment-decisions

  Depending on your situation, your doctor might suggest you also have radiotherapy or chemoradiotherapy before the surgery, or chemotherapy after surgery. This is to lower the chance of your cancer coming back. […] Radiotherapy uses high energy rays to destroy cancer cells. If your doctor thinks you need radiotherapy, you usually have it before surgery. […] Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. The drugs circulate throughout the body in your bloodstream. […] You might have chemotherapy combined with radiotherapy (chemoradiotherapy) before or after surgery. Or you might have chemotherapy on its own after surgery, to lower the risk of the cancer coming back. This is called adjuvant chemotherapy. […] Chemotherapy combined with radiotherapy is called chemoradiotherapy or chemoradiation. You usually have chemoradiotherapy before surgery.

• #33 Rectal cancer: Treatment may reduce recurrence risk without surgery

  https://www.medicalnewstoday.com/articles/new-rectal-cancer-treatment-may-reduce-risk-recurrence-avoid-surgery

  The idea of giving neoadjuvant therapy means great compliance to the intended therapies and a greater chance of downstaging the tumor before surgery. This is novel compared with historical therapies for rectal cancer, Dr. Vora said. […] TNT means all radiotherapy and chemotherapy before surgery and nothing afterwards, Glimelius said. […] TNT is more or less taking over around the world. Could be provided worldwide.

• #34 Promising treatment for rectal cancer confirmed in major study

  https://medicalxpress.com/news/2024-08-treatment-rectal-cancer-major.html

  A new treatment for locally advanced rectal cancer shows favorable results in that surgery can sometimes be avoided completely. It also reduces the risk of recurrence. The method has been confirmed as effective in a comprehensive study conducted at Uppsala University and published in eClinicalMedicine. […] „If the tumor disappears completely during treatment, surgery is not required. This means that the rectum is preserved and the need for a stoma and a new rectum is eliminated.” […] A study conducted by Uppsala University in everyday health care shows that it is possible to double the chance of eliminating the need to surgically remove part of the bowel if all radiotherapy and chemotherapy are given first and then the patient undergoes surgery, if necessary. […] The new study confirms the results of the previous randomized study, but also that the noted increase in local recurrences was not observed here. […] „With the old treatment, the randomized study failed to find any tumor in 14% of patients who underwent surgery. The new model doubled that figure to 28%.”

• #35 As Cancer Therapies Improve, More Patients with Rectal Cancer Forego Surgery | URMC Newsroom

  https://www.urmc.rochester.edu/news/story/as-cancer-therapies-improve-more-patients-with-rectal-cancer-forego-surgery

  While surgery to remove rectal cancer can be necessary and lifesaving, it can sometimes come with significant drawbacks, like loss of bowel control. According to a study led by Wilmot Cancer Institute researchers, patients with rectal cancer who respond well to radiation and chemotherapy are increasingly foregoing surgery and opting for a watch-and-wait approach. […] The study, published in JAMA Oncology, shows that the number of patients opting out of surgery rose nearly 10 percent between 2006 and 2020. These data reflect a shift toward what is known as an organ-preserving approach to care: It requires patients to undergo frequent follow-ups with experienced oncologists over five years, but potentially allows them to avoid surgery that could alter their bowel function and quality of life long-term.

• #36 What does the rectal cancer trial’s 100% remission rate mean for young patients? | Cancer | Discovery | UT Southwestern Medical Center

  https://utswmed.org/medblog/rectal-cancer-cure/

  MSKCC researchers reported that dostarlimab alone eliminated all 12 participants tumors and induced remission and none of them needed the radiation and/or chemo that was planned as the next step in treatment, and none have needed surgery. […] While more research is needed, it is possible that dostarlimab may be an effective, nonoperative treatment option for the 5-10% of patients who have MMR deficient rectal cancer. […] Ten years ago, non-operative management of rectal cancer seemed like a pipe dream. Today, it is a reality for many patients. Studies such as these are moving us closer to a future in which most, if not all, patients with rectal cancer could have a nonsurgical curative treatment option.

• #37 As Cancer Therapies Improve, More Patients with Rectal Cancer Forego Surgery | URMC Newsroom

  https://www.urmc.rochester.edu/news/story/as-cancer-therapies-improve-more-patients-with-rectal-cancer-forego-surgery

  Not yet part of standard clinical care, this organ-preserving approach is primarily available to patients through clinical trials. Wilmot is involved in several such trials, including the national Organ Preservation in Patients with Rectal Adenocarcinoma trial, which recently reported that half of the patients who opted to watch and wait were able to avoid surgery long-term. […] These positive early results and Flemings study suggest that a sea change in rectal cancer care is imminent. But Fleming cautions that better guidance is needed before watch-and-wait care can be used more broadly. […] But not all cancer centers are set up that way and not all rectal cancer programs have the resources and experience to effectively implement watch-and-wait. To ensure that all eligible patients have the opportunity to benefit, Fleming says this new approach must be designed with patients from all walks of life in mind and it must be deployed equitably across the nation. We are committed to providing the highest quality of rectal cancer care to all our patients across our Wilmot-affiliated sites, he says.

• #38 Colon and Rectal Cancer Treatment Options | Willamette Valley Cancer

  https://www.oregoncancer.com/colorectal-cancer/treatment-options

  Surgery is a common treatment for rectal cancer. The type of operation used to remove the rectal cancer depends on the stage (extent) of the cancer and its location within the rectum. […] Radiation therapy (also called radiotherapy) uses high-energy rays to kill cancer cells. […] Chemotherapy (chemo) uses anti-cancer drugs to kill cancer cells. […] Immunotherapy, also referred to as biologic therapy, uses the bodys immune system to fight cancer. […] This type of colorectal cancer treatment targets specific genes, proteins, or the tissue contributing to the cancers growth and blocks it while allowing healthy cells to continue growing with minimal impact. […] Clinical trials are crucial for advancing treatments for colorectal cancers. They allow cancer researchers to determine whether new cancer treatments are safe, effective, or better than existing treatment protocols. […] If you have been newly diagnosed with colon or rectal cancer, the next step is to schedule a consultation with a colorectal cancer doctor.

• #39 Rectal Cancer and Rectal Tumors – Gastrointestinal Cancer | UCLA Health Jonsson Comprehensive Cancer Center

  https://www.uclahealth.org/cancer/cancer-services/gi-cancer/conditions/rectal-cancer

  UCLAs colorectal cancer team includes advanced endoscopists who can remove complex polyps and tumors without open surgery. […] Robotic and laparoscopic surgery require only tiny incisions. […] Radiation uses strong X-rays to destroy cancer cells. Your radiation oncologist will develop a customized plan to target tumor cells and minimize damage to delicate rectal tissue. […] UCLA doctors helped develop medications that treat metastatic colorectal cancer, including panitumumab (Vectibix) and bevacizumab (Avastin). Our ongoing clinical trials study new medicines. […] You may have chemoradiation therapy radiation and chemotherapy at the same time before rectal surgery. Chemotherapy can make cells more sensitive to radiation therapy. […] Two types of biologic treatments, also known as targeted therapy, can attack rectal cancer cells. Anti-angiogenesis therapy starves tumors of blood and nutrients. Epidermal Growth Factor Receptor (EGFR) Inhibitor blocks the EGFR protein that may make colorectal cancer grow. […] Your doctor will discuss if clinical trials of immunotherapy medicines for colorectal cancer are an option for you.

• #40 Treatments for rectal cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/colorectal/treatment/rectal-cancer

  Radiation therapy is almost always offered for stage 2 rectal cancer. It may be given alone or as part of chemoradiation. […] Chemotherapy may be given alone after surgery. If radiation therapy or chemoradiation was not used before surgery, chemotherapy may be given in addition to chemoradiation after surgery. […] Surgery is the main treatment for stage 3 rectal cancer. Other treatments such as chemotherapy, radiation therapy or chemoradiation may also be used before or after surgery. […] Chemotherapy is usually offered for stage 4 or recurrent rectal cancer. It may be used as the main treatment for unresectable tumours in the rectum or metastases in the liver. […] Targeted therapy is usually offered for stage 4 or recurrent rectal cancer. It is usually given with chemotherapy, but it may be used alone.

• #41 Treatment for colorectal cancer | GCCA

  https://www.globalcca.org/learn/colorectal-cancer-treatment

  The primary goals of colorectal cancer treatment are to remove tumors, to prevent the cancer from returning, and to prevent the spread of cancer cells to other parts of the body (metastasis). […] Colorectal cancer (CRC) treatment options depend on many factors including your cancer’s location in the colon or rectum, whether you have early-stage or advanced colorectal cancer, results of biomarker testing, and your overall health. […] Local CRC treatment methods are surgery and radiation therapy. The goal of surgical resection (removal) is to cut out the cancer, and radiation therapy is used to destroy cancer cells or slow tumor growth. […] Systemic treatment for CRC can include conventional chemotherapy drugs, as well as therapies like immunotherapy and targeted therapy. […] Treatment plans for colorectal cancer may include surgery, chemotherapy, immunotherapy, targeted therapy drugs, and radiation therapy.

• #42 Chemo, radiation, & other therapies | Colorectal Cancer Alliance

  https://colorectalcancer.org/treatment/types-treatment/chemo-radiation-other-therapies

  Your doctor may recommend chemotherapy, radiation therapy, immunotherapy targeted therapy, and/or other therapies to treat colorectal cancer. […] Your doctor may recommend chemotherapy, radiation therapy, immunotherapy, and/or other therapies to treat your cancer. […] Treatment for colorectal cancer depends on several factors including the: […] Chemotherapy is treatment with cytotoxic drugs that are injected into a vein (IV) or pills taken by mouth. These drugs travel through the bloodstream and destroy cancer cells. […] Radiation therapy is a form of cancer treatment that uses high-energy rays to destroy cancer cells. Rectal cancer is treated with radiation more frequently than colon cancer. […] Cancer immunotherapy, also known as immuno-oncology or biological therapy, is a form of cancer treatment that uses the bodys own immune system to help prevent, control, and eliminate cancer. […] Targeted therapy uses drugs to target and „turn off” specific genes and proteins that help cancer cells grow. […] Hepatic Artery Infusion (HAI) therapy is an FDA-approved cancer treatment that delivers medicine into the liver through the hepatic artery.

• #43 Rectal Cancer Disappears After Experimental Use of Immunotherapy, Now an FDA Designated Breakthrough Therapy | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/news/rectal-cancer-disappears-after-experimental-use-immunotherapy

  Four people who were successfully treated for rectal cancer in a clinical trial at Memorial Sloan Kettering join the trials two principal investigators. All participants in the trial saw their tumors disappear using immunotherapy, without surgery, radiation, or chemotherapy. […] A small but heralded clinical trial at Memorial Sloan Kettering Cancer Center (MSK) that saw rectal cancer disappear in 100% of people who took part has taken a step towards approval by the Food and Drug Administration (FDA). […] The form of immunotherapy used in the trial, called Jemperli (dostarlimab) and produced by the drug company GSK, received the FDAs Breakthrough Therapy Designation on December 16, 2024, for treating people with a particular type of rectal cancer. […] Using immunotherapy alone means that people are spared the standard treatment for rectal cancer, which includes surgery, radiation, and chemotherapy.

• #44 Rectal Cancer Disappears After Experimental Use of Immunotherapy, Now an FDA Designated Breakthrough Therapy | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/news/rectal-cancer-disappears-after-experimental-use-immunotherapy

  Everyone on the clinical trial is doing great, says MSK gastrointestinal oncologist Andrea Cercek, MD, who led the clinical trial with gastrointestinal oncologist Luis Diaz, MD. […] So far, 42 people have completed treatment, and all of them have no evidence of disease. […] This new treatment is also proving very durable. Most people on the trial have been free of cancer for at least a year, and the original participants have been healthy for up to four years and counting. The success rate remains 100%. […] The trial has even sparked a small baby boom. […] In every case, the rectal cancer disappeared after immunotherapy without the need for the standard treatments of radiation, surgery, or chemotherapy. […] The most exciting part of this is that every single one of our patients has only needed immunotherapy. We havent radiated anybody, and we havent put anybody through surgery.

• #45 Immunotherapy for Colorectal Cancer – Cancer Research Institute

  https://www.cancerresearch.org/cancer-types/colorectal-cancer

  Immunotherapy for colorectal cancer can be effective, especially in cases where tumors show high microsatellite instability. […] Traditional treatments for colorectal cancer include chemotherapy, radiation, and surgery. Immunotherapy is a class of treatments that take advantage of a person’s own immune system to help kill cancer cells. There are several FDA-approved immunotherapy options for colorectal cancer, including for tumors with high microsatellite instability (MSI-H) or DNA mismatch repair deficiency (dMMR). […] Many immunotherapies that show promise in addressing other types of cancer are in clinical testing for colorectal cancer. […] The Cancer Research Institute has a long history of supporting scientific research for the advancement of colorectal cancer treatment, seeing many major breakthroughs that have made immunotherapy a promising approach for this disease.

• #46 Rectal Cancer Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/colorectal/hp/rectal-treatment-pdq

  Immunotherapy […] Among patients with rectal adenocarcinomas, 5% to 10% of the tumors have mismatch repair deficiency or high microsatellite instability. Immune checkpoint inhibitors are efficacious as a first-line therapy for metastatic colorectal cancers, with overall response rates of 30% to 60%. These responses proved durable, and prolonged overall survival (OS) was demonstrated in these settings. […] Primary Surgical Therapy […] The primary treatment for patients with rectal cancer is surgical resection of the primary tumor. The surgical approach to treatment varies according to: […] – Tumor location. […] – Stage of disease. […] – Presence or absence of high-risk features (i.e., positive margins, lymphovascular invasion, perineural invasion, and poorly differentiated histology).

• #47 Rectal Cancer Disappears After Experimental Use of Immunotherapy, Now an FDA Designated Breakthrough Therapy | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/news/rectal-cancer-disappears-after-experimental-use-immunotherapy

  All patients in the trial must have stage 2 or 3 rectal tumors that are MMRd which makes their cancer particularly sensitive to immunotherapy. […] The immunotherapy shrank the tumors much faster than I expected, says Dr. Cercek. […] It turned out Sascha was not an exception. […] Dr. Cercek says: The most exciting part of this is that every single one of our patients has only needed immunotherapy. […] Dr. Diaz hopes its the tip of the iceberg. […] We are currently enrolling patients with gastric (stomach), prostate, and pancreatic cancers. […] Dr. Diaz has coined a term for this new method of using immunotherapy alone to target MMRd tumors, calling it immunoablative therapy that means using immunotherapy to replace surgery, chemotherapy, and radiation to remove cancer.

• #48 Rectal Cancer Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/colorectal/hp/rectal-treatment-pdq

  Treatment Options for Rectal Cancer Stage (TNM Definitions) Treatment Options FOLFOX = leucovorin, fluorouracil, and oxaliplatin. […] Stage 0 Rectal Cancer Polypectomy or surgery […] Stage I Rectal Cancer Surgery with or without chemoradiation therapy […] Stages II and III Rectal Cancer Preoperative chemoradiation therapy Neoadjuvant chemotherapy with FOLFOX without preoperative chemoradiation therapy (for select patients with lower-risk disease) Short-course preoperative radiation therapy followed by surgery and chemotherapy Postoperative chemoradiation therapy Surgery Primary chemoradiation therapy followed by intensive surveillance for complete clinical responders Immunotherapy (for patients with mismatch repair deficiency or high microsatellite instability) […] Stages IV and Recurrent Rectal Cancer Surgery with or without chemotherapy or radiation therapy Systemic therapy Second-line chemotherapy Immunotherapy Palliative therapy

• #49 Rectal Cancer | UCSF Department of Surgery

  https://surgery.ucsf.edu/condition/rectal-cancer

  Treatment of stage I rectal cancer may include: local excision, resection, resection with radiation therapy and chemotherapy after surgery. […] Treatment of stage II and stage III rectal cancer may include: chemoradiation followed by surgery, chemotherapy alone followed by surgery, short-course radiation therapy followed by surgery and chemotherapy, surgery followed by chemoradiation, surgery, chemoradiation followed by active surveillance and possibly surgery if the cancer recurs, immunotherapy with dostarlimab. […] Treatment of stage IV and recurrent rectal cancer may include: surgery with or without chemotherapy or radiation therapy, systemic chemotherapy with or without targeted therapy, systemic chemotherapy with or without immunotherapy, chemotherapy to control the growth of the tumor, radiation therapy, chemotherapy, or a combination of both, placement of a stent to help keep the rectum open if it is partly blocked by the tumor.

• #50 Rectal Cancer Treatment & Management: Approach Considerations, Neoadjuvant Therapy, Transanal Excision

  https://emedicine.medscape.com/article/281237-treatment

  Local transanal excision of rectal cancer is reserved for early-stage cancers in a select group of patients. […] The advantages of local excision include rapid recovery, minimal effect on sphincter function, and relatively low perioperative morbidity and mortality. […] The local recurrence rate ranges from 0-40%. […] The disadvantages of abdominoperineal resection include the need for permanent colostomy and significantly higher short-term morbidity and mortality. […] Although radical resection of rectum is the mainstay of therapy, surgery alone has a high recurrence rates. […] Adjuvant radiation therapy appears to have a significant impact on local recurrence but does not increase survival rates. […] Stage I rectal cancer patients do not require adjuvant therapy due to their high cure rate with surgical resection. […] High-risk patients, including those with poorly differentiated tumor histology and those with lymphovascular invasion, should be considered for adjuvant chemotherapy and radiotherapy.

• #51 Rectal Cancer Treatment – NCI

  https://www.cancer.gov/types/colorectal/patient/rectal-treatment-pdq

  Treatment of stage IV and recurrent rectal cancer may include: surgery with or without chemotherapy or radiation therapy, systemic chemotherapy with or without targeted therapy, systemic chemotherapy with or without immunotherapy, 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. […] Treatment for rectal cancer may cause side effects. […] Follow-up care may be needed.

• #52 How We Treat Rectal Cancer | Dana-Farber Cancer Institute

  https://www.dana-farber.org/cancer-care/types/rectal-cancer/treatment

  Dana-Farber Brigham Cancer Center’s Colon and Rectal Cancer Center brings together experts who specialize in treating rectal cancer. We see more than 300 cases of rectal cancer a year, and offer patients the most advanced treatments for rectal cancer, including innovative surgical procedures, personalized gene-based treatments, and clinical trials for different stages of the disease. Our own researchers developed many of these therapies. […] Surgery (removing the cancerous growth in an operation) is often the key component of treatment for patients with rectal cancer. It is the most common treatment for people with all stages of the disease. […] Rectal surgeons at Brigham and Women’s Hospital (BWH) are the surgical team for the Dana-Farber Brigham Cancer Center’s Gastrointestinal Cancer Treatment Center, a unique center uniting some of the world’s foremost GI cancer experts. Our surgeons are leaders in rectal cancer surgery, performing a large volume of minimally-invasive, sphincter-sparing surgical techniques, including total mesorectal excision and transanal endoscopic microsurgery.

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• #55 Treatment for Rectal Cancer | Fred Hutchinson Cancer Center

  https://www.fredhutch.org/en/diseases/rectal-cancer/treatment.html

  Sometimes in order to completely remove the cancer, surgeons cannot save the anal sphincters so they need to perform a colostomy. […] During surgery to treat rectal cancer, some patients need reconstruction of the pelvis or perineum. […] Targeted therapies are newer cancer treatments that work more selectively than standard chemotherapy. […] This treatment is for people with rectal cancer that has spread to the abdominal lining (peritoneum). […] Over the past decade, amazing advances have been made in treating rectal cancers that have spread to the liver.

• #56 Metastatic Colorectal Cancer Treatment – UChicago Medicine

  https://www.uchicagomedicine.org/cancer/types-treatments/colorectal-cancer/metastatic-colorectal-cancer-treatment

  UChicago Medicine is a leader in this emerging field of oncology, which uses image-guided, minimally invasive procedures to treat cancer. […] For patients with metastatic colorectal cancer in the liver, these therapies may include: Transarterial radioembolization (TARE), In this type of therapy, an interventional radiologist goes through an artery to deliver radiation directly to a liver tumor. […] We understand how metastatic colorectal cancer can affect so many aspects of your life from what you eat to how well you sleep. […] If your colorectal cancer is advanced, we may be able to help. […] Our team can suggest treatments that may help extend and improve the quality of your life. […] Our highly regarded metastatic colorectal cancer specialists work together to determine the best approach to treat your disease. […] Our goal is to help you and your family feel more in control of your care plan. […] Through our clinical trials, we offer patients with stage 4 colorectal cancer access to innovative treatments that are not available at most hospitals.

• #57 Colon and Rectal Cancer Treatments | Northwestern Medicine

  https://www.nm.org/conditions-and-care-areas/cancer-care/gastrointestinal-cancers/colorectal-cancer/treatments

  Radioembolization: Interventional radiologists place tiny beads of radioactive isotopes (yttrium-90 or Y-90) directly in the blood vessels that feed a liver tumor. […] Ablation therapies include microwave ablation and radiofrequency ablation. […] Palliative medicine specialists provide care to: […] Throughout your care, the palliative medicine team can help you remain stronger in your fight against cancer and feel better, every step of the way. […] You may be eligible to participate in clinical trials that focus on preventing and treating colorectal cancer.

• #58 Metastatic Colorectal Cancer Treatment – UChicago Medicine

  https://www.uchicagomedicine.org/cancer/types-treatments/colorectal-cancer/metastatic-colorectal-cancer-treatment

  This includes advanced radiation techniques like stereotactic body radiation therapy (SBRT) plus immunotherapy, which uses the bodys own immune system to kill cancer. […] We also specialize in the latest interventional and surgical options, including ablation to destroy tumors and hyperthermic intraperitoneal chemoperfusion (HIPEC), which uses heated chemotherapy to kill cancer cells. […] We are also the only hospital in Illinois to offer hepatic artery infusion that delivers chemotherapy directly to tumors in the liver. […] Our physicians are also leading research to discover even better ways to help patients with metastatic colorectal cancer live longer and with less pain and fewer side effects from treatment. […] UChicago Medicine physician-scientists conducted groundbreaking research into new methods to predict which patients with metastatic colorectal cancer are more likely to have a favorable treatment outcome after removal of liver metastases.

• #59 Metastatic Colorectal Cancer Treatment – UChicago Medicine

  https://www.uchicagomedicine.org/cancer/types-treatments/colorectal-cancer/metastatic-colorectal-cancer-treatment

  Our cancer team can order different types of tests to make a diagnosis. […] This plan depends on several factors, including: Your specific type of colorectal cancer based on detailed molecular profiling of your tumor, The number and size of tumors that have spread to other parts of your body, Your personal goals and preferences, Your overall health. […] Our surgeons offer several procedures for metastatic colorectal cancer that are not widely available. […] During this treatment, cancer surgeons remove visible tumors and then coat the inside of the abdomen with heated chemotherapy to kill remaining cancer cells. […] For patients with colorectal cancer that has spread to the liver, a hepatic artery infusion pump delivers chemotherapy directly to the liver through a surgically implanted pump.

• #60 Metastatic Colorectal Cancer Treatment – UChicago Medicine

  https://www.uchicagomedicine.org/cancer/types-treatments/colorectal-cancer/metastatic-colorectal-cancer-treatment

  The hepatic artery infusion pump is a wireless metal pump that is placed inside the abdominal wall during a surgical procedure. […] The HAI device pumps high doses of chemotherapy directly into the liver– as much as 300 to 400 times higher than intravenous chemotherapy. […] We may recommend one or more drug therapies in combination with other treatments, such as surgery or radiation, to treat metastatic colorectal cancer. […] This type of treatment helps the bodys immune system fight cancer. […] Our cancer experts are considered international leaders in using immunotherapy against cancer and have been studying these treatments for more than three decades. […] Our radiation oncologists are working with medical oncologists to test new approaches of using radiation therapy to burst open cancer cells in tumors and prime the immune system before immunotherapy for patients with limited metastatic colorectal cancer.

• #61 Rectal cancer | Macmillan Cancer Support

  https://www.macmillan.org.uk/cancer-information-and-support/bowel-cancer/rectal-cancer

  A team of specialists will meet to discuss the best possible treatment for you. This is called a multidisciplinary team (MDT). […] Your doctor or cancer specialist or nurse will explain the different treatments and their side effects. They will also talk to you about things to consider when making treatment decisions. […] Before your treatment starts your cancer team might talk to you about preparing for your treatment. This is sometimes called prehabilitation. It can help to improve your fitness, health and well-being before treatment. We have more information about preparing for bowel cancer treatment (prehabilitation). […] Surgery is the most common treatment for rectal cancer. The type of operation you have depends on the stage of the cancer and where it is in the rectum. […] Radiotherapy is also a main treatment. It is often given along with chemotherapy.

• #62 Colon and Rectal Cancer Center | Dana-Farber Cancer Institute

  https://www.dana-farber.org/cancer-care/treatment/gastrointestinal/programs/colorectal-cancer

  At the Colon and Rectal Cancer Center, our mission is to deliver compassionate, multi-disciplinary, leading-edge colon and rectal cancer care, providing patients and their families with access to a comprehensive range of services based on specialized treatment modalities and innovative research. […] This approach includes genetic screening, family risk assessment, specialized endoscopic treatments, minimally invasive and robotic surgery, targeted therapies, clinical trials, and recurrence prevention. […] Our medical, surgical, and radiation oncologists, endoscopy specialists, gastroenterologists, radiologists, and pathologists work every day to improve outcomes for patients with colon or rectal cancer, as they research new ways to prevent, diagnose, and treat these diseases. […] We offer an approach to treatment that includes: Precision cancer medicine. Highly advanced diagnostic procedures. Treatment based on personalized genetic testing and current research. Experienced physicians who specialize in treating people with heightened genetic risk. Multiple clinical trials for early-stage and metastatic colon cancer, as well as for survivors of colon cancer, including trials with novel and targeted therapies and immunotherapies. Sphincter-preserving operations for rectal cancer patients. Laparoscopic, minimally-invasive and robotic surgical procedures. A team of surgical oncologists specializing in metastases of the liver. Advanced interventional radiology techniques, such as radiofrequency ablation and radioembolization. State-of-the-art techniques for the planning and delivery of radiation therapy, with treatment plans developed in collaboration with medical and surgical oncologists. Our unique Enhanced Recovery After Surgery program. […] Learn about how we diagnose and treat rectal cancer.

• #63 8 Things To Know About Surgery for Rectal Cancer > News > Yale Medicine

  https://www.yalemedicine.org/news/8-things-to-know-about-rectal-cancer-surgery

  After surgery, rectal cancer patients are taken to a hospital floor where there are nurses with specialized knowledge about their procedure. […] A stoma shouldnt interfere with a persons regular activities, and a variety of products can help. […] Rectal surgery can be different for each patient. […] Meanwhile, Dr. Mongiu is involved in the developmentand related researchof a pre-surgery program to help people strengthen the muscles involved in bowel movements, so they are more functional after surgery. […] If you get checked and you learn you have something, dont be afraid to proceed with the treatments you need, Giannettino says.

• #64 Rectal cancer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rectal-cancer/diagnosis-treatment/drc-20352889

  Immunotherapy for cancer is a treatment with medicine that helps the body’s immune system kill cancer cells. […] Palliative care is a special type of healthcare that helps you feel better when you have a serious illness. If you have cancer, palliative care can help relieve pain and other symptoms. […] The use of palliative care with other proper treatments can help people with cancer feel better and live longer.

• #65 Colon and Rectal Cancer | In Treatment | Legacy Health

  https://www.legacyhealth.org/Services-and-Resources/services/adult/cancer-institute/In-Treatment/Colon-cancer-treatment

  Surgery is the most common treatment for all stages of colon and rectal cancers. […] For rectal, options include: Local transanal excision: For small, early stage disease, the cancer and surrounding tissue are removed with instruments inserted into the rectum through the anus. […] Radiation therapy uses high-energy X-rays or other radiation to kill cancer cells or keep them from growing. For rectal cancer, radiation is often done first, aiming to shrink the tumor before surgery. […] Chemotherapy uses drugs used to slow or kill cancer cells throughout the body. For colon cancer, chemotherapy is recommended if cancer is also found in nearby lymph nodes. For advanced rectal cancers, chemotherapy is often given at the same time as radiation therapy. […] Many cancer treatments can cause challenging side effects. Your cancer team is dedicated to helping you manage these symptoms in the best ways possible. Comfort care can treat symptoms to help improve your quality of life; this is also called palliative care.

• #66 Rectal cancer | Macmillan Cancer Support

  https://www.macmillan.org.uk/cancer-information-and-support/bowel-cancer/rectal-cancer

  Chemotherapy is also commonly used to treat advanced rectal cancer. Surgery, ablation and different types of radiotherapy can also be used depending on where in the body rectal cancer has spread to. […] Radiotherapy is also sometimes used to control symptoms of advanced cancer. […] We have more information about treatment for advanced bowel cancer. […] You may have some treatments as part of a clinical trial. […] Find out more about treatment options for rectal cancer.

• #67 Colorectal Cancer Treatment | How to Treat Colorectal Cancer | American Cancer Society

  https://www.cancer.org/cancer/types/colon-rectal-cancer/treating.html

  Its important to discuss all of your treatment options, including their goals and possible side effects, with your doctors to help make the decision that best fits your needs. […] Clinical trials are carefully controlled research studies that are done to get a closer look at promising new treatments or procedures. Clinical trials are one way to get state-of-the-art cancer treatment. […] Complementary methods are treatments that are used along with your regular medical care. Alternative treatments are used instead of standard medical treatment. […] People with cancer need support and information, no matter what stage of illness they may be in. […] For some people, when treatments have been tried and are no longer controlling the cancer, it could be time to weigh the benefits and risks of continuing to try new treatments. […] People who have advanced cancer and who are expected to live less than 6 months may want to consider hospice care.

• #68 Colorectal Cancer Treatment – UChicago Medicine

  https://www.uchicagomedicine.org/cancer/types-treatments/colorectal-cancer/treatment

  Chemotherapy and/or radiation therapy are typically recommended for patients with advanced colorectal cancer. These treatments can be prescribed before and/or after surgery with the goal of preventing recurrence of the cancer. […] Our physicians are currently studying the use of preoperative chemotherapy for locally advanced rectal cancer and selective non-operative management for patients with a good response to chemotherapy/radiation for rectal cancer.

• #69 Rectal Cancer | Fred Hutchinson Cancer Center

  https://www.fredhutch.org/en/diseases/rectal-cancer.html

  Many patients at Fred Hutch receive promising therapies by taking part in clinical trials. These research studies are done by physician-scientists from Fred Hutch and UW Medicine. They test new treatments or new ways to use current treatments. […] For some people, taking part in a clinical study may be the best treatment choice. Access to clinical studies by researchers at both Fred Hutch and UW Medicine is one reason many patients come to us for care.

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