Making a Treatment Plan for Rectal Cancer

In order to develop the best plan of care for your rectal cancer diagnosis, your doctors and other members of your healthcare team will look at the stage of the disease through several tests that are given. Some tests that your doctor could order include an MRI and a CT. Blood tests are often ordered as well in order to look at various levels. 

Once the results of your tests are available, they can help the team decide on the best types of treatment that should be used, such as which medications might be needed or if surgery might be an option to consider. Chemotherapy and radiation could be used to shrink the tumor before surgery is performed. Doctors can look at test results to determine the stage of your rectal cancer as this is a factor for determining your treatment as well. Other factors that could come into play when deciding on the best treatment plan include the size of the tumor and the location. Your healthcare team will also look to see if the tumor has metastasized or spread to other areas of your body. 

Stage 0

At this stage, the tumor is usually small and hasn't spread to other areas. In most situations, surgery can be performed to remove the tumor without any further treatments. 

Stage 1

Tumors are usually within the wall of the rectum. However, they typically haven't invaded the areas surrounding the rectum. The tumors are typically removed surgically with additional areas removed as well to prevent the spread of any cancer cells. Endoscopic surgery is sometimes performed if there are larger tumors that need to be removed. Sometimes, incisions might need to be made to allow the doctor to better see the tumors or reach areas that are higher up in the rectum. These incisions are typically made in the lower part of the abdomen. 

Stages 2 and 3

A component of stage 2 rectal cancer is that the tumor has started growing outside of the rectum. The lymph nodes usually aren't involved. However, during stage 3, cancer cells have usually invaded the lymph nodes, which could require various treatments including radiation or surgery. Some patients might undergo chemotherapy or radiation before surgery while other patients might have a treatment plan that is significantly different due to the location of the tumor and the severity of the progression of cancer. 

Prior to Surgery

Before your doctor performs surgery, radiation or chemotherapy options are typically explored to try to minimize the size of tumors that are present. This can make recovery from surgery a bit easier as the procedure could be less invasive. It could also decrease the possibility that you would need a colostomy. Radiation treatments are often given over the course of six weeks. The tumor will be assessed once again to see if the therapy worked before another treatment plan is put into action. 

Some of the treatments after surgery include a colostomy or an ileostomy. With a colostomy, there is an opening through the abdominal wall that allows for fecal matter to be eliminated into a bag. An ileostomy is a treatment that is used once the bowels are functioning again. 

Stage 4

Other tissues or organs are affected by this stage. As with other stages, chemotherapy and radiation are looked at first, but surgery is often the best treatment to remove the tumors.