Treatment Option Overview
Key Points for This Section
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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.
Three types of standard treatment are used:
Surgery
Surgery is the most
common treatment for all stages of rectal cancer. A doctor may remove the
cancer using one of the following types of surgery:
- Local excision: If the cancer is found at a very early stage, the doctor may remove it
without cutting into the abdomen. If
the cancer is found in a polyp (a
growth that protrudes from the rectal mucous membrane), the operation is called
a polypectomy.
- Resection: If
the cancer is larger, the doctor will perform a resection of the rectum (removing the cancer and a
small amount of healthy tissue around it). The doctor will then perform an anastomosis (sewing the healthy parts of the
rectum together, sewing the remaining rectum to the colon, or sewing the colon to the anus). The doctor will also take out lymph nodes near the rectum and
examine them under a microscope to see if they contain cancer.
Enlarge | | | Rectal cancer surgery with anastomosis. The rectum and part of the colon are removed, and then the colon and anus are joined. |
- Resection and colostomy: If the doctor is not able to sew the
rectum back together, a stoma (an opening) is made
on the outside of the body for waste to pass through. This procedure 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 doctor needs to remove the entire
rectum, however, the colostomy may be permanent.
Even if the doctor removes all the cancer that can be seen at the
time of the operation, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after surgery to increase the chances of a cure is called adjuvant
therapy.
Radiation
therapy
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. 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.
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 spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.
New types of treatment are being tested in clinical
trials.
This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI Web
site.
Biologic therapy
Biologic therapy 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 type of cancer treatment is also called biotherapy or immunotherapy.
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. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's clinical trials database.
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. This is sometimes called re-staging.
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.
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