https://www.cancer.org/cancer/colon-rectal-cancer/treating/by-stage-rectum.html
Treatment of Rectal Cancer, by Stage
Treatment for rectal cancer is based largely on the stage (extent) of the cancer, although 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 used before or after surgery..
Treating stage I rectal cancer
Stage I rectal cancers have grown into deeper layers of the rectal wall but have not spread outside the rectum itself.
This stage includes cancers that were part of a polyp. If the polyp is removed completely during colonoscopy, with no cancer in the edges, no other treatment may be needed. If the cancer in the polyp was high grade, or if there were cancer cells at the edges of the polyp, you might be advised to have more surgery.
Treating stage II rectal cancer
Many stage II rectal cancers have grown through the wall of the rectum and might extend into nearby tissues. They have not spread to the lymph nodes.
Many people get both chemo and radiation therapy (called chemoradiation) as their first treatment. The chemo given with radiation is usually either 5-FU or capecitabine (Xeloda).
This is usually followed by surgery, such as a low anterior resection (LAR), proctectomy with colo-anal anastomosis, or abdominoperineal resection (APR), depending on where the cancer is in the rectum. If the chemo and radiation therapy shrink the tumor enough, sometimes a transanal resection can be done instead of a more invasive LAR or APR. This might help you avoid having a colostomy. But not all doctors agree with this method, because it doesn’t let the surgeon check the nearby lymph nodes for cancer.
Additional chemo is then given after surgery, usually for a total of about 6 months. The chemo may be the FOLFOX regimen (oxaliplatin, 5-FU, and leucovorin), 5-FU and leucovorin, CAPEOx (capecitabine plus oxaliplatin) or capecitabine alone, based on what’s best suited to your health needs.
Treating stage III rectal cancer
Stage III rectal cancers have spread to nearby lymph nodes but not to other parts of the body.
Most people with stage III rectal cancer will be treated with chemotherapy, radiation therapy, and surgery, although the order of these treatments might differ.
Most often, chemo is given along with radiation therapy (called chemoradiation) first. This may shrink the cancer, often making it easier to take out larger tumors. It also lowers the chance that the cancer will come back in the pelvis. Giving radiation before surgery also tends to lead to fewer problems than giving it after surgery.
Chemoradiation is followed by surgery to remove the rectal tumor and nearby lymph nodes, usually by low anterior resection (LAR), proctectomy with colo-anal anastomosis, or abdominoperineal resection (APR), depending on where the cancer is in the rectum. If the cancer has reached nearby organs, a more e
Treatment of Rectal Cancer, by Stage
Treatment for rectal cancer is based largely on the stage (extent) of the cancer, although 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 used before or after surgery..
Treating stage I rectal cancer
Stage I rectal cancers have grown into deeper layers of the rectal wall but have not spread outside the rectum itself.
This stage includes cancers that were part of a polyp. If the polyp is removed completely during colonoscopy, with no cancer in the edges, no other treatment may be needed. If the cancer in the polyp was high grade, or if there were cancer cells at the edges of the polyp, you might be advised to have more surgery.
Treating stage II rectal cancer
Many stage II rectal cancers have grown through the wall of the rectum and might extend into nearby tissues. They have not spread to the lymph nodes.
Many people get both chemo and radiation therapy (called chemoradiation) as their first treatment. The chemo given with radiation is usually either 5-FU or capecitabine (Xeloda).
This is usually followed by surgery, such as a low anterior resection (LAR), proctectomy with colo-anal anastomosis, or abdominoperineal resection (APR), depending on where the cancer is in the rectum. If the chemo and radiation therapy shrink the tumor enough, sometimes a transanal resection can be done instead of a more invasive LAR or APR. This might help you avoid having a colostomy. But not all doctors agree with this method, because it doesn’t let the surgeon check the nearby lymph nodes for cancer.
Additional chemo is then given after surgery, usually for a total of about 6 months. The chemo may be the FOLFOX regimen (oxaliplatin, 5-FU, and leucovorin), 5-FU and leucovorin, CAPEOx (capecitabine plus oxaliplatin) or capecitabine alone, based on what’s best suited to your health needs.
Treating stage III rectal cancer
Stage III rectal cancers have spread to nearby lymph nodes but not to other parts of the body.
Most people with stage III rectal cancer will be treated with chemotherapy, radiation therapy, and surgery, although the order of these treatments might differ.
Most often, chemo is given along with radiation therapy (called chemoradiation) first. This may shrink the cancer, often making it easier to take out larger tumors. It also lowers the chance that the cancer will come back in the pelvis. Giving radiation before surgery also tends to lead to fewer problems than giving it after surgery.
Chemoradiation is followed by surgery to remove the rectal tumor and nearby lymph nodes, usually by low anterior resection (LAR), proctectomy with colo-anal anastomosis, or abdominoperineal resection (APR), depending on where the cancer is in the rectum. If the cancer has reached nearby organs, a more e
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