Rectal Cancer Treatment by Stage

Rectal cancer is staged much the same way as colon cancer, but because the tumor is much lower down in the large intestine, the treatment options may vary.

Surgery to remove the cancer is almost always the first treatment.

Stage 0

In Stage 0 rectal cancer, the tumor is located only on the inner lining of the rectum. To treat this early stage cancer, surgery can be performed to remove the tumor or a small section of the rectum where the cancer is located can be removed. Radiation treatment, given either externally (beamed in from the outside) or internally (radioactive beads are placed inside the rectum) may be considered.

Stage I

Also called Dukes A rectal cancer, this is another early form or limited form of cancer. The tumor has broken through the inner lining of the rectum but has not made it past the muscular wall. Treatment usually involves:

• Surgery to remove the tumor
• If the tumor is small or you are very old or sick, radiation alone can be used to treat the tumor. This hasn't proven to be as effective as surgery.

Stage II

Also called Dukes B rectal cancer, this cancer is a little more advanced. The tumor has penetrated all the way through the bowel wall and may have invaded other organs, like the bladder, uterus, or prostate gland. Treatment includes:

• Surgery to remove all the organs involved with the cancer (wide-resection) is used to control the disease.
• Some doctors will recommend radiation be used before, after, or during the surgery, while others recommend radiation and chemotherapy be used. Note that radiation before the surgery may keep the doctor from determining if the cancer has spread to the lymph nodes or into the pelvis.

Stage III

Also called Dukes C rectal cancer, the tumor has spread to the lymph nodes (small structures that are found throughout the body that produce and store cells that fight infection). Treatment includes:

• Surgery to remove the tumor.
• Radiation therapy is also often used before or after surgery.
• Chemotherapy is offered after surgery. However, it can be given before surgery to shrink a tumor to make surgery easier.

Stage IV

Also called Dukes D rectal cancer, the tumor has spread to distant parts of the body (metastasized). The tumor can be any size and sometimes is not that large. The liver and lung are two favored places for rectal cancer to spread.

The mainstay of treatment is chemotherapy, but sometimes surgery to remove the tumor may also be recommended.

Surgery, when performed is often used to relieve or prevent blockage of the rectum or to prevent rectal bleeding. It is not considered a curative procedure. Surgeries of this type can also help a patient with stage IV rectal cancer live longer.

Liver metastases can also be removed surgically if there are only one or two tumors. Other options for treating metastases include freezing the tumors (cryosurgery), destroying them with microwaves, a procedure called photocoagulation to vaporize the tumor with a laser or other non surgical methods.