Find Information About:

Drugs & Supplements

Get information and reviews on prescription drugs, over-the-counter medications, vitamins, and supplements. Search by name or medical condition.

Pill Identifier
WebMD

Pill Identifier

Having trouble identifying your pills?

Enter the shape, color, or imprint of your prescription or OTC drug. Our pill identification tool will display pictures that you can compare to your pill.

Get Started
My Medicine
WebMD

My Medicine

Save your medicine, check interactions, sign up for FDA alerts, create family profiles and more.

Get Started

WebMD Health Experts and Community

Talk to health experts and other people like you in WebMD's Communities. It's a safe forum where you can create or participate in support groups and discussions about health topics that interest you.

  • Second Opinion
    WebMD

    Second Opinion

    Read expert perspectives on popular health topics.

  • Community
    WebMD

    Community

    Connect with people like you, and get expert guidance on living a healthy life.

Got a health question? Get answers provided by leading organizations, doctors, and experts.

Get Answers

Sign up to receive WebMD's award-winning content delivered to your inbox.

Sign Up

Colorectal Cancer Health Center

Font Size
A
A
A

Rectal Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stage IV and Recurrent Rectal Cancer

Treatment options for local control:

  1. Resection of locally recurrent rectal cancer may be curative in selected patients.[1]
  2. Palliative surgical resection with either low-anterior resection (LAR) or abdominoperineal resection (APR).[1]
  3. Palliative radiation therapy.[2,3]
  4. Palliative chemotherapy.[4,5,6,7,8,9,10]
  5. Palliative chemoradiation.[11,12]
  6. Chemotherapy alone for local control.
  7. Palliative, endoscopic-placed stents to relieve obstruction.[13]

Treatment options for systemic control:

Recommended Related to Colorectal Cancer

Follow-up Care After Colon Cancer

Now that your treatment for colon cancer is over, you'll need good follow-up care in order to live a full and healthy life. That means regular check-ups with your oncologist and primary care doctor to help you maintain the progress you"ve made. Here are some of the things you'll want to think about as you move forward.

Read the Follow-up Care After Colon Cancer article > >

  1. Resection of liver metastases in selected patients (5-year cure rate with resection of solitary metastases exceeds 20%).[14,15,16,17,18,19,20,21,22,23]
  2. Resection of isolated pulmonary or ovarian metastases.
  3. Systemic chemotherapy (see below).
  4. Clinical trials evaluating new drugs.

Metastatic Rectal Cancer

Treatment of patients with recurrent or advanced colorectal cancer depends on the location of the disease. For patients with locally recurrent and/or liver-only and/or lung-only metastatic disease, surgical resection, if feasible, is the only potentially curative treatment. Hepatic metastasis may be considered to be resectable based on the following:[17,21,24,25,26,27]

  • Limited number of lesions.
  • Intrahepatic locations of lesions.
  • Lack of major vascular involvement.
  • Absent or limited extrahepatic disease.
  • Sufficient functional hepatic reserve.

For patients with hepatic metastasis considered to be resectable, a negative margin resection has been associated with 5-year survival rates of 25% to 40% in mostly nonrandomized studies (such as the North Central Cancer Treatment Group trial, NCCTG-934653).[28,29,30,31,32][Level of evidence: 3iiiDiv] Better surgical techniques and advances in preoperative imaging have improved patient selection for resection. In addition, multiple studies with multiagent chemotherapy have demonstrated that patients with metastatic disease isolated to the liver, which historically would be considered unresectable, can occasionally be made resectable after the administration of chemotherapy.[33]

Currently, there are seven active and approved drugs for patients with metastatic colorectal cancer:

When 5-FU was the only active chemotherapy drug, trials in patients with locally advanced, unresectable, or metastatic disease demonstrated partial responses and prolongation of the time-to-progression (TTP) of disease [5,34] as well as improved survival and quality of life for patients receiving chemotherapy compared with best supportive care.[35,36,37] Several trials have analyzed the activity and toxic effects of various 5-FU-leucovorin (5-FU/LV) regimens, using different doses and administration schedules, and showed essentially equivalent results with a median survival time in the 12-month range.[38] Prior to the advent of multiagent chemotherapy, two randomized studies demonstrated that capecitabine was associated with equivalent efficacy when compared with the Mayo Clinic regimen of 5-FU/LV.[39,40][Level of evidence: 1iiA]

1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10
1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10
Next Article:

Today on WebMD

Colorectal cancer cells
The right diagnosis is the most important factor.
man with a doctor
Our health check will steer you in the right direction.
 
sauteed cherry tomatoes
Fight cancer one plate at a time.
bladder cancer x-ray
Do you know the warning signs?
 
bread
ARTICLE
Colon vs Rectal Cancer
VIDEO
 
New Colorectal Treatments
VIDEO
can lack of sleep affect your immune system
FEATURE
 
Cancer Facts Quiz
QUIZ
Virtual Colonoscopy
VIDEO
 
Picture of the Colon
ANATOMY
Vitamin D
SLIDESHOW