Reviewed by Varnada Karriem-Norwood on May 27, 2012
Nancy Kemeny, MD. Oncologist; Colorectal Cancer Specialist Memorial Sloan-Kettering Cancer Center Professor of MedicineWeill Medical College of Cornell University
© 2006 WebMD, Inc. All rights reserved.
Nancy Kemeny, MD: You start from the GI tract, you go into the esophagus, the stomach, the small bowel, and then you hit the colon. And at the very end of the colon is the rectum. So, in a sense, rectal cancer is worse, because it's very low, many times if it's really low, in order to remove it, the patient has to have a colostomy, which in the minds of many patients is a very bad thing. But for almost all colon cancers, you do not need a colostomy. So it's only the very low rectal cancers where that's needed, and also in the treatment, when you're talking about adjuvant treatment, which means the treatment after a section, the treatments will be different.
Nancy Kemeny, MD (cont.): Because in colon cancer, since it's higher up, and since it spreads in the abdomen, and to the liver and lungs, the treatment is chemotherapy afterwards. But in rectal cancer, since it's very low, and it's very close to the nerves and the bones and everything is very close to where the rectum is, you need radiation as well as chemotherapy after the surgery, or even before the surgery. A lot of surgeons these days like to do radiation and chemotherapy before the surgery to try to reduce the tumor, so they will have to do less surgery.
Nancy Kemeny, MD (cont.): So the treatments are different, depending on whether it's colon or rectum. But once it's metastatic, meaning that it's spread to the liver or lungs, or to the bones, then the treatment is the same.