Rectal Cancer Treatment by Stage

Treatments of cancer of the rectum depend on the stage of the disease and the patient's overall condition.

Standard treatments, that have been proven effective in past studies, may be received or participation in a clinical trial may be considered. Clinical trials are done to find better ways to treat cancer patients and are based on the most up-to-date information. Clinical trials are ongoing in most parts of the country for most stages of cancer of the rectum. To learn more about clinical trials, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.

Stage 0 rectal cancer

Treatment may be one of the following:

1. Local removal of the tumor.
2. Surgery (bowel resection).
3. Internal radiation therapy.
4. Radiation therapy.

Stage I rectal cancer

Treatment may be one of the following:

1. Surgery (bowel resection) to remove the tumor.
2. Local removal of the tumor with or without radiation therapy plus chemotherapy.
3. Internal radiation therapy.

Stage II rectal cancer

Treatment may be one of the following:

1. Surgery (bowel resection) to remove the tumor, followed by radiation therapy and chemotherapy.
2. Surgery (bowel resection) to remove the tumor, as well as the colon, rectum, prostate, or bladder, depending on where the cancer has spread. Surgery is followed by radiation therapy and chemotherapy.
3. Radiation therapy with or without chemotherapy followed by surgery (bowel resection) followed by chemotherapy.
4. Clinical trials evaluating all of the above treatments to find better combinations of chemotherapy drugs and better ways of combining radiation therapy with chemotherapy.
5. Radiation therapy following surgery with chemotherapy or radiation therapy.

Stage III rectal cancer

Treatment may be one of the following:

1. Surgery (bowel resection) to remove the tumor, followed by radiation therapy and chemotherapy.
2. Surgery (bowel resection) to remove the tumor, as well as the colon, rectum, prostate, or bladder, depending on where the cancer has spread. Surgery is followed by radiation therapy and chemotherapy.
3. Radiation therapy with or without chemotherapy followed by surgery (bowel resection) followed by chemotherapy.
4. Clinical trials evaluating all of the above treatments to find better combinations of chemotherapy drugs and better ways of combining radiation therapy with chemotherapy.
5. Radiation therapy following surgery with chemotherapy or radiation therapy.

Stage IV rectal cancer

Treatment may be one of the following:

1. Surgery (bowel resection) to remove or go around the tumor or to make the patient more comfortable.
2. If the tumor has spread only to the liver, lungs, or ovaries, surgery to take out the tumor where it has spread.
3. Radiation therapy and chemotherapy to reduce the size of the tumor and make the patient more comfortable.
4. Chemotherapy to kill the tumor if it has spread (metastasized) to other parts of the body.
5. A clinical trial evaluating chemotherapy and biological therapy.

Recurrent rectal cancer

Treatment may be one of the following:

1. Surgery (bowel resection) to remove or go around the tumor or to make the patient more comfortable.
2. Radiation therapy to reduce the size of the tumor and make the patient more comfortable.
3. Chemotherapy to reduce the size of the tumor and make the patient more comfortable.
4. Radiation therapy and chemotherapy to reduce the size of the tumor and make the patient more comfortable.

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For more information on colorectal cancer, please visit the  Colorectal Cancer Home Page.