Rectal Cancer Questions & Answers

Updated: Aug 04, 2019
  • Author: Burt Cagir, MD, FACS; Chief Editor: N Joseph Espat, MD, MS, FACS  more...
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Questions & Answers

Overview

What is rectal cancer?

What are the common signs and symptoms of rectal cancer?

How is a physical exam performed in suspected rectal cancer?

Which lab studies are indicated in the workup of suspected rectal cancer?

Which screening tests are used in suspected rectal cancer?

Which imaging studies are used in the workup of metastatic rectal cancer?

What is the approach to the treatment of rectal cancer?

What are the surgical options for the treatment of rectal cancer?

What are the options for medical management of rectal cancer?

Which drugs are recommended by the NCCN for the treatment of rectal cancer?

How common is rectal cancer and what are the most common types?

What is the anatomy of the rectum in relation to rectal cancer?

What is the pathophysiology of rectal cancer?

What are the pathways to colon and rectal cancer?

What is the epidemiology of rectal cancer in the US?

What is the international incidence of rectal cancer?

What is the mortality of rectal cancer?

What is the role of aspirin in the reduction of cancer death rates?

What is the incidence of rectal cancer by race?

Is rectal cancer more common in men or women?

What is the incidence of rectal cancer by age?

Presentation

What is the clinical history of rectal cancer?

How is a physical exam conducted in suspected rectal cancer?

What causes rectal cancer?

Which dietary habits contribute to the development or prevention of rectal cancer?

What is the role of alcohol in the development of rectal cancer?

What is the role of tobacco in the development of rectal cancer?

What is the relationship between cholecystectomy and rectal cancer?

Which hereditary factors increase the risk of rectal cancer?

What is the role of familial adenomatous polyposis (FAP) in the development of rectal cancer?

What causes hereditary nonpolyposis colorectal cancer (HNPCC) (Lynch syndrome), and who is at risk?

What is the malignant pathway of rectal cancer in patients with ulcerative colitis or Crohn disease?

Workup

Which lab studies are indicated in the workup of rectal cancer?

When is screening for colon and rectal cancer indicated in high-risk patients?

What is the purpose of screening for colon and rectal cancer?

What are the screening options for colon and rectal cancer?

When is screening for colon and rectal cancer indicated in average-risk patients?

What are the screening options and regimens for colon and rectal cancer?

What are the advantages of the different colon and rectal cancer screening tests?

When is surveillance for colon and rectal cancer indicated?

What are the screening recommendations for rectal cancer by risk factor?

Which histopathologic features of rectal cancer are associated with a poor outcome?

What are the 5-year survival rates for rectal cancer according to the tumor, node, metastasis (TNM) system?

What are the stages of rectal cancer according to the Dukes Classification?

What are the subdivisions of Dukes Classification stages B and C in rectal cancer?

What is the role of the tumor, node, metastasis (TNM) system in rectal cancer?

What are the TNM system tumor classifications in rectal cancer?

What are the TNM system node classifications in rectal cancer?

What are the TNM system metastasis classifications in rectal cancer?

Treatment

What are the approach considerations in the treatment of rectal cancer?

Which factors influence sphincter and organ preservation in patients with rectal cancer?

When is sphincter preservation difficult in the treatment of rectal cancer?

When is local excision indicated in the treatment of rectal cancer?

What are disadvantages of abdominoperineal resection in the treatment of rectal cancer?

What is the role of transanal excision in the treatment of rectal cancer?

What is the role of endocavitary radiation in the treatment of rectal cancer?

What is the role of transanal endoscopic microsurgery (TEM) in the treatment of rectal cancer?

What are the sphincter-sparing surgical options the treatment of in rectal cancer?

What are indications for low anterior resection (LAR) in the treatment of rectal cancer?

What are indications for total mesorectal excision (TME) in the treatment of rectal cancer?

How effective is mesorectal excision (TME) in the treatment of rectal cancer?

When is coloanal anastomosis (CAA) indicated in the treatment of rectal cancer?

When is abdominal perineal resection (APR) indicated in the treatment of rectal cancer?

How is an abdominal perineal resection (APR) performed in the treatment of rectal cancer?

How is liver metastasis treated in patients with rectal cancer?

What are the options for adjuvant care in the treatment of rectal cancer?

What is the role of adjuvant radiation therapy in the treatment of rectal cancer?

How effective is postoperative radiation therapy in the treatment of rectal cancer?

What is the role of intraoperative radiation therapy in the treatment of rectal cancer?

What is the role of adjuvant chemotherapy in the management of rectal cancer?

Which chemotherapeutic agents are used in the treatment of rectal cancer?

How effective is chemotherapy in the treatment of rectal cancer?

What is the role of biologic therapy in the treatment of rectal cancer?

What is the role of adjuvant chemoradiation in the treatment of rectal cancer?

What is the role of radioembolization in the treatment of rectal cancer?

What dietary recommendations are indicated in the treatment of rectal cancer?

What are the USMSTF guidelines for long-term monitoring of patients with rectal cancer?

What are the NCCN guidelines for long-term monitoring of patients with rectal cancer?

Guidelines

Which organizations have issued guidelines on rectal cancer screening?

What are the risk factors and ACS/USMSTF/ACR guidelines for rectal cancer screening?

Which tests are recommended to detect adenomatous polyps and cancer?

Which tests are recommended to detect rectal cancer?

What are the updated 2018 ACS colorectal screening guidelines?

What are USPSTF guidelines on rectal cancer screening?

What are the stool-based tests used in rectal cancer screening and their recommended intervals?

What are the direct visualization tests used in rectal cancer screening and their recommended intervals?

What are the ACP recommended strategies for rectal cancer screening?

What are the ACG guidelines for rectal cancer screening?

What are NCCN screening recommendations for patients at increased risk of rectal cancer?

Which syndromes associated with rectal cancer are addressed in the NCCN guidelines?

When is further evaluation indicated for high-risk syndromes in rectal cancer screening?

When is testing for Lynch Syndrome (HNPCC) indicated in patients with rectal cancer?

What are the guidelines for testing in familial risk-rectal cancer?

What are the colonoscopy findings and associated recommended follow up in patients at risk for rectal cancer?

What are recommended surveillance intervals for patients with serrated lesions and risk for rectal cancer?

What are the guidelines for surveillance of patients with familial adenomatous polyposis (FAP) and risk for rectal cancer?

What are the recommendations for surveillance of patients with attenuated familial adenomatous polyposis (FAP) and risk for rectal cancer?

What is the role of genetic testing in patients with familial adenomatous polyposis (FAP) and risk for rectal cancer?

In addition to genetic counseling, what are the recommendations for surveillance and treatment of patients with familial adenomatous polyposis (FAP) and risk for rectal cancer?

What are the ASCRS guidelines on surgery for rectal cancer?

What are the NCCN guidelines on adjuvant therapy regimens for rectal cancer?

What are the NCCN guidelines on adjuvant therapy for stage II or stage III rectal cancer?

What are the guidelines on follow-up care for survivors of stage II and stage III rectal cancer?

What are the USMSTF guidelines on colonoscopy after rectal cancer resection?

What are the recommendations on gene mutation testing in metastatic colorectal carcinoma (mCRC)?

Medications

What are the goals of drug treatment in rectal cancer?

Which medications in the drug class Vaccine are used in the treatment of Rectal Cancer?

Which medications in the drug class Antineoplastic agents are used in the treatment of Rectal Cancer?