About Rectal Cancer

Rectal Cancer Treatment (PDQ®)

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General Information About Rectal Cancer

Key Points:

Rectal cancer is a disease in which malignant (cancer) cells form in the tissues of the rectum.

The rectum is part of the body’s digestive system. The digestive system removes and processes nutrients (vitamins, minerals, carbohydrates, fats, proteins, and water) from foods and helps pass waste material out of the body. The digestive system is made up of the esophagus, stomach, and the small and large intestines. The first 6 feet of the large intestine are called the large bowel or colon. The last 6 inches are the rectum and the anal canal. The anal canal ends at the anus (the opening of the large intestine to the outside of the body).

Gastrointestinal (digestive) system anatomy; shows esophagus, liver, stomach, colon, small intestine, rectum, and anus.Gastrointestinal (digestive) system anatomy; shows esophagus, liver, stomach, colon, small intestine, rectum, and anus.

See the following PDQ summaries for more information about rectal cancer:

  • Gastrointestinal Stromal Tumors Treatment
  • Colorectal Cancer Prevention
  • Colorectal Cancer Screening
  • Genetics of Colorectal Cancer
  • Unusual Cancers of Childhood

Age and family history can affect the risk of rectal cancer.

Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. Talk with your doctor if you think you may be at risk. The following are possible risk factors for rectal cancer:

Signs of rectal cancer include a change in bowel habits or blood in the stool.

These and other signs and symptoms may be caused by rectal cancer or by other conditions. Check with your doctor if you have any of the following:

  • A change in bowel habits.
    • Diarrhea.
    • Constipation.
    • Feeling that the bowel does not empty completely.
    • Stools that are narrower or have a different shape than usual.
  • Blood (either bright red or very dark) in the stool.
  • General abdominal discomfort (frequent gas pains, bloating, fullness, or cramps).
  • Change in appetite.
  • Weight loss for no known reason.
  • Feeling very tired.

Tests that examine the rectum and colon are used to detect (find) and diagnose rectal cancer.

Tests used to diagnose rectal cancer include the following:

  • Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
  • Digital rectal exam (DRE): An exam of the rectum. The doctor or nurse inserts a lubricated, gloved finger into the lower part of the rectum to feel for lumps or anything else that seems unusual. In women, the vagina may also be examined.
  • Colonoscopy: A procedure to look inside the rectum and colon for polyps (small pieces of bulging tissue), abnormal areas, or cancer. A colonoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove polyps or tissue samples, which are checked under a microscope for signs of cancer.

    Colonoscopy; shows colonoscope inserted through the anus and rectum and into the colon.  Inset shows patient on table having a colonoscopy.Colonoscopy; shows colonoscope inserted through the anus and rectum and into the colon. Inset shows patient on table having a colonoscopy.

  • Biopsy: The removal of cells or tissues so they can be viewed under a microscope to check for signs of cancer. Tumor tissue that is removed during the biopsy may be checked to see if the patient is likely to have the genemutation that causes HNPCC. This may help to plan treatment. The following tests may be used:
  • Carcinoembryonic antigen (CEA) assay: A test that measures the level of CEA in the blood. CEA is released into the bloodstream from both cancer cells and normal cells. When found in higher than normal amounts, it can be a sign of rectal cancer or other conditions

Certain factors affect prognosis (chance of recovery) and treatment options.

The prognosis (chance of recovery) and treatment options depend on the following:

  • The stage of the cancer (whether it affects the inner lining of the rectum only, involves the whole rectum, or has spread to lymph nodes, nearby organs, or other places in the body).
  • Whether the tumor has spread into or through the bowel wall.
  • Where the cancer is found in the rectum.
  • Whether the bowel is blocked or has a hole in it.
  • Whether all of the tumor can be removed by surgery.
  • The patient’s general health.
  • Whether the cancer has just been diagnosed or has recurred (come back).
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Stages of Rectal Cancer

Key Points:

After rectal cancer has been diagnosed, tests are done to find out if cancer cells have spread within the rectum or to other parts of the body.

The process used to find out whether cancer has spread within the rectum or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following tests and procedures may be used in the staging process:

  • Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
  • CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, such as the abdomen, pelvis, or chest, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
  • MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
  • PET scan (positron emission tomography scan): A procedure to find malignanttumorcells in the body. A small amount of radioactiveglucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
  • Endorectal ultrasound: A procedure used to examine the rectum and nearby organs. An ultrasound transducer (probe) is inserted into the rectum and used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. The doctor can identify tumors by looking at the sonogram. This procedure is also called transrectal ultrasound.

There are three ways that cancer spreads in the body.

Cancer can spread through tissue, the lymph system, and the blood:

  • Tissue. The cancer spreads from where it began by growing into nearby areas.
  • Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
  • Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.

Cancer may spread from where it began to other parts of the body.

When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood.

  • Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body.
  • Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.

The metastatic tumor is the same type of cancer as the primary tumor. For example, if rectal cancer spreads to the lung, the cancer cells in the lung are actually rectal cancer cells. The disease is metastatic rectal cancer, not lung cancer.

The following stages are used for rectal cancer:

Stage 0 (Carcinoma in Situ)

Stage 0 colon/rectal carcinoma in situ; shows a cross-section of the colon/rectum. An inset shows the layers of the colon/rectum wall with abnormal cells in the mucosa layer. Also shown are the submucosa, muscle layers, serosa, a blood vessel, and lymph nodes.Stage 0 colon/rectal carcinoma in situ; shows a cross-section of the colon/rectum. An inset shows the layers of the colon/rectum wall with abnormal cells in the mucosa layer. Also shown are the submucosa, muscle layers, serosa, a blood vessel, and lymph nodes.

In stage 0, abnormalcells are found in the mucosa (innermost layer) of the rectum wall. These abnormal cells may become cancer and spread. Stage 0 is also called carcinoma in situ.

Stage I

Stage I colorectal cancer; shows a cross-section of the colon/rectum. An inset shows the layers of the colon/rectum wall with cancer in the mucosa, submucosa, and muscle layers. Also shown are the serosa, a blood vessel, and lymph nodes.Stage I colorectal cancer; shows a cross-section of the colon/rectum. An inset shows the layers of the colon/rectum wall with cancer in the mucosa, submucosa, and muscle layers. Also shown are the serosa, a blood vessel, and lymph nodes.

In stage I, cancer has formed in the mucosa (innermost layer) of the rectum wall and has spread to the submucosa (layer of tissue under the mucosa). Cancer may have spread to the muscle layer of the rectum wall.

Stage II

Stage II colorectal cancer; shows a cross-section of the colon/rectum and a three-panel inset. Each panel shows the layers of the colon/rectum wall: mucosa, submucosa, muscle layers, and serosa. Also shown are a blood vessel and lymph nodes. First panel shows stage IIA with cancer in the mucosa, submucosa, muscle layers, and serosa. Second panel shows stage IIB with cancer in all layers and spreading through the serosa. Third panel shows stage IIC with cancer spreading to nearby organs.Stage II colorectal cancer; shows a cross-section of the colon/rectum and a three-panel inset. Each panel shows the layers of the colon/rectum wall: mucosa, submucosa, muscle layers, and serosa. Also shown are a blood vessel and lymph nodes. First panel shows stage IIA with cancer in the mucosa, submucosa, muscle layers, and serosa. Second panel shows stage IIB with cancer in all layers and spreading through the serosa. Third panel shows stage IIC with cancer spreading to nearby organs.

Stage II rectal cancer is divided into stage IIA, stage IIB, and stage IIC.

  • Stage IIA: Cancer has spread through the muscle layer of the rectum wall to the serosa (outermost layer) of the rectum wall.
  • Stage IIB: Cancer has spread through the serosa (outermost layer) of the rectum wall but has not spread to nearby organs.
  • Stage IIC: Cancer has spread through the serosa (outermost layer) of the rectum wall to nearby organs.

Stage III

Stage III rectal cancer is divided into stage IIIA, stage IIIB, and stage IIIC.

Stage IIIA colorectal cancer; shows a cross-section of the colon/rectum and a two-panel inset. Each panel shows the layers of the colon/rectum wall: mucosa, submucosa, muscle layers, and serosa. Also shown are a blood vessel and lymph nodes. First panel shows cancer in the mucosa, submucosa, muscle layers, and 2 lymph nodes. Second panel  shows cancer in the mucosa, submucosa, and 5 lymph nodes.Stage IIIA colorectal cancer; shows a cross-section of the colon/rectum and a two-panel inset. Each panel shows the layers of the colon/rectum wall: mucosa, submucosa, muscle layers, and serosa. Also shown are a blood vessel and lymph nodes. First panel shows cancer in the mucosa, submucosa, muscle layers, and 2 lymph nodes. Second panel shows cancer in the mucosa, submucosa, and 5 lymph nodes.

In stage IIIA:

  • Cancer may have spread through the mucosa (innermost layer) of the rectum wall to the submucosa (layer of tissue under the mucosa) and may have spread to the muscle layer of the rectum wall. Cancer has spread to at least one but not more than 3 nearby lymph nodes or cancer cells have formed in tissues near the lymph nodes; or
  • Cancer has spread through the mucosa (innermost layer) of the rectum wall to the submucosa (layer of tissue under the mucosa). Cancer has spread to at least 4 but not more than 6 nearby lymph nodes.

Stage IIIB colorectal cancer; shows a cross-section of the colon/rectum and a two-panel inset. Each panel shows the layers of the colon/rectum wall: mucosa, submucosa, muscle layers, and serosa. Also shown are a blood vessel and lymph nodes. First panel shows cancer in all layers, spreading through the serosa, and in 3 lymph nodes. Second panel shows cancer in all layers and in 5 lymph nodes. Third panel shows cancer in the mucosa, submucosa, muscle layers, and 7 lymph nodes.Stage IIIB colorectal cancer; shows a cross-section of the colon/rectum and a two-panel inset. Each panel shows the layers of the colon/rectum wall: mucosa, submucosa, muscle layers, and serosa. Also shown are a blood vessel and lymph nodes. First panel shows cancer in all layers, spreading through the serosa, and in 3 lymph nodes. Second panel shows cancer in all layers and in 5 lymph nodes. Third panel shows cancer in the mucosa, submucosa, muscle layers, and 7 lymph nodes.

In stage IIIB:

  • Cancer has spread through the muscle layer of the rectum wall to the serosa (outermost layer) of the rectum wall or has spread through the serosa but not to nearby organs. Cancer has spread to at least one but not more than 3 nearby lymph nodes or cancer cells have formed in tissues near the lymph nodes; or
  • Cancer has spread to the muscle layer of the rectum wall or to the serosa (outermost layer) of the rectum wall. Cancer has spread to at least 4 but not more than 6 nearby lymph nodes; or
  • Cancer has spread through the mucosa (innermost layer) of the rectum wall to the submucosa (layer of tissue under the mucosa) and may have spread to the muscle layer of the rectum wall. Cancer has spread to 7 or more nearby lymph nodes.

Stage IIIC colorectal cancer; shows a cross-section of the colon/rectum wall and a three-panel inset. Each panel shows the layers of the colon/rectum wall: mucosa, submucosa, muscle layers, and serosa. Also shown are a blood vessel and lymph nodes. First panel shows cancer in all layers, spreading through the serosa, and in 4 lymph nodes. Second panel shows cancer in all layers and in 7 lymph nodes. Third panel shows cancer in all layers, spreading through the serosa, in 2 lymph nodes, and spreading to nearby organs.Stage IIIC colorectal cancer; shows a cross-section of the colon/rectum wall and a three-panel inset. Each panel shows the layers of the colon/rectum wall: mucosa, submucosa, muscle layers, and serosa. Also shown are a blood vessel and lymph nodes. First panel shows cancer in all layers, spreading through the serosa, and in 4 lymph nodes. Second panel shows cancer in all layers and in 7 lymph nodes. Third panel shows cancer in all layers, spreading through the serosa, in 2 lymph nodes, and spreading to nearby organs.

In stage IIIC:

  • Cancer has spread through the serosa (outermost layer) of the rectum wall but has not spread to nearby organs. Cancer has spread to at least 4 but not more than 6 nearby lymph nodes; or
  • Cancer has spread through the muscle layer of the rectum wall to the serosa (outermost layer) of the rectum wall or has spread through the serosa but has not spread to nearby organs. Cancer has spread to 7 or more nearby lymph nodes; or
  • Cancer has spread through the serosa (outermost layer) of the rectum wall and has spread to nearby organs. Cancer has spread to one or more nearby lymph nodes or cancer cells have formed in tissues near the lymph nodes.

Stage IV

Stage IV rectal cancer is divided into stage IVA and stage IVB.

Stage IV rectal cancer; drawing shows other parts of the body where rectal cancer may spread, including lymph nodes, lung, liver, abdominal wall, and ovary. Inset shows cancer spreading through the blood and lymph nodes to other parts of the body.Stage IV rectal cancer; drawing shows other parts of the body where rectal cancer may spread, including lymph nodes, lung, liver, abdominal wall, and ovary. Inset shows cancer spreading through the blood and lymph nodes to other parts of the body.

  • Stage IVA: Cancer may have spread through the rectum wall and may have spread to nearby organs or lymph nodes. Cancer has spread to one organ that is not near the rectum, such as the liver, lung, or ovary, or to a distant lymph node.
  • Stage IVB: Cancer may have spread through the rectum wall and may have spread to nearby organs or lymph nodes. Cancer has spread to more than one organ that is not near the rectum or into the lining of the abdominal wall.
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Recurrent Rectal Cancer

    Recurrentrectal cancer is cancer that has recurred (come back) after it has been treated. The cancer may come back in the rectum or in other parts of the body, such as the colon, pelvis, liver, or lungs.

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    Treatment Option Overview

    Key Points:

    There are different types of treatment for patients with rectal cancer.

    Different types of treatment are available for patients with rectal cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

    Four types of standard treatment are used:

    Surgery

    Surgery is the most common treatment for all stages of rectal cancer. The cancer is removed using one of the following types of surgery:

    After the cancer is removed, the surgeon will either:

    • do an anastomosis (sew the healthy parts of the rectum together, sew the remaining rectum to the colon, or sew the colon to the anus);

      Three-panel drawing showing rectal cancer surgery with anastomosis; first panel shows area of rectum with cancer, middle panel shows cancer and nearby tissue removed, last panel shows the colon and anus joined.Three-panel drawing showing rectal cancer surgery with anastomosis; first panel shows area of rectum with cancer, middle panel shows cancer and nearby tissue removed, last panel shows the colon and anus joined.

      or
    • make a stoma (an opening) from the rectum to the outside of the body for waste to pass through. This procedure is done if the cancer is too close to the anus and is called a colostomy. A bag is placed around the stoma to collect the waste. Sometimes the colostomy is needed only until the rectum has healed, and then it can be reversed. If the entire rectum is removed, however, the colostomy may be permanent.

    Radiation therapy or chemotherapy may be given before surgery to shrink the tumor, make it easier to remove the cancer, and lessen problems with bowel control after surgery. Treatment given before surgery is called neoadjuvant therapy. Even if all the cancer that can be seen at the time of the operation is removed, some patients may be given radiation therapy or chemotherapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy.

    Radiation therapy

    Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.

    Chemotherapy

    Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly in the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy).

    Chemoembolization of the hepatic artery is a type of regional chemotherapy that may be used to treat cancer that has spread to the liver. This is done by blocking the hepatic artery (the main artery that supplies blood to the liver) and injecting anticancer drugs between the blockage and the liver. The liver’s arteries then carry the drugs into the liver. Only a small amount of the drug reaches other parts of the body. The blockage may be temporary or permanent, depending on what is used to block the artery. The liver continues to receive some blood from the hepatic portal vein, which carries blood from the stomach and intestine.

    The way the chemotherapy is given depends on the type and stage of the cancer being treated.

    See Drugs Approved for Rectal Cancer for more information.

    Targeted therapy

    Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. Monoclonal antibodytherapy is a type of targeted therapy being used for the treatment of rectal cancer.

    Monoclonal antibody therapy uses antibodies made in the laboratory from a single type of immune system cell. These antibodies can identify substances on cancer cells or normal substances that may help cancer cells grow. The antibodies attach to the substances and kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by infusion. They may be used alone or to carry drugs, toxins, or radioactive material directly to cancer cells.

    See Drugs Approved for Rectal Cancer for more information.

    Other types of treatment are being tested in clinical trials.

    Information about clinical trials is available from the NCI Web site.

    Patients may want to think about taking part in a clinical trial.

    For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.

    Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.

    Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.

    Patients can enter clinical trials before, during, or after starting their cancer treatment.

    Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.

    Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's listing of clinical trials.

    Follow-up tests may be needed.

    Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. This is sometimes called re-staging.

    Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.

    After treatment for rectal cancer, a blood test to measure amounts of carcinoembryonic antigen (a substance in the blood that may be increased when cancer is present) may be done to see if the cancer has come back.

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    Treatment Options by Stage

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      Stage 0 (Carcinoma in Situ)

        Treatment of stage 0 may include the following:

        Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage 0 rectal cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI Web site.

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        Stage I Rectal Cancer

          Treatment of stage I rectal cancer may include the following:

          Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage I rectal cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI Web site.

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          Stage II Rectal Cancer

            Treatment of stage II rectal cancer may include the following:

            Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage II rectal cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI Web site.

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            Stage III Rectal Cancer

              Treatment of stage III rectal cancer may include the following:

              Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage III rectal cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI Web site.

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              Stage IV and Recurrent Rectal Cancer

                Treatment of stage IV and recurrentrectal cancer may include the following:

                Treatment of rectal cancer that has spread to other organs depends on which organ the cancer has spread to.

                • Treatment for areas of cancer that have spread to the liver includes the following:
                • Treatment for areas of cancer that has spread to the lung or ovaries is surgery.

                Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage IV rectal cancer and recurrent rectal cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI Web site.

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                To Learn More About Rectal Cancer

                  For more information from the National Cancer Institute about rectal cancer, see the following:

                  For general cancer information and other resources from the National Cancer Institute, see the following:

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                  Changes to This Summary (10/24/2013)

                    The PDQcancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.

                    Editorial changes were made to this summary.

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                    About This PDQ Summary

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                      Purpose of This Summary

                        This PDQ cancer information summary has current information about the treatment of rectal cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.

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                        Reviewers and Updates

                          Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change.

                          The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Adult Treatment Editorial Board.

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                          Clinical Trial Information

                            A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

                            Clinical trials are listed in PDQ and can be found online at NCI's Web site. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237).

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                              The best way to cite this PDQ summary is:

                              National Cancer Institute: PDQ® Rectal Cancer Treatment. Bethesda, MD: National Cancer Institute. Date last modified <MM/DD/YYYY>. Available at: http://cancer.gov/cancertopics/pdq/treatment/rectal/Patient. Accessed <MM/DD/YYYY>.

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