Cancer is complex — there is no routine rectal cancer, nor is there a routine way to treat it.

The OSUCCC – James physicians are nationally and internationally renowned in research and patient care for their one particular cancer. Because of that expertise and understanding of cancer’s complexities and how it acts and reacts differently in each person, the very best outcomes — and the most effective means of treating cancer patients — come from a team approach.

At the OSUCCC – James, rectal cancer patients have a team of experts that includes medical oncologists, surgical oncologists, radiation oncologists, geneticists, gastroenterologists, nutritionists and more. Also on that team are rectal cancer researchers who help sequence tumors to identify key molecules that fuel each patient’s cancer and who then develop drugs that target only those particular molecules. Many of our experts also help write the national clinical guidelines for treatments.

As one of only a few cancer centers in the country funded by the National Cancer Institute to conduct both phase I and phase II clinical trials, the OSUCCC – James offers patients access to more clinical trials than nearly any other cancer hospital in the country and to more of the latest, most targeted, most effective treatment options — many that are available nowhere else but at the OSUCCC – James.

There are several types of treatment for rectal cancer. The OSUCCC – James team of subspecialists determine the best treatment for each patient based on his or her specific, individual rectal cancer. Patients may receive one treatment or a combination of treatments.

Treatment Options

The following treatments are available for rectal cancer:


Most stages of rectal cancer involve removal of the rectal cancer by a specially trained surgeon. Many of the surgeries for rectal cancer at OSUCCC – James are performed using laparoscopic and robotic methods. These advanced techniques are less invasive, or use smaller incisions, and lead to faster recoveries for patients.

Using advanced surgery methods means we can treat rectal cancer more aggressively in patients of all ages.

Surgery may be one of several types. They include:

Local Excision

Rectal cancers found early can be removed through the rectum using a tube with a special cutting tool at the end of the tube, often during a colonoscopy. This also is called a polypectomy. A surgeon also might remove some of the tissue around the tumor if it is only on the surface of the rectum.


Rectal cancer that has spread into the rectum wall must be removed by making an incision in the patient’s abdomen. The surgeon also removes nearby lymph nodes, a portion of tissue around the cancer and sometimes a small amount of tissue from the wall of the abdomen to make sure no cancer cells remain. The surgeon will reattach the areas of the rectum and colon by sewing areas of the intestine together, if possible.

Pelvic Exenteration

When rectal cancer has spread to organs near the rectum, the surgeon must remove the lower colon tissue, rectum and the bladder. Depending on where the cancer has spread, the surgeon may have to remove a woman’s ovaries, cervix and vagina, or a man’s prostate. Any lymph nodes near the cancer also are removed. The surgeon creates stroma for urine and stool.

Following rectal cancer removal, the surgeon will perform one of two additional procedures:

  • An anastomosis, to either sew the healthy parts of the rectum together, or sew the remaining rectum to the colon or sew the colon to the anus
  • A colostomy, to make 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

Radiation Therapy

Patients who have rectal cancer surgery may receive radiation therapy following their surgery. Radiation therapy uses high-energy X-rays or other types of radiation to destroy cancer cells. Most patients with rectal cancer receive radiation, from a machine outside their bodies, that is targeted directly at the rectal cancer cells.

Ablation Therapies

With radiofrequency ablation, a physician inserts a probe using imaging to guide the probe to the rectal cancer. The probe has high-energy electrodes that destroy cancer cells. With cryosurgery, a tiny instrument destroys the cancer cells by freezing them with liquid nitrogen or liquid carbon dioxide.


A patient who has surgery may have chemotherapy following surgery to make sure that any remaining rectal cancer cells are destroyed. Chemotherapy uses drugs to stop the growth of cancer cells, either by destroying the cells or by stopping the cells from dividing.


Embolization is a technique used to destroy cancer growth by stopping the blood supply to the tumor or by targeting chemotherapy drugs using the vessels that supply tumors. The physician guides a thin tube called a catheter through the artery near the cancer and injects a special material into the vessel. Chemoembolization of the hepatic artery may be used to treat rectal cancer that has spread to the liver.

Targeted Therapy

Targeted therapies are drugs that attack cancer cells without destroying healthy surrounding cells. Targeted therapies for rectal cancer include monoclonal antibodies, which identify and block certain substances on cells that support cancer cell growth.

Gastrointestinal biomarker

Rectal Cancer & Clinical Trials

For cancer patients, clinical trials mean hope. Hope for a cancer-free world and for better, more targeted ways to prevent, detect, treat and cure individual cancers. Patients can enter clinical trials before, during or after starting their cancer treatment.

The OSUCCC – James has more than 500 open clinical trials at any given time, with some of the world’s latest discoveries available to clinical trial patients right here in Columbus, Ohio. In fact, patients have access to more cancer clinical trials here than at nearly any other hospital in the region as well as access to some of the most advanced, targeted treatments and drugs available.

The OSUCCC – James is one of only a few U.S. cancer centers funded by the National Cancer Institute (NCI) to conduct phase I and phase II clinical trials on novel anticancer drugs. These trials go only to centers that demonstrate an exemplary capacity for research and clinical care, the expertise to deliver the latest in treatments and the infrastructure to interpret and track treatment results.

Additionally, Ohio State has nearly 300 cancer researchers dedicated to understanding what makes each patient’s cancer grow, move, metastasize or reoccur. Because of the OSUCCC – James’ NCI phase I and phase II approvals, these experts can move research discoveries into clinical trials and make them available to patients sooner.

If you have received a rectal cancer diagnosis, or if you want a second opinion or just want to speak to a rectal cancer specialist, we are here to help you. Call 800-293-5066 or 614-293-5066 to make an appointment.

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The James Cancer Hospital and Solove Research Institute

460 West 10th Avenue

Columbus, Ohio 43210

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