Does rectal cancer require chemotherapy?

Written by Gong Chun
Oncology
Updated on March 07, 2025
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The question of whether chemotherapy is necessary for rectal cancer needs to be analyzed specifically, taking into account factors such as the patient's physical condition, pathological staging, and whether the surgery was completely successful. Chemotherapy for colorectal cancer can be divided into adjuvant chemotherapy and palliative chemotherapy for advanced colorectal cancer, and it can also serve to enhance the effects of radiotherapy. For low rectal cancer, neoadjuvant chemoradiotherapy can be administered if the tumor cannot be directly removed, followed by surgery after the treatment. If surgery is possible for rectal cancer, and there is lymph node metastasis or the pathological stage is relatively advanced, postoperative adjuvant chemotherapy can be performed. Therefore, the need for chemotherapy in cases of rectal cancer should ideally be assessed at a specialized oncology department in a hospital to provide a detailed analysis and evaluation by oncologists.

Other Voices

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Written by Liu Liang
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What tests are used to check for rectal cancer?

When clinical symptoms such as diarrhea or constipation, changes in bowel habits, bloody stools, and abdominal pain occur, we should be vigilant about the possibility of rectal cancer. The examination for rectal cancer can start with a digital rectal exam, especially for low-lying rectal cancer, which is closer to the anus; these tumors can be detected through this method. Then, a colonoscopy should be performed to take a biopsy to confirm the diagnosis, which is the gold standard for confirmation. Additionally, blood tests for tumor markers can be conducted. Generally, carcinoembryonic antigen (CEA) and CA199 levels may be elevated, but this is not absolute as their specificity and sensitivity are not very high. An enhanced CT scan of the abdomen can also be done. In such scans, we can see thickening of the intestinal wall where the tumor is located, and the enhancement can show the intensified thickening of the intestinal wall. Combining all these methods can confirm the diagnosis of rectal cancer.

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Written by Yu Xu Chao
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Is chemotherapy effective for late-stage rectal cancer?

Late-stage rectal cancer is primarily due to the metastasis and proliferation of cancer cells. At this stage, surgery alone cannot completely eliminate cancer cells, so chemotherapy is necessary. Chemotherapy has certain effects clinically, especially in patients who are sensitive to chemotherapy drugs, where the effects are more pronounced. This can control the spread of cancer cells in multiple locations and can, to some extent, improve patient survival rates. For patients, it is important to maintain good health, enhance their immune system, consume foods rich in high-quality proteins, and engage in appropriate exercise. Moreover, maintaining a positive mindset is beneficial for extending life. Additionally, patients can integrate traditional Chinese medicine and acupuncture as complementary therapies, which can also potentially improve postoperative survival rates.

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Written by Si Li Li
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Is rectal bleeding an indication of rectal cancer?

Rectal bleeding is not necessarily colorectal cancer; there are several reasons for rectal bleeding: First, caused by constipation, which leads to difficulty during bowel movements and tearing of the anal mucosa, resulting in bleeding. Second, ulcerative colitis, which commonly presents symptoms such as abdominal pain, diarrhea, and blood and mucus in the stool. Third, rectal or colon cancer, where the main symptoms also include abdominal pain, changes in stool characteristics, and rectal bleeding. Fourth, ischemic bowel disease, generally seen in older patients with some cardiovascular and ischemic diseases, where symptoms mainly include significant abdominal pain and rectal bleeding. Therefore, not all cases of rectal bleeding are due to rectal cancer; there are many causes, and it is essential to diagnose clearly before treatment.

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Which is more serious, anal canal cancer or rectal cancer?

Rectal cancer and anal canal cancer both belong to the category of malignant tumors of the digestive system, with anal canal cancer generally considered a type of rectal cancer, primarily occurring at the anal canal close to the anus. Comparatively, anal canal cancer is somewhat more serious than rectal cancer. Clinically, the closer the tumor is to the anus, the potentially higher the malignancy, meaning more severe. However, subsequent treatment outcomes also need to be considered. Both anal canal cancer and rectal cancer can be considered for curative surgery. If the cancer is very close to the anus and an anus-preserving surgery is not feasible, further colostomy surgery may be required.

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Is rectal cancer hereditary?

This answer is also possible, as one of the causes of any cancer includes the possibility of genetics. However, this possibility is generally small and not everyone is likely to have it. It also depends on the incidence of disease within the entire family. If one is in a high-risk category due to certain genetic factors, then it is crucial to have regular and thorough follow-up checks. Some people might even try treatments specifically targeting genetically inherited colorectal cancer.