NCCN Guidelines for Patients
Rectal Cancer, Version 1.2017
Overview of cancer treatments
Side effects are unplanned physical or emotional
reactions to treatment. Surgery causes pain,
swelling, and scars. Pain and swelling often fade
away in the weeks following surgery. Scars from
surgery don’t fully fade away.
As with any surgery, there is a chance of
complications. These include major blood loss,
infection, heart attack, and blood clots. There can
also be injury to nearby organs. Your surgical team
will design care to prevent these risks.
Rectal surgery may cause certain side effects.
Your urine stream may be delayed during healing.
If nerves or other structures are cut, bladder and
sexual functioning may be impaired. Scar tissue may
block stool from passing through. Food may leak out
where the bowel was connected.
Not all side effects of surgery are listed here. Please
ask your treatment team for a complete list of
common and rare side effects. If a side effect bothers
you, tell your treatment team. There may be ways to
help you feel better.
Radiation therapy most often uses high-energy
x-rays to treat rectal cancer. The x-rays damage DNA
in cancer cells. This either kills the cancer cells or
stops new cancer cells from being made.
Radiation therapy is most often used to treat the
primary rectal site. It is often given to the tumor
before surgery. If done after surgery, it is given to the
tumor bed and nearby lymph nodes.
The internal iliac, perirectal, and presacral nodes
should also be treated.
See Figure 10
. For some
T4 tumors, the external iliac nodes should also be
A radiation oncologist will oversee your radiation
treatment. A radiation oncologist is a doctor who’s an
expert in treating cancer with radiation. He or she will
tailor treatment to you.
Radiation therapy is most often
used to treat the primary rectal
site. It is often given to the tumor
before surgery. If done after
surgery, it is given to the tumor
bed and nearby lymph nodes.
internal iliac nodes
external iliac nodes
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