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NCCN Guidelines for Patients



Rectal Cancer, Version 1.2017


Overview of cancer treatments


when talking about a cancer treatment for the whole


Chemotherapy received by HAI (






nfusion) differs. It is given through a port or pump

within your artery supplying blood to your liver. If a

pump is used, it is placed within the artery during

surgery. HAI may be a treatment option for rectal

cancer in the liver. NCCN experts advise that HAI

should only be done at treatment centers with much

experience in this method.

Chemotherapy is given in cycles of treatment days

followed by days of rest. The cycles vary in length

depending on which drugs are used. Common

cycles are 14 or 21 days long. Giving chemotherapy

in cycles gives your body a chance to recover

after receiving chemotherapy. If you will have

chemotherapy, ask your doctor how many cycles will

be given. Also ask how many days of treatment there

are within a cycle.

Side effects

Side effects differ among people. Some people have

many side effects. Other people have few. Some

side effects can be very serious. Others can be

unpleasant but not serious. Most side effects appear

shortly after treatment starts and will stop after

treatment. However, other side effects are long-term

or may appear years later.

Side effects of chemotherapy depend on multiple

factors. These factors include the drug type,

amount taken, length of treatment, and the person.

In general, side effects are caused by the death

of fast-growing cells. These cells are found in the

hair follicles, gut, mouth, and blood. Thus, common

side effects of chemotherapy include low blood

cell counts, not feeling hungry, nausea, vomiting,

diarrhea, hair loss, and mouth sores.

Oxaliplatin causes a very unique side effect. It can

cause a short-lived and sometimes painful sensitivity

in areas exposed to cold. Examples of these areas

are your mouth when drinking cold liquids and

your fingers when holding a cold object. If more

oxaliplatin is used over time, loss of sensation and

tingling in fingers and toes can occur. It can take

months or years for these symptoms to resolve. After

long-term treatment, you may have a permanent

loss of sensation in your feet or fingers (sensory


Not all side effects of chemotherapy 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. There are also ways to prevent

some side effects.

Supportive care

Supportive care doesn’t aim to treat cancer

but aims to improve quality of life. It is

also called palliative care. It can address

many needs. One example is treatment for

physical and emotional symptoms.

Supportive care can also help with treatment

decisions as you may have more than one

option. It can also help with coordination of

care between health providers. Talk with your

treatment team to plan the best supportive

care for you.