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NCCN Guidelines for Patients



Rectal Cancer, Version 1.2017


Making treatment decisions

Deciding between options

Deciding between options

Deciding which option is best can be hard. Doctors

from different fields of medicine may have different

opinions on which option is best for you. This can be

very confusing. Your spouse or partner may disagree

with which option you want. This can be stressful.

In some cases, one option hasn’t been shown to

work better than another. Some ways to decide on

treatment are discussed next.




The time around deciding a treatment is very

stressful. People with cancer often want to get

treated as soon as possible. They want to make

their cancer go away before it spreads farther. While

cancer can’t be ignored, usually there is time to think

about and choose which option is best for you.

You may wish to have another doctor review your

test results and suggest a treatment plan. This is

called getting a 2


opinion. You may completely trust

your doctor, but a 2


opinion about which option is

best can help.

Copies of the pathology report, a DVD of the

imaging tests, and other test results need to be sent

to the doctor giving the 2


opinion. Some people

feel uneasy asking for copies from their doctors.

However, a 2


opinion is a normal part of cancer


When doctors have cancer, most will talk with more

than one doctor before choosing their treatment.

What’s more, some health plans require a 2


opinion. If your health plan doesn’t cover the cost

of a 2


opinion, you have the choice of paying for it


If the two opinions are the same, you may feel more

at peace about the treatment you accept to have.

If the two opinions differ, think about getting a 3


opinion. A 3


opinion may help you decide between

your options. Choosing your cancer treatment is a

very important decision. It can affect your length and

quality of life.

Support groups

Besides talking to health experts, it may help to talk

to other people who have walked in your shoes. At

support groups, you can ask questions and hear

about the experiences of other people with rectal

cancer. Find a support group at the websites listed

on page 79.

Compare benefits and downsides

Every option has benefits and downsides. Consider

these when deciding which option is best for you.

Talking to others can help identify benefits and

downsides you haven’t thought of. Scoring each

factor from 0 to 10 can also help since some factors

may be more important to you than others.

I was not ready for a permanent

ostomy and my second opinion

guaranteed me a reversal after

resection of my very low lying

rectal tumor. I will be forever

grateful that I took the time to get

a second opinion. Seek out those

that point the compass in the

direction that brings you peace and



Survivor, Stage III