Rectal cancer, often called colorectal cancer, is cancer involving the rectum, or the last several inches of the colon. Stage I rectal cancer involves the cancer spreading from the inner most layer of the rectal wall, or mucosa, to deeper tissue of the rectal wall. According to the American Cancer Society, stage 1 indicates that the cancer may also have spread to the muscle layer, but not outside of the rectal wall. Treatments for stage I rectal cancer include surgery, chemotherapy and/or radiotherapy.
Surgery
Surgery alone, without chemotherapy and radiation, is the main treatment for stage I rectal cancer. The type of surgery performed depends on the location of the cancer in the rectum. Low anterior resection is performed when the cancer is located in the upper portion of the rectum. The portion of the rectum containing the tumor will be removed, and the remaining rectum attached to the colon so that normal bowel functions can resume after surgery. Coloanal anastomosis is used when the tumor is located in the mid-rectum. This involves removing the entire rectum, connecting the colon directly to the anus. An abdominoperineal procedure may also be indicated, where the anus and surrounding tissues are completely removed. Because the anus is removed, a permanent colostomy is needed.
Chemotherapy
Chemotherapy utilizes drugs to kill cancer cells. According to the Mayo Clinic, chemotherapy can be used to destroy cancer cells after surgery, to control tumor growth or to relieve symptoms of rectal cancer. In stage I rectal cancer, chemotherapy is generally not necessary; however, if the cancer is found to be more advanced than the surgeon initially thought, chemotherapy is given. Chemotherapy is usually used along with radiation therapy.
Radiation Therapy
If a patient with stage I rectal cancer is deemed too sick to proceed with surgery, radiation therapy is used. Radiation therapy involves the use of high-energy radiation to shrink tumors and destroy cancer cells. Two types of radiation therapy used for stage I rectal cancer are endocavitary radiation and brachytherapy. Endocavitary radiation delivers external radiation via a machine which beams radiation through the anus to treat the cancer. Brachytherapy utilizes implants such as pellets, seeds, capsules, wires, or tubes which are placed inside the tumor or its surrounding region. According to the American Cancer Society, radiation therapy has not been proven to be as effective as surgery.
