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Treatment of Stage IV and Recurrent Rectal Cancer

For information about the treatments listed below, see the Treatment Option Overview section.

Treatment of stage IV and recurrent rectal cancer may include the following:

  • Surgery with or without chemotherapy or radiation therapy.
  • Systemic chemotherapy with or without targeted therapy (angiogenesis inhibitor).
  • Systemic chemotherapy with or without immunotherapy (immune checkpoint inhibitor therapy).
  • Chemotherapy to control the growth of the tumor.
  • Radiation therapy, chemotherapy, or a combination of both, as palliative therapy to relieve symptoms and improve the quality of life.
  • Placement of a stent to help keep the rectum open if it is partly blocked by the tumor, as palliative therapy to relieve symptoms and improve the quality of life.
  • Targeted therapy with a protein kinase inhibitor and a monoclonal antibody in patients with a certain change in the BRAF gene.
  • Immunotherapy.
  • Clinical trials of chemotherapy and/or targeted therapy.

Treatment of rectal cancer that has spread to other organs depends on where the cancer has spread.

  • Treatment for areas of cancer that have spread to the liver includes the following:
    • Surgery to remove the tumor. Chemotherapy may be given before surgery, to shrink the tumor.
    • Cryosurgery or radiofrequency ablation.
    • Chemoembolization and/or systemic chemotherapy.
    • A clinical trial of chemoembolization combined with radiation therapy to the tumors in the liver.

Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

This information is not intended to replace the advice of a doctor. Navigating Care disclaims any liability for the decisions you make based on this information. This information was sourced and adapted from Adapted from the National Cancer Institute's Physician Data Query (PDQ®) Cancer Information Summaries on www.cancer.gov.

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The Navigating Care Library includes articles about cancer, chemotherapy regimens and drugs from the the National Cancer Institute and other experts.