Which of the following treatments is used for rectal cancer but not for colon cancer?
A. Chemotherapy
B. Colonoscopy
C. Radiation
D. Surgical resection
Correct Answer: C. Radiation
A client with rectal cancer can expect to have radiation therapy in addition to chemotherapy and surgical resection of the tumor. Radiation therapy isn’t usually indicated in colon cancer. Neoadjuvant combined CRT is recommended for locally advanced resectable colon cancer (cT3-4N0-2M0). Adjuvant therapy is strongly suggested for all pathological T3 and/or N positive tumors.
Option A: Palliative systemic chemotherapy is offered to non-surgical candidates with unresectable locally advanced disease or high metastatic burden to improve quality of life and prolongs life expectancy. Rectal cancer has strong recommendations for neoadjuvant therapy for stage II (T3 or T4 node-negative) and III (node-positive), although the best regimen has not been established.
Option B: A colonoscopy is performed to diagnose the disease. The initial evaluation may involve barium enema or computed tomography (CT) colonography, but endoscopy is ultimately required for tissue biopsy. Flexible sigmoidoscopy is no replacement for a complete diagnostic colonoscopy; still, it is a screening modality that reduces CRC mortality.
Option D: Endoscopic resection (ER) is reserved for selected candidates with favorable-risk and early-stage (cT1N0M0) found in a completely excised rectal polyp. Upfront Rca surgical resection is appropriate for lesions that do not invade the muscularis propria and negative lymphatic nodes (cT2N0M0) on appropriate surgical candidates.
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