Dr. VanderWalde on Utility of Radiation Therapy in Rectal Cancer

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Noam VanderWalde, MD, MS, discusses radiation therapy in early-stage versus later-stage rectal cancer.

Noam VanderWalde, MD, MS, an associate professor of radiation oncology at West Cancer Center and Research Institute, discusses radiation therapy in early-stage versus later-stage rectal cancer.

In patients with earlier-stage disease, for example, those with node-negative disease, the use of preoperative radiation therapy is dependent on the tumor location, says VanderWalde. In a patient who has high-grade rectal cancer, such as T2 or T3, it may be preferred to avoid radiation, added VanderWalde. Data from several studies have demonstrated that patients with high T3 disease have a very low risk of locoregional recurrence. 

That being said, a low-lying rectal cancer may require abdominoperineal resection (APR) if the patient did not receive any downstaging, says VanderWalde. In those patients, radiation may be used even though they have a lower-stage cancer. The goal of this is to provide patients with nonoperative management of their disease or to go from an APR to a low anterior resection, concludes VanderWalde.

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