Staging rectal cancer
Rectal cancer is staged both clinically before treatment and pathologically after surgery when a specimen of the tumor and near-by lymph nodes are available for examination by a pathologist.
Clinical staging is necessary to decide on initial treatment. Chemoradiation may result in downstaging the final pathological stage. Pathologic staging is important to decide on treatment after surgery.
Testing before beginning rectal cancer treatment includes:
- Flexible sigmoidoscopy or colonoscopy to identify tumor and obtain specimens for biopsy
- Colonoscopy, if not done previously, to remove polyps and identify other potential tumors
- Endorectal ultrasound (ERUS) where a probe is placed inside the rectum to use sound waves to provide a picture of the rectum, the tumor, its margins, and any potentially involved lymph nodes, or
- Pelvic MRI to obtain similar information
- Carcinoembryonic antigen (CEA) blood test
- CT scans of chest, abdomen, and pelvis to see if the cancer has spread to other places in the body.
Where Can You Go for More Information
NCI Stages of Rectal Cancer provides specific information and graphics on rectal cancer stages.
The American Society for Gastroenterological Oncology has patient information about Understanding EUS: Endoscopic Ultrasonography that provides information about endorectal ultrasound including preparing for it and what to expect during the procedure.
Last Update: January 9, 2009
Medical Review
Reviewed By: Joel Tepper, MD
Review Date: January 9, 2009
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