Rectal Cancer Treatment Options in Glendale, CA

When faced with a rectal cancer diagnosis, understanding your rectal cancer treatment options is one of the most important steps toward making confident decisions about your health.

In Glendale, CA, patients often have access to a wide range of evidence-based treatments, including surgery, radiation, chemotherapy, targeted therapy, and immunotherapy, that can be tailored to their specific cancer stage and personal needs.

Because treatment strategies continue to evolve with advances like total neoadjuvant therapy and immune-based regimens, knowing what’s available and how these approaches differ is critical.

This guide breaks down the options, highlights emerging therapies, and explains how patients and their care teams can choose the right pathway for the best possible outcome.

Common Challenges in Choosing Rectal Cancer Treatment Options

Navigating rectal cancer treatment can feel overwhelming because the right approach often depends on details like tumor stage, genetic factors, and overall health.

Many patients struggle to distinguish between standard protocols and newer, evolving options, while providers may vary in how they present these choices.

Minimally invasive surgeries, organ-preserving strategies, and innovative therapies such as immunotherapy or total neoadjuvant therapy are sometimes overlooked or misunderstood. On top of this, the complexity of long-term surveillance after treatment often goes underemphasized, leaving patients uncertain about what to expect once active therapy ends.

• Treatment varies significantly depending on the cancer stage, making the pathway complex.
• Minimally invasive surgical options like local excision or transanal approaches may be overlooked (e.g., for early-stage disease).
• Emerging strategies, such as total neoadjuvant therapy (TNT) or nonoperative management, are not yet widely understood
  Memorial Sloan Kettering Cancer Center.
• Immunotherapy breakthroughs like dostarlimab for mismatch repair-deficient (dMMR) tumors are promising but not broadly implemented.
• Post-treatment surveillance protocols are often neglected despite being vital for early detection of recurrence.

In this article, you’ll learn how to avoid these pitfalls and make informed choices.

Why Rectal Cancer Treatment Options Matter (and What to Do)

Different interventions serve distinct roles depending on tumor stage and patient factors:

• Surgery remains the foundational approach, especially for tumors amenable to resection. Techniques vary: local excision for select T1 tumors, transanal microsurgery, total mesorectal excision (TME), or abdominoperineal resection (APR) for low-lying tumors. Many patients begin by consulting a proctologist or colorectal specialist, who can evaluate whether minimally invasive surgery, local excision, or advanced procedures like total mesorectal excision (TME) are most appropriate.
  • TME is the gold-standard surgery that removes the rectum and mesorectum, preserving sphincter and lowering recurrence.
  • APR, though necessary in some cases, results in a permanent colostomy and is generally avoided when possible.
• Radiation Therapy, frequently combined with chemotherapy (chemoradiation), is applied before surgery (to shrink tumors) or after surgery (to reduce recurrence risk).
• Chemotherapy, systemic or coupled with radiation, is used to destroy cancer cells throughout the body and improve surgical outcomes.
• Targeted Therapy & Immunotherapy: For advanced disease or specific mutations, drugs targeting VEGF (e.g., bevacizumab) or EGFR, and immunotherapies (e.g., pembrolizumab, nivolumab, dostarlimab) may be utilized.
• Advanced Strategies:
  • Total Neoadjuvant Therapy (TNT): chemotherapy and radiation before surgery improve tumor response and allow organ preservation in some cases.
  • Nonoperative (“Watch-and-Wait”) Management: In cases of complete response, surgery may be deferred in favor of close surveillance.
  • Intraoperative Radiation Therapy (IORT): delivers a concentrated radiation dose during surgery, beneficial for locally advanced or recurrent tumors.
• Surveillance After Treatment: Stage II and III patients require long-term follow-up, including history, physical exams, CEA blood tests, colonoscopies, and imaging, for at least 5 years.

A Common Mistake: Treating Without Stage-Specific Strategy

Why people make it:

• A one-size-fits-all approach overlooks critical differences in cancer extent and biology.
• Lack of awareness of modern protocols like TNT or immunotherapy-first approaches.

Correct approach:

• Base treatment on accurate staging and risk features.
• Incorporate TNT or consider a watch-and-wait approach when appropriate.
• Ensure multidisciplinary consultation, including surgical, medical, and radiation oncology.

What You Can Expect When Treatment Is Tailored and Up-to-Date

When rectal cancer care is based on the latest research and personalized to each patient, the benefits extend well beyond survival. Patients often experience better disease control, fewer invasive procedures, and a higher quality of life, while ongoing monitoring reduces the risk of recurrence.

• Better tumor control: Studies show TNT and precise surgeries like TME improve outcomes.
• Fewer surgeries or preserved function: Immune-alone regimens like dostarlimab have induced long-term cancer-free status in some rectal cancer patients, potentially avoiding surgery entirely.
• Improved quality of life: Minimally invasive techniques and organ-sparing strategies limit long-term side effects.
• Reduced recurrence risk: Surveillance protocols help detect recurrence early when treatment is most effective.

Alongside medical advances, emotional and practical support from family and friends plays a vital role in recovery. If you’re caring for someone, learn more about how to support a loved one with rectal cancer.

FAQs

How do doctors decide which rectal cancer treatment option is best?

Treatment decisions are based on cancer stage, tumor location, genetic markers, and the patient’s overall health. A multidisciplinary team, including surgeons, medical oncologists, and radiation oncologists, typically collaborates to create a personalized plan.

What are the side effects of rectal cancer treatments?

Side effects vary depending on the treatment type. Surgery may affect bowel or bladder function, radiation can cause irritation or fatigue, and chemotherapy may lead to nausea, neuropathy, or low blood counts. Targeted therapy and immunotherapy also have unique side effects that should be discussed with a doctor.

Is rectal cancer treatment different from colon cancer treatment?

Yes. While both are forms of colorectal cancer, rectal cancer often requires a different treatment approach due to the rectum’s location and its proximity to other organs. This is why radiation and specialized surgical techniques, such as total mesorectal excision (TME), are more commonly used for rectal cancer.

What are the main treatment options for rectal cancer?

Treatment typically includes surgery, radiation therapy, chemotherapy, chemoradiation, targeted therapy, immunotherapy, or combinations, chosen based on cancer stage and overall health.

What is total neoadjuvant therapy (TNT)?

TNT involves delivering chemotherapy and radiation before surgery to shrink the tumor, improve response, and potentially allow less invasive management.

Can rectal cancer ever be treated without surgery?

Yes, in select cases, such as dMMR tumors responding completely to immunotherapy (e.g., dostarlimab), nonoperative management may be possible, though this is highly specialized and currently in early clinical use

For help with rectal cancer treatment options in Glendale, CA, contact Armen Gregorian, MD at (818) 847-7067.