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Pelvic Exoneration

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Hi everyone,

Ok I'm hoping someone out there can help. My mom has stage 3 or 4 rectal

cancer, it was never really staged I guess but the tumor is pretty much through

out the pelvic area. She had radiation and chemo. Surgeon said it was not

possible to remove tumor, so she began chemo (avastin,oxal,5fu) she has

completed

6 treatments so far. They found she had a blockage to the left kidney so she

went in to have a stent put in. While there the surgeon (a new one) said

that she should consider a pelvic exoneration (removal of bladder, rectum,

vagina, ect.). We are so damn confused. I know its a big surgery and the

outcome

can be bad but I would think leaving the stuff there would be bad too. The

wall that separates the vagina and rectum is basically no longer there he said

the opening is at least 5 inches long. She is in so much pain from the pressure

she feels. She can sit straight up, walking and standing is very painful.

Anyone have any ideas, suggestions or feedback about this.

Thanks for anything you have to offer!

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Your poor mom, what an ordeal to go through. I guess I would do what doc

suggests but will she be more comfortable? That is the important thing.

Get her comfortable.. Wish I could give you more encouragement here...

but here are so BIG HUGS for you and your mom.. Take care God Bless

Jolene

sftfemme@... wrote:

> Hi everyone,

> Ok I'm hoping someone out there can help. My mom has stage 3 or 4 rectal

> cancer, it was never really staged I guess but the tumor is pretty

> much through

> out the pelvic area. She had radiation and chemo. Surgeon said it

> was not

> possible to remove tumor, so she began chemo (avastin,oxal,5fu) she

> has completed

> 6 treatments so far. They found she had a blockage to the left kidney

> so she

> went in to have a stent put in. While there the surgeon (a new one) said

> that she should consider a pelvic exoneration (removal of bladder,

> rectum,

> vagina, ect.). We are so damn confused. I know its a big surgery and

> the outcome

> can be bad but I would think leaving the stuff there would be bad

> too. The

> wall that separates the vagina and rectum is basically no longer there

> he said

> the opening is at least 5 inches long. She is in so much pain from

> the pressure

> she feels. She can sit straight up, walking and standing is very

> painful.

> Anyone have any ideas, suggestions or feedback about this.

> Thanks for anything you have to offer!

>

>

>

>

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Guest guest

Here's an article from the National Cancer Institute that may help

Treatment statement for Patients

Rectal Cancer

____________________________________

____________________________________

General Information About Rectal Cancer

Rectal cancer is a disease in which malignant (cancer) cells form in the

tissues of the rectum.

The _rectum_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046555.html) is

part of the body's _digestive system_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046446.html) . The

digestive system removes

and processes _nutrients_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044697.html)

(_vitamins_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044744.html) ,

_minerals_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045787.html) ,

_carbohydrates_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000285960.html) , fats,

_proteins_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046092.html) , and

water)

from foods and helps pass waste material out of the body. The digestive system

is made up of the _esophagus_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046408.html) ,

_stomach_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046604.html) , and

the _small_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046582.html) and

_large intestines_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045097.html) . The

first 6

feet of the large intestine are called the large _bowel_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046500.html) or

_colon_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046462.html) . The

last 6 inches

are the rectum and the anal canal. The anal canal ends at the _anus_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046523.html) (the

opening of the large intestine to the outside of the body).

(http://www.meb.uni-bonn.de/cancer.gov/Media/CDR0000415499.jpg) _Anatomy of

the lower digestive system, showing the colon and other organs._

(http://www.meb.uni-bonn.de/cancer.gov/Media/CDR0000415499.jpg)

Age and family history can affect the risk of developing rectal cancer.

The following are possible _risk factors_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045873.html) for

_rectal_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044083.html)

_cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045333.html) :

* Age 50 years or older.

* A _family history_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000302456.html) of

cancer of the colon or rectum.

* A personal history of cancer of the colon, rectum, _ovary_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046687.html) ,

_endometrium_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046108.html) , or

_breast_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000304766.html) .

* A history of _ulcerative colitis_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045493.html) (ulcers

in the lining of the large

intestine) or _Crohn's disease_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045661.html) .

* Certain _hereditary_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045983.html)

conditions, such as _familial adenomatous

polyposis_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045688.html) and

_hereditary nonpolyposis colon cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044884.html) (HNPCC;

Lynch syndrome).

Possible signs of rectal cancer include a change in bowel habits or blood in

the stool.

These and other _symptoms_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045022.html) may be

caused by rectal cancer or other conditions. A

doctor should be consulted if any of the following problems occur:

* A change in bowel habits.

* _Blood_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000270735.html)

(either bright red or very dark) in the _stool_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046605.html) .

* _Diarrhea_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000306496.html) ,

_constipation_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000407757.html) , or

feeling that the bowel does not empty

completely.

* Stools that are narrower than usual.

* General _abdominal_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046684.html)

discomfort (frequent gas pains, bloating, fullness,

or cramps).

* Weight loss with no known reason.

* Constant tiredness.

* Vomiting.

Tests that examine the rectum and colon are used to detect (find) and

diagnose rectal cancer.

Tests used in _diagnosing_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045959.html) rectal

cancer include the following:

* _Fecal occult blood test_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045050.html) : A test

to check stool (solid waste) for blood

that can only be seen with a microscope. Small samples of stool are placed on

special cards and returned to the doctor or laboratory for testing.

(http://www.meb.uni-bonn.de/cancer.gov/Media/CDR0000415502.jpg) _Fecal

Occult Blood Test (FOBT) kit to check for blood in stool._

(http://www.meb.uni-bonn.de/cancer.gov/Media/CDR0000415502.jpg)

* _Digital rectal exam_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045668.html) : An

exam of the rectum. The doctor or nurse inserts

a lubricated, gloved finger into the rectum to feel for lumps or _abnormal_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044636.html)

areas.

* _Barium enema_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046513.html) : A

series of _x-rays_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045944.html) of the

lower _gastrointestinal tract_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046189.html) . A

liquid that contains _barium_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046514.html) (a

silver-white metallic compound) is put into the

rectum. The barium coats the lower gastrointestinal tract and x-rays are taken.

This procedure is also called a _lower GI series_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046310.html) .

(http://www.meb.uni-bonn.de/cancer.gov/Media/CDR0000415505.jpg) _Barium

enema procedure. The patient lies on an x-ray table. Barium liquid is put into

the rectum and flows through the colon. X-rays are taken to look for abnormal

areas._ (http://www.meb.uni-bonn.de/cancer.gov/Media/CDR0000415505.jpg)

* _Sigmoidoscopy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045880.html) : A

procedure to look inside the rectum and _sigmoid_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000357588.html)

(lower)

colon for _polyps_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045844.html) ,

abnormal areas, or cancer. A _sigmoidoscope_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046680.html) (a

thin, lighted

tube) is inserted through the rectum into the sigmoid colon. Polyps or _tissue_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046683.html)

samples may be taken for _biopsy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045164.html) .

(http://www.meb.uni-bonn.de/cancer.gov/Media/CDR0000415503.jpg)

_Sigmoidoscopy. A thin, lighted tube is inserted through the anus and rectum

and into the

lower part of the colon to look for abnormal areas._

(http://www.meb.uni-bonn.de/cancer.gov/Media/CDR0000415503.jpg)

* _Colonoscopy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045648.html) : A

procedure to look inside the rectum and colon for

polyps, abnormal areas, or cancer. A _colonoscope_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046463.html) (a

thin, lighted tube) is inserted

through the rectum into the colon. Polyps or tissue samples may be taken for

biopsy.

(http://www.meb.uni-bonn.de/cancer.gov/Media/CDR0000415504.jpg)

_Colonoscopy. A thin, lighted tube is inserted through the anus and rectum and

into the

colon to look for abnormal areas._

(http://www.meb.uni-bonn.de/cancer.gov/Media/CDR0000415504.jpg)

* _Biopsy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045164.html) : The

removal of _cells_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046476.html) or

tissues so they can be viewed under a

microscope to check for signs of cancer.

Certain factors affect prognosis (chance of recovery) and treatment options.

The prognosis (chance of recovery) and treatment options depend on the

following:

* The _stage_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045885.html) of the

cancer (whether it affects the inner lining of the

rectum only, involves the whole rectum, or has spread to other places in the

body).

* The patient’s general health.

* Whether the cancer has just been diagnosed or has recurred (come

back).

Stages of Rectal Cancer

After rectal cancer has been diagnosed, tests are done to find out if cancer

cells have spread within the rectum or to other parts of the body.

The process used to find out whether _cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045333.html) has

spread within the _rectum_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046555.html) or to

other parts of the body is called _staging_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046597.html) . The

information gathered from the

staging process determines the _stage_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045885.html) of the

disease. It is important to know the

stage in order to plan treatment. The following tests and procedures may be

used

in the staging process:

* _Digital rectal exam_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045668.html) : An

exam of the rectum. The doctor or nurse inserts

a lubricated, gloved finger into the rectum to feel for lumps or _abnormal_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044636.html)

areas.

* _CT scan_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046033.html) (CAT

scan): A procedure that makes a series of detailed

pictures of areas inside the body, taken from different angles. The pictures

are

made by a computer linked to an _x-ray_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045944.html)

machine. A dye may be _injected_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044678.html) into a

vein or

swallowed to help the _organs_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000257523.html) or

_tissues_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046683.html) show

up more clearly. This procedure is

also called computed tomography, computerized tomography, or computerized axial

tomography.

* _MRI_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045788.html)

(magnetic resonance imaging): A procedure that uses a magnet, radio

waves, and a computer to make a series of detailed pictures of areas inside

the body. This procedure is also called nuclear magnetic resonance imaging

(NMRI).

* _Sigmoidoscopy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045880.html) or

_colonoscopy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045648.html) and

_biopsy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045164.html) : A

procedure to look inside the

rectum and _colon_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046462.html) for

_polyps_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045844.html) ,

abnormal areas, or cancer. A _sigmoidoscope_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046680.html) or

_colonoscope_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046463.html) is

inserted through the rectum into the colon. Polyps or tissue samples may be

taken for biopsy.

* _Endoscopic ultrasound_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046602.html) (EUS):

A procedure in which an _endoscope_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046428.html) (a

thin,

lighted tube) is inserted into the body. The endoscope is used to bounce

high-energy sound waves (_ultrasound_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046157.html) ) off

internal tissues or organs and make echoes.

The echoes form a picture of body tissues called a _sonogram_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046587.html) . This

procedure is

also called endosonography.

The following stages are used for rectal cancer:

(http://www.meb.uni-bonn.de/cancer.gov/Media/CDR0000415501.jpg) _As rectal

cancer progresses from Stage 0 to Stage IV, the cancer cells grow through the

layers of the rectum wall and spread to lymph nodes and other organs._

(http://www.meb.uni-bonn.de/cancer.gov/Media/CDR0000415501.jpg)

Stage 0 (carcinoma in situ)

In stage 0, _cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045333.html) is

found in the innermost lining of the _rectum_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046555.html) only.

Stage 0

cancer is also called _carcinoma in situ_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046488.html) .Stage I

In _stage I_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045890.html) ,

_cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045333.html) has

spread beyond the innermost lining of the _rectum_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046555.html) to the

second and third layers and involves the inside wall of the rectum, but it has

not spread to the outer wall of the rectum or outside the rectum. Stage I

_rectal_ (http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044083.html)

cancer is sometimes called Dukes’ A rectal cancer. Stage II

In _stage II_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045891.html) ,

_cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045333.html) has

spread outside the _rectum_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046555.html) to

nearby _tissue_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046683.html) , but

it has not

gone into the _lymph nodes_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045762.html) (small,

bean-shaped structures found throughout the body

that filter substances in a fluid called _lymph_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046305.html) and

help fight _infection_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045364.html) and

_disease_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045669.html)

). Stage II rectal cancer is sometimes called Dukes’ B rectal cancer.Stage

III

In _stage III_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045892.html) ,

_cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045333.html) has

spread to nearby _lymph nodes_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045762.html) , but it

has not spread to

other parts of the body. Stage III rectal cancer is sometimes called Dukes’ C

rectal cancer. Stage IV

In _stage IV_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045893.html) ,

_cancer_ (http://www.meb.uni-

bonn.de/cancer.gov/GlossaryTerm/CDR0000045333.html) has spread to other parts

of the body, such as the _liver_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046312.html) ,

_lungs_ (http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000270740.html)

,

or _ovaries_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046687.html) . Stage

IV rectal cancer is sometimes called Dukes’ D rectal cancer.

Recurrent Rectal Cancer

_Recurrent_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045862.html)

_rectal_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044083.html)

_cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045333.html) is

cancer that has recurred (come back) after it has been

treated. The cancer may come back in the _rectum_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046555.html) or in

other parts of the body,

such as the _colon_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046462.html) ,

_pelvis_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046246.html) ,

_liver_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046312.html) , or

_lungs_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000270740.html) .

Treatment Option Overview

There are different types of treatment for patients with rectal cancer.

Different types of treatment are available for patients with _rectal_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044083.html)

_cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045333.html) . Some

treatments are _standard_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044930.html) (the

currently used treatment), and some are being

tested in _clinical trials_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045961.html) . Before

starting treatment, patients may want to think

about taking part in a clinical trial. A treatment clinical trial is a research

study meant to help improve current treatments or obtain information on new

treatments for patients with cancer. When clinical trials show that a new

treatment is better than the standard treatment, the new treatment may become

the

standard treatment

Clinical trials are taking place in many parts of the country. Information

about ongoing clinical trials is available from the _NCI Web site_

(http://cancer.gov/clinicaltrials) . Choosing the most appropriate cancer

treatment is a

decision that ideally involves the patient, family, and health care team.

Three types of standard treatment are used:

Surgery

_Surgery_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045570.html) is the

most common treatment for all _stages_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045885.html) of

_rectal_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044083.html)

_cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045333.html) . A

doctor may

remove the cancer using one of the following types of surgery:

* _Local_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045755.html)

_excision_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000269459.html) : If

the cancer is found at a very early _stage_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045885.html) , the

doctor

may remove it without cutting into the _abdomen_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045070.html) . If

the cancer is found in a

_polyp_ (http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045844.html)

(a

growth that protrudes from the rectal _mucous membrane_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000257212.html) ), the

operation is called

a _polypectomy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000270865.html) .

* _Resection_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046565.html) : If

the cancer is larger, the doctor will perform a resection

of the _rectum_ (http://www

..meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046555.html) (removing the

cancer and a small amount of healthy _tissue_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046683.html) around

it). The doctor will then perform an _anastomosis_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046534.html)

(sewing the healthy parts of the

rectum together, sewing the remaining rectum to the _colon_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046462.html) , or

sewing the colon

to the _anus_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046523.html) ). The

doctor will also take out _lymph nodes_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045762.html) near

the rectum and

examine them under a microscope to see if they contain cancer.

(http://www.meb.uni-bonn.de/cancer.gov/Media/CDR0000415508.jpg) _Rectal

cancer surgery with anastomosis. The rectum and part of the colon are removed,

and then the colon and anus are joined._

(http://www.meb.uni-bonn.de/cancer.gov/Media/CDR0000415508.jpg)

* Resection and _colostomy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046464.html) : If

the doctor is not able to sew the rectum

back together, a _stoma_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045104.html) (an

opening) is made on the outside of the body for waste

to pass through. This procedure is called a colostomy. Sometimes the colostomy

is needed only until the rectum has healed, and then it can be reversed. If

the doctor needs to remove the entire rectum, however, the colostomy may be

permanent.

Even if the doctor removes all the cancer that can be seen at the time of the

operation, some patients may be offered _chemotherapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045214.html) or

_radiation therapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044971.html) after

surgery to kill any cancer cells that are left. Treatment given after surgery

to increase the chances of a cure is called _adjuvant therapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045587.html)

..Radiation therapy

_Radiation therapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044971.html) is a

cancer treatment that uses high-energy _x-rays_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045944.html) or

other

types of _radiation_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045072.html) to

kill cancer _cells_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046476.html) . There

are two types of radiation therapy.

_External radiation_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046686.html) therapy

uses a machine outside the body to send radiation

toward the cancer. _Internal radiation_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046345.html) therapy

uses a _radioactive_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046550.html)

substance sealed in

needles, _seeds_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000257219.html) ,

wires, or _catheters_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045637.html) that

are placed directly into or near the

cancer. The way the radiation therapy is given depends on the type and stage of

the cancer being treated.Chemotherapy

_Chemotherapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045214.html) is a

cancer treatment that uses _drugs_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000348921.html) to

stop the growth of cancer

cells, either by killing the cells or by stopping the cells from dividing.

When chemotherapy is taken by mouth or _injected_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044678.html) into a

vein or muscle, the drugs

enter the bloodstream and can reach cancer cells throughout the body (_systemic

chemotherapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000301626.html) ). When

chemotherapy is placed directly in the _spinal column_ (h

ttp://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000396787.html) , an

_organ_ (http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000257523.html)

,

or a body cavity such as the _abdomen_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045070.html) , the

drugs mainly affect cancer cells in

those areas (_regional chemotherapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046559.html) ). The

way the chemotherapy is given depends on

the type and stage of the cancer being treated.

After treatment, a _blood_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000270735.html) test

to measure amounts of _carcinoembryonic antigen_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000357558.html) (a

substance in the blood that may be increased when cancer is present) may be

done to see if the cancer has come back. Other types of treatment are being

tested in clinical trials. These include the following:

Chemotherapy and biologic therapy

_Biologic therapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045617.html) is a

treatment that uses the patient’s _immune system_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046356.html) to

fight

cancer. Substances made by the body or made in a laboratory are used to boost,

direct, or restore the body’s natural defenses against cancer. This type of

cancer treatment is also called biotherapy or immunotherapy.

This summary section refers to specific treatments under study in _clinical

trials_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045961.html) , but it

may not mention every new treatment being studied. Information

about ongoing clinical trials is available from the _NCI Web site_

(http://cancer.gov/clinicaltrials) .

Treatment Options by Stage

Stage 0 Rectal Cancer

Treatment of stage 0 (_carcinoma in situ_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046488.html) )

_rectal_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044083.html)

_cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045333.html) may

include the following:

* _Local_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045755.html)

_excision_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000269459.html)

(_surgery_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045570.html) to

remove the _tumor_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046634.html)

without cutting into the

_abdomen_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045070.html) )

or simple _polypectomy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000270865.html)

(surgery to remove a growth that protrudes from the rectal

_mucous membrane_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000257212.html) ).

* _Resection_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046565.html)

(surgery to remove the cancer). This is done when the

cancerous _tissue_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046683.html) is too

large to remove by local excision.

* _Internal_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046345.html) or

_external radiation_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046686.html)

therapy.

Stage I Rectal Cancer

Treatment of _stage I rectal cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045890.html) may

include the following:

* _Surgery_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045570.html) to

remove the _tumor_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046634.html) with

or without _anastomosis_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046534.html)

(joining the cut

ends of the _rectum_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046555.html) ).

* Surgery to remove the tumor with or without _radiation therapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044971.html) and

_chemotherapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045214.html) .

* _Internal_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046345.html) and/or

_external radiation_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046686.html)

_therapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044737.html) .

Stage II Rectal Cancer

Treatment of _stage II rectal cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045891.html) may

include the following:

* _Resection_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046565.html) with

or without _anastomosis_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046534.html)

(joining the cut ends of the

_rectum_ (http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046555.html)

and _colon_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046462.html) , or

the colon and _anus_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046523.html) )

followed by _chemotherapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045214.html) and

_radiation therapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044971.html) .

* Partial or total _pelvic exenteration_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000322874.html)

(_surgery_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045570.html) to

remove the _organs_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000257523.html) and

nearby structures of the _pelvis_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046246.html) ),

depending on where the _cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045333.html) has

spread. Surgery is

followed by radiation therapy and chemotherapy.

* Radiation therapy with or without chemotherapy followed by surgery

and chemotherapy.

* Radiation therapy during surgery followed by _external-beam

radiation_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046751.html)

therapy and chemotherapy.

* A _clinical trial_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045961.html)

evaluating new treatment options.

Information about ongoing clinical trials is available from the _NCI Web

site_ (http://cancer.gov/clinicaltrials) .

Stage III Rectal Cancer

Treatment of _stage III rectal cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045892.html) may

include the following:

* _Resection_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046565.html) with

or without _anastomosis_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046534.html)

(joining the cut ends of the

_rectum_ (http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046555.html)

and _colon_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046462.html) , or

the colon and _anus_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046523.html) )

followed by _chemotherapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045214.html) and

_radiation therapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044971.html) .

* Partial or total_ pelvic exenteration_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000322874.html)

(_surgery_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045570.html) to

remove the _organs_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000257523.html) and

nearby structures of the _pelvis_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046246.html) ),

depending on where the _cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045333.html) has

spread. Surgery is

followed by radiation therapy and chemotherapy.

* Radiation therapy with or without chemotherapy followed by surgery

and chemotherapy.

* Radiation therapy during surgery followed by _external-beam

radiation_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046751.html)

_therapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044737.html) and

chemotherapy.

* Chemotherapy and radiation therapy to relieve _symptoms_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045022.html) caused

by

advanced cancer.

* A _clinical trial_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045961.html)

evaluating new treatment options.

Information about ongoing clinical trials is available from the _NCI Web

site_ (http://cancer.gov/clinicaltrials) .

Stage IV Rectal Cancer

Treatment of _stage IV rectal cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045893.html) may

include the following:

* _Resection_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046565.html)

/_anastomosis_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046534.html)

(_surgery_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045570.html) to

remove the _cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045333.html) and

join the cut ends of

the _rectum_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046555.html) and

_colon_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046462.html) , or

colon and _anus_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046523.html) ) to

relieve _symptoms_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045022.html) caused

by advanced cancer.

* Surgery to remove parts of other _organs_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000257523.html) , such

as the _liver_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046312.html) ,

_lung_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000270740.html) , and

_ovaries_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046687.html) ,

where the cancer may have spread.

* _Chemotherapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045214.html) and

_radiation therapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044971.html) to

relieve symptoms caused by advanced

cancer.

* Chemotherapy following surgery.

* _Clinical trials_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045961.html) of

chemotherapy and _biological therapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045617.html) .

This summary section refers to specific treatments under study in clinical

trials, but it may not mention every new treatment being studied. Information

about ongoing clinical trials is available from the_ NCI Web site_

(http://cancer.gov/clinicaltrials) .

Treatment Options for Recurrent Rectal Cancer

Treatment of _recurrent_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045862.html)

_rectal_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044083.html)

_cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045333.html) may

include the following:

* _Surgery_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045570.html) to

remove the _tumor_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046634.html) or as

_palliative therapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045815.html) to

relieve _symptoms_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045022.html)

caused by advanced cancer.

* Surgery to remove parts of other _organs_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000257523.html) , such

as the _liver_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046312.html) ,

_lungs_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000270740.html) , and

_ovaries_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046687.html)

, where the cancer may have spread.

* _Radiation therapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044971.html) and/or

_chemotherapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045214.html) as

palliative therapy to reduce the

size of the tumor and relieve symptoms caused by advanced cancer.

Changes to This Summary (01/12/2005)

The PDQ cancer information summaries are reviewed regularly and updated as

new information becomes available. This section describes the latest changes

made to this summary as of the date above.

Images were added to this summary.

To Learn More

Call

For more information, U.S. residents may call the National Cancer Institute's

(NCI's) Cancer Information Service toll-free at 1-800-4-CANCER

(1-) Monday through Friday from 9:00 a.m. to 4:30 p.m. Deaf and

hard-of-hearing callers with TTY equipment may call 1-. The call is

free and a

trained Cancer Information Specialist is available to answer your questions.

Web sites and Organizations

The _NCI Web site_ (http://cancer.gov/) provides online access to

information on cancer, clinical trials, and other Web sites and organizations

that

offer support and resources for cancer patients and their families. There are

also many other places where people can get materials and information about

cancer treatment and services. Local hospitals may have information on local and

regional agencies that offer information about finances, getting to and from

treatment, receiving care at home, and dealing with problems associated with

cancer treatment.

Publications

The NCI has booklets and other materials for patients, health professionals,

and the public. These publications discuss types of cancer, methods of cancer

treatment, coping with cancer, and clinical trials. Some publications

provide information on tests for cancer, cancer causes and prevention, cancer

statistics, and NCI research activities. NCI materials on these and other topics

may be ordered online or printed directly from the _NCI Publications Locator_

(https://cissecure.nci.nih.gov/ncipubs) . These materials can also be ordered

by telephone from the Cancer Information Service toll-free at 1-800-4-CANCER

(1-), TTY at 1-.

LiveHelp

The NCI's LiveHelp service, a program available on several of the Institute's

Web sites, provides Internet users with the ability to chat online with an

Information Specialist. The service is available from 9:00 a.m. to 11:00 p.m.

Eastern time, Monday through Friday. Information Specialists can help

Internet users find information on NCI Web sites and answer questions about

cancer.

Write

For more information from the NCI, please write to this address:

* NCI Public Inquiries Office

* Suite 3036A

* 6116 Executive Boulevard, MSC8322

* Bethesda, MD 20892-8322

About PDQ

PDQ is a comprehensive cancer database available on NCI's Web site.

PDQ is the National Cancer Institute's (NCI's) comprehensive cancer

information database. Most of the information contained in PDQ is available

online at

_NCI's Web site_ (http://cancer.gov/) . PDQ is provided as a service of the

NCI. The NCI is part of the National Institutes of Health, the federal

government's focal point for biomedical research.

PDQ contains cancer information summaries.

The PDQ database contains summaries of the latest published information on

cancer prevention, detection, genetics, treatment, supportive care, and

complementary and alternative medicine. Most summaries are available in two

versions. The health professional versions provide detailed information written

in

technical language. The patient versions are written in easy-to-understand,

nontechnical language. Both versions provide current and accurate cancer

information.

The PDQ cancer information summaries are developed by cancer experts and

reviewed regularly.

Editorial Boards made up of experts in oncology and related specialties are

responsible for writing and maintaining the cancer information summaries. The

summaries are reviewed regularly and changes are made as new information

becomes available. The date on each summary ( " Date Last Modified " ) indicates

the

time of the most recent change.

PDQ also contains information on clinical trials.

Before starting treatment, patients may want to think about taking part in a

clinical trial. A clinical trial is a study to answer a scientific question,

such as whether one treatment is better than another. Trials are based on

past studies and what has been learned in the laboratory. Each trial answers

certain scientific questions in order to find new and better ways to help

cancer

patients. During treatment clinical trials, information is collected about

new treatments, the risks involved, and how well they do or do not work. If a

clinical trial shows that a new treatment is better than one currently being

used, the new treatment may become " standard. "

Listings of clinical trials are included in PDQ and are available online at

_NCI's Web site_ (http://cancer.gov/clinical_trials) . Descriptions of the

trials are available in health professional and patient versions. Many cancer

doctors who take part in clinical trials are also listed in PDQ. For more

information, call the Cancer Information Service 1-800-4-CANCER

(1-);

TTY at 1-.Physicians version: _CDR0000062726_

(http://www.meb.uni-bonn.de/cancer.gov/CDR0000062726.html)

Date last modified: 2005-01-12

____________________________________

Sponsors:

The following organisations have financed parts of our PhD research project

on improving the quality of online cancer information.

* The Commission of the European Communities, Directorate General XIII

by contract INCO 962100 (ARGONAUTA)

* Health on the Net Foundation (Geneva)

* Landesregierung NRW (im Rahmen von HSP III)

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Guest guest

/Narice

I tried clicking on either one, tried copy and paste and nothing

worked. I tried from original email as well and it didn't work. Hate

when that happens.

I tried a google and didn't get much at all, most of it dead as well....

Jolene

/

flipper759@... wrote:

> Sorry it didn't send well. Go to:

>

> _http://www.meb.uni-bonn.de/cancer.gov/CDR0000062959.html_

> (http://www.meb.uni-bonn.de/cancer.gov/CDR0000062959.html)

> http://www.meb.uni-bonn.de/cancer.gov/CDR0000062959.html%29>

>

> to read the article.

>

> Narice

>

>

>

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Guest guest

Heck, all I get on all of these is This page cannot be found, maybe because of

the parenthesis, and I dont have time to change them all. I'd like to know what

I'd if I was working, I cant keep up with my life now. Taking mom to her regular

doc this afternoon and for a blood test. Now trying to cut up material to make a

rug, I have yards and yards of it to do. ~~Dianna

flipper759@... wrote:Here's an article from the National Cancer Institute

that may help

Treatment statement for Patients

Rectal Cancer

____________________________________

____________________________________

General Information About Rectal Cancer

Rectal cancer is a disease in which malignant (cancer) cells form in the

tissues of the rectum.

The _rectum_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046555.html) is

part of the body's _digestive system_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046446.html) . The

digestive system removes

and processes _nutrients_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044697.html)

(_vitamins_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044744.html) ,

_minerals_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045787.html) ,

_carbohydrates_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000285960.html) , fats,

_proteins_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046092.html) , and

water)

from foods and helps pass waste material out of the body. The digestive system

is made up of the _esophagus_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046408.html) ,

_stomach_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046604.html) , and

the _small_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046582.html) and

_large intestines_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045097.html) . The

first 6

feet of the large intestine are called the large _bowel_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046500.html) or

_colon_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046462.html) . The

last 6 inches

are the rectum and the anal canal. The anal canal ends at the _anus_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046523.html) (the

opening of the large intestine to the outside of the body).

(http://www.meb.uni-bonn.de/cancer.gov/Media/CDR0000415499.jpg) _Anatomy of

the lower digestive system, showing the colon and other organs._

(http://www.meb.uni-bonn.de/cancer.gov/Media/CDR0000415499.jpg)

Age and family history can affect the risk of developing rectal cancer.

The following are possible _risk factors_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045873.html) for

_rectal_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044083.html)

_cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045333.html) :

* Age 50 years or older.

* A _family history_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000302456.html) of

cancer of the colon or rectum.

* A personal history of cancer of the colon, rectum, _ovary_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046687.html) ,

_endometrium_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046108.html) , or

_breast_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000304766.html) .

* A history of _ulcerative colitis_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045493.html) (ulcers

in the lining of the large

intestine) or _Crohn's disease_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045661.html) .

* Certain _hereditary_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045983.html)

conditions, such as _familial adenomatous

polyposis_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045688.html) and

_hereditary nonpolyposis colon cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044884.html) (HNPCC;

Lynch syndrome).

Possible signs of rectal cancer include a change in bowel habits or blood in

the stool.

These and other _symptoms_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045022.html) may be

caused by rectal cancer or other conditions. A

doctor should be consulted if any of the following problems occur:

* A change in bowel habits.

* _Blood_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000270735.html)

(either bright red or very dark) in the _stool_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046605.html) .

* _Diarrhea_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000306496.html) ,

_constipation_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000407757.html) , or

feeling that the bowel does not empty

completely.

* Stools that are narrower than usual.

* General _abdominal_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046684.html)

discomfort (frequent gas pains, bloating, fullness,

or cramps).

* Weight loss with no known reason.

* Constant tiredness.

* Vomiting.

Tests that examine the rectum and colon are used to detect (find) and

diagnose rectal cancer.

Tests used in _diagnosing_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045959.html) rectal

cancer include the following:

* _Fecal occult blood test_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045050.html) : A test

to check stool (solid waste) for blood

that can only be seen with a microscope. Small samples of stool are placed on

special cards and returned to the doctor or laboratory for testing.

(http://www.meb.uni-bonn.de/cancer.gov/Media/CDR0000415502.jpg) _Fecal

Occult Blood Test (FOBT) kit to check for blood in stool._

(http://www.meb.uni-bonn.de/cancer.gov/Media/CDR0000415502.jpg)

* _Digital rectal exam_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045668.html) : An

exam of the rectum. The doctor or nurse inserts

a lubricated, gloved finger into the rectum to feel for lumps or _abnormal_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044636.html)

areas.

* _Barium enema_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046513.html) : A

series of _x-rays_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045944.html) of the

lower _gastrointestinal tract_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046189.html) . A

liquid that contains _barium_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046514.html) (a

silver-white metallic compound) is put into the

rectum. The barium coats the lower gastrointestinal tract and x-rays are taken.

This procedure is also called a _lower GI series_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046310.html) .

(http://www.meb.uni-bonn.de/cancer.gov/Media/CDR0000415505.jpg) _Barium

enema procedure. The patient lies on an x-ray table. Barium liquid is put into

the rectum and flows through the colon. X-rays are taken to look for abnormal

areas._ (http://www.meb.uni-bonn.de/cancer.gov/Media/CDR0000415505.jpg)

* _Sigmoidoscopy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045880.html) : A

procedure to look inside the rectum and _sigmoid_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000357588.html)

(lower)

colon for _polyps_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045844.html) ,

abnormal areas, or cancer. A _sigmoidoscope_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046680.html) (a

thin, lighted

tube) is inserted through the rectum into the sigmoid colon. Polyps or _tissue_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046683.html)

samples may be taken for _biopsy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045164.html) .

(http://www.meb.uni-bonn.de/cancer.gov/Media/CDR0000415503.jpg)

_Sigmoidoscopy. A thin, lighted tube is inserted through the anus and rectum

and into the

lower part of the colon to look for abnormal areas._

(http://www.meb.uni-bonn.de/cancer.gov/Media/CDR0000415503.jpg)

* _Colonoscopy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045648.html) : A

procedure to look inside the rectum and colon for

polyps, abnormal areas, or cancer. A _colonoscope_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046463.html) (a

thin, lighted tube) is inserted

through the rectum into the colon. Polyps or tissue samples may be taken for

biopsy.

(http://www.meb.uni-bonn.de/cancer.gov/Media/CDR0000415504.jpg)

_Colonoscopy. A thin, lighted tube is inserted through the anus and rectum and

into the

colon to look for abnormal areas._

(http://www.meb.uni-bonn.de/cancer.gov/Media/CDR0000415504.jpg)

* _Biopsy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045164.html) : The

removal of _cells_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046476.html) or

tissues so they can be viewed under a

microscope to check for signs of cancer.

Certain factors affect prognosis (chance of recovery) and treatment options.

The prognosis (chance of recovery) and treatment options depend on the

following:

* The _stage_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045885.html) of the

cancer (whether it affects the inner lining of the

rectum only, involves the whole rectum, or has spread to other places in the

body).

* The patient’s general health.

* Whether the cancer has just been diagnosed or has recurred (come

back).

Stages of Rectal Cancer

After rectal cancer has been diagnosed, tests are done to find out if cancer

cells have spread within the rectum or to other parts of the body.

The process used to find out whether _cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045333.html) has

spread within the _rectum_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046555.html) or to

other parts of the body is called _staging_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046597.html) . The

information gathered from the

staging process determines the _stage_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045885.html) of the

disease. It is important to know the

stage in order to plan treatment. The following tests and procedures may be

used

in the staging process:

* _Digital rectal exam_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045668.html) : An

exam of the rectum. The doctor or nurse inserts

a lubricated, gloved finger into the rectum to feel for lumps or _abnormal_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044636.html)

areas.

* _CT scan_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046033.html) (CAT

scan): A procedure that makes a series of detailed

pictures of areas inside the body, taken from different angles. The pictures

are

made by a computer linked to an _x-ray_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045944.html)

machine. A dye may be _injected_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044678.html) into a

vein or

swallowed to help the _organs_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000257523.html) or

_tissues_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046683.html) show

up more clearly. This procedure is

also called computed tomography, computerized tomography, or computerized axial

tomography.

* _MRI_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045788.html)

(magnetic resonance imaging): A procedure that uses a magnet, radio

waves, and a computer to make a series of detailed pictures of areas inside

the body. This procedure is also called nuclear magnetic resonance imaging

(NMRI).

* _Sigmoidoscopy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045880.html) or

_colonoscopy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045648.html) and

_biopsy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045164.html) : A

procedure to look inside the

rectum and _colon_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046462.html) for

_polyps_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045844.html) ,

abnormal areas, or cancer. A _sigmoidoscope_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046680.html) or

_colonoscope_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046463.html) is

inserted through the rectum into the colon. Polyps or tissue samples may be

taken for biopsy.

* _Endoscopic ultrasound_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046602.html) (EUS):

A procedure in which an _endoscope_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046428.html) (a

thin,

lighted tube) is inserted into the body. The endoscope is used to bounce

high-energy sound waves (_ultrasound_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046157.html) ) off

internal tissues or organs and make echoes.

The echoes form a picture of body tissues called a _sonogram_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046587.html) . This

procedure is

also called endosonography.

The following stages are used for rectal cancer:

(http://www.meb.uni-bonn.de/cancer.gov/Media/CDR0000415501.jpg) _As rectal

cancer progresses from Stage 0 to Stage IV, the cancer cells grow through the

layers of the rectum wall and spread to lymph nodes and other organs._

(http://www.meb.uni-bonn.de/cancer.gov/Media/CDR0000415501.jpg)

Stage 0 (carcinoma in situ)

In stage 0, _cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045333.html) is

found in the innermost lining of the _rectum_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046555.html) only.

Stage 0

cancer is also called _carcinoma in situ_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046488.html) .Stage I

In _stage I_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045890.html) ,

_cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045333.html) has

spread beyond the innermost lining of the _rectum_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046555.html) to the

second and third layers and involves the inside wall of the rectum, but it has

not spread to the outer wall of the rectum or outside the rectum. Stage I

_rectal_ (http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044083.html)

cancer is sometimes called Dukes’ A rectal cancer. Stage II

In _stage II_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045891.html) ,

_cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045333.html) has

spread outside the _rectum_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046555.html) to

nearby _tissue_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046683.html) , but

it has not

gone into the _lymph nodes_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045762.html) (small,

bean-shaped structures found throughout the body

that filter substances in a fluid called _lymph_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046305.html) and

help fight _infection_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045364.html) and

_disease_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045669.html)

). Stage II rectal cancer is sometimes called Dukes’ B rectal cancer.Stage

III

In _stage III_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045892.html) ,

_cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045333.html) has

spread to nearby _lymph nodes_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045762.html) , but it

has not spread to

other parts of the body. Stage III rectal cancer is sometimes called Dukes’ C

rectal cancer. Stage IV

In _stage IV_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045893.html) ,

_cancer_ (http://www.meb.uni-

bonn.de/cancer.gov/GlossaryTerm/CDR0000045333.html) has spread to other parts

of the body, such as the _liver_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046312.html) ,

_lungs_ (http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000270740.html)

,

or _ovaries_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046687.html) . Stage

IV rectal cancer is sometimes called Dukes’ D rectal cancer.

Recurrent Rectal Cancer

_Recurrent_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045862.html)

_rectal_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044083.html)

_cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045333.html) is

cancer that has recurred (come back) after it has been

treated. The cancer may come back in the _rectum_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046555.html) or in

other parts of the body,

such as the _colon_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046462.html) ,

_pelvis_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046246.html) ,

_liver_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046312.html) , or

_lungs_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000270740.html) .

Treatment Option Overview

There are different types of treatment for patients with rectal cancer.

Different types of treatment are available for patients with _rectal_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044083.html)

_cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045333.html) . Some

treatments are _standard_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044930.html) (the

currently used treatment), and some are being

tested in _clinical trials_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045961.html) . Before

starting treatment, patients may want to think

about taking part in a clinical trial. A treatment clinical trial is a research

study meant to help improve current treatments or obtain information on new

treatments for patients with cancer. When clinical trials show that a new

treatment is better than the standard treatment, the new treatment may become

the

standard treatment

Clinical trials are taking place in many parts of the country. Information

about ongoing clinical trials is available from the _NCI Web site_

(http://cancer.gov/clinicaltrials) . Choosing the most appropriate cancer

treatment is a

decision that ideally involves the patient, family, and health care team.

Three types of standard treatment are used:

Surgery

_Surgery_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045570.html) is the

most common treatment for all _stages_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045885.html) of

_rectal_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044083.html)

_cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045333.html) . A

doctor may

remove the cancer using one of the following types of surgery:

* _Local_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045755.html)

_excision_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000269459.html) : If

the cancer is found at a very early _stage_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045885.html) , the

doctor

may remove it without cutting into the _abdomen_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045070.html) . If

the cancer is found in a

_polyp_ (http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045844.html)

(a

growth that protrudes from the rectal _mucous membrane_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000257212.html) ), the

operation is called

a _polypectomy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000270865.html) .

* _Resection_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046565.html) : If

the cancer is larger, the doctor will perform a resection

of the _rectum_ (http://www

..meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046555.html) (removing the

cancer and a small amount of healthy _tissue_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046683.html) around

it). The doctor will then perform an _anastomosis_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046534.html)

(sewing the healthy parts of the

rectum together, sewing the remaining rectum to the _colon_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046462.html) , or

sewing the colon

to the _anus_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046523.html) ). The

doctor will also take out _lymph nodes_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045762.html) near

the rectum and

examine them under a microscope to see if they contain cancer.

(http://www.meb.uni-bonn.de/cancer.gov/Media/CDR0000415508.jpg) _Rectal

cancer surgery with anastomosis. The rectum and part of the colon are removed,

and then the colon and anus are joined._

(http://www.meb.uni-bonn.de/cancer.gov/Media/CDR0000415508.jpg)

* Resection and _colostomy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046464.html) : If

the doctor is not able to sew the rectum

back together, a _stoma_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045104.html) (an

opening) is made on the outside of the body for waste

to pass through. This procedure is called a colostomy. Sometimes the colostomy

is needed only until the rectum has healed, and then it can be reversed. If

the doctor needs to remove the entire rectum, however, the colostomy may be

permanent.

Even if the doctor removes all the cancer that can be seen at the time of the

operation, some patients may be offered _chemotherapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045214.html) or

_radiation therapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044971.html) after

surgery to kill any cancer cells that are left. Treatment given after surgery

to increase the chances of a cure is called _adjuvant therapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045587.html)

..Radiation therapy

_Radiation therapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044971.html) is a

cancer treatment that uses high-energy _x-rays_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045944.html) or

other

types of _radiation_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045072.html) to

kill cancer _cells_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046476.html) . There

are two types of radiation therapy.

_External radiation_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046686.html) therapy

uses a machine outside the body to send radiation

toward the cancer. _Internal radiation_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046345.html) therapy

uses a _radioactive_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046550.html)

substance sealed in

needles, _seeds_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000257219.html) ,

wires, or _catheters_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045637.html) that

are placed directly into or near the

cancer. The way the radiation therapy is given depends on the type and stage of

the cancer being treated.Chemotherapy

_Chemotherapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045214.html) is a

cancer treatment that uses _drugs_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000348921.html) to

stop the growth of cancer

cells, either by killing the cells or by stopping the cells from dividing.

When chemotherapy is taken by mouth or _injected_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044678.html) into a

vein or muscle, the drugs

enter the bloodstream and can reach cancer cells throughout the body (_systemic

chemotherapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000301626.html) ). When

chemotherapy is placed directly in the _spinal column_ (h

ttp://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000396787.html) , an

_organ_ (http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000257523.html)

,

or a body cavity such as the _abdomen_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045070.html) , the

drugs mainly affect cancer cells in

those areas (_regional chemotherapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046559.html) ). The

way the chemotherapy is given depends on

the type and stage of the cancer being treated.

After treatment, a _blood_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000270735.html) test

to measure amounts of _carcinoembryonic antigen_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000357558.html) (a

substance in the blood that may be increased when cancer is present) may be

done to see if the cancer has come back. Other types of treatment are being

tested in clinical trials. These include the following:

Chemotherapy and biologic therapy

_Biologic therapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045617.html) is a

treatment that uses the patient’s _immune system_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046356.html) to

fight

cancer. Substances made by the body or made in a laboratory are used to boost,

direct, or restore the body’s natural defenses against cancer. This type of

cancer treatment is also called biotherapy or immunotherapy.

This summary section refers to specific treatments under study in _clinical

trials_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045961.html) , but it

may not mention every new treatment being studied. Information

about ongoing clinical trials is available from the _NCI Web site_

(http://cancer.gov/clinicaltrials) .

Treatment Options by Stage

Stage 0 Rectal Cancer

Treatment of stage 0 (_carcinoma in situ_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046488.html) )

_rectal_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044083.html)

_cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045333.html) may

include the following:

* _Local_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045755.html)

_excision_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000269459.html)

(_surgery_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045570.html) to

remove the _tumor_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046634.html)

without cutting into the

_abdomen_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045070.html) )

or simple _polypectomy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000270865.html)

(surgery to remove a growth that protrudes from the rectal

_mucous membrane_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000257212.html) ).

* _Resection_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046565.html)

(surgery to remove the cancer). This is done when the

cancerous _tissue_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046683.html) is too

large to remove by local excision.

* _Internal_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046345.html) or

_external radiation_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046686.html)

therapy.

Stage I Rectal Cancer

Treatment of _stage I rectal cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045890.html) may

include the following:

* _Surgery_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045570.html) to

remove the _tumor_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046634.html) with

or without _anastomosis_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046534.html)

(joining the cut

ends of the _rectum_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046555.html) ).

* Surgery to remove the tumor with or without _radiation therapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044971.html) and

_chemotherapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045214.html) .

* _Internal_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046345.html) and/or

_external radiation_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046686.html)

_therapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044737.html) .

Stage II Rectal Cancer

Treatment of _stage II rectal cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045891.html) may

include the following:

* _Resection_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046565.html) with

or without _anastomosis_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046534.html)

(joining the cut ends of the

_rectum_ (http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046555.html)

and _colon_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046462.html) , or

the colon and _anus_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046523.html) )

followed by _chemotherapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045214.html) and

_radiation therapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044971.html) .

* Partial or total _pelvic exenteration_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000322874.html)

(_surgery_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045570.html) to

remove the _organs_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000257523.html) and

nearby structures of the _pelvis_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046246.html) ),

depending on where the _cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045333.html) has

spread. Surgery is

followed by radiation therapy and chemotherapy.

* Radiation therapy with or without chemotherapy followed by surgery

and chemotherapy.

* Radiation therapy during surgery followed by _external-beam

radiation_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046751.html)

therapy and chemotherapy.

* A _clinical trial_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045961.html)

evaluating new treatment options.

Information about ongoing clinical trials is available from the _NCI Web

site_ (http://cancer.gov/clinicaltrials) .

Stage III Rectal Cancer

Treatment of _stage III rectal cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045892.html) may

include the following:

* _Resection_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046565.html) with

or without _anastomosis_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046534.html)

(joining the cut ends of the

_rectum_ (http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046555.html)

and _colon_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046462.html) , or

the colon and _anus_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046523.html) )

followed by _chemotherapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045214.html) and

_radiation therapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044971.html) .

* Partial or total_ pelvic exenteration_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000322874.html)

(_surgery_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045570.html) to

remove the _organs_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000257523.html) and

nearby structures of the _pelvis_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046246.html) ),

depending on where the _cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045333.html) has

spread. Surgery is

followed by radiation therapy and chemotherapy.

* Radiation therapy with or without chemotherapy followed by surgery

and chemotherapy.

* Radiation therapy during surgery followed by _external-beam

radiation_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046751.html)

_therapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044737.html) and

chemotherapy.

* Chemotherapy and radiation therapy to relieve _symptoms_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045022.html) caused

by

advanced cancer.

* A _clinical trial_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045961.html)

evaluating new treatment options.

Information about ongoing clinical trials is available from the _NCI Web

site_ (http://cancer.gov/clinicaltrials) .

Stage IV Rectal Cancer

Treatment of _stage IV rectal cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045893.html) may

include the following:

* _Resection_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046565.html)

/_anastomosis_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046534.html)

(_surgery_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045570.html) to

remove the _cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045333.html) and

join the cut ends of

the _rectum_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046555.html) and

_colon_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046462.html) , or

colon and _anus_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046523.html) ) to

relieve _symptoms_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045022.html) caused

by advanced cancer.

* Surgery to remove parts of other _organs_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000257523.html) , such

as the _liver_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046312.html) ,

_lung_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000270740.html) , and

_ovaries_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046687.html) ,

where the cancer may have spread.

* _Chemotherapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045214.html) and

_radiation therapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044971.html) to

relieve symptoms caused by advanced

cancer.

* Chemotherapy following surgery.

* _Clinical trials_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045961.html) of

chemotherapy and _biological therapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045617.html) .

This summary section refers to specific treatments under study in clinical

trials, but it may not mention every new treatment being studied. Information

about ongoing clinical trials is available from the_ NCI Web site_

(http://cancer.gov/clinicaltrials) .

Treatment Options for Recurrent Rectal Cancer

Treatment of _recurrent_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045862.html)

_rectal_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044083.html)

_cancer_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045333.html) may

include the following:

* _Surgery_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045570.html) to

remove the _tumor_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046634.html) or as

_palliative therapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045815.html) to

relieve _symptoms_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045022.html)

caused by advanced cancer.

* Surgery to remove parts of other _organs_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000257523.html) , such

as the _liver_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046312.html) ,

_lungs_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000270740.html) , and

_ovaries_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000046687.html)

, where the cancer may have spread.

* _Radiation therapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000044971.html) and/or

_chemotherapy_

(http://www.meb.uni-bonn.de/cancer.gov/GlossaryTerm/CDR0000045214.html) as

palliative therapy to reduce the

size of the tumor and relieve symptoms caused by advanced cancer.

Changes to This Summary (01/12/2005)

The PDQ cancer information summaries are reviewed regularly and updated as

new information becomes available. This section describes the latest changes

made to this summary as of the date above.

Images were added to this summary.

To Learn More

Call

For more information, U.S. residents may call the National Cancer Institute's

(NCI's) Cancer Information Service toll-free at 1-800-4-CANCER

(1-) Monday through Friday from 9:00 a.m. to 4:30 p.m. Deaf and

hard-of-hearing callers with TTY equipment may call 1-. The call is

free and a

trained Cancer Information Specialist is available to answer your questions.

Web sites and Organizations

The _NCI Web site_ (http://cancer.gov/) provides online access to

information on cancer, clinical trials, and other Web sites and organizations

that

offer support and resources for cancer patients and their families. There are

also many other places where people can get materials and information about

cancer treatment and services. Local hospitals may have information on local and

regional agencies that offer information about finances, getting to and from

treatment, receiving care at home, and dealing with problems associated with

cancer treatment.

Publications

The NCI has booklets and other materials for patients, health professionals,

and the public. These publications discuss types of cancer, methods of cancer

treatment, coping with cancer, and clinical trials. Some publications

provide information on tests for cancer, cancer causes and prevention, cancer

statistics, and NCI research activities. NCI materials on these and other topics

may be ordered online or printed directly from the _NCI Publications Locator_

(https://cissecure.nci.nih.gov/ncipubs) . These materials can also be ordered

by telephone from the Cancer Information Service toll-free at 1-800-4-CANCER

(1-), TTY at 1-.

LiveHelp

The NCI's LiveHelp service, a program available on several of the Institute's

Web sites, provides Internet users with the ability to chat online with an

Information Specialist. The service is available from 9:00 a.m. to 11:00 p.m.

Eastern time, Monday through Friday. Information Specialists can help

Internet users find information on NCI Web sites and answer questions about

cancer.

Write

For more information from the NCI, please write to this address:

* NCI Public Inquiries Office

* Suite 3036A

* 6116 Executive Boulevard, MSC8322

* Bethesda, MD 20892-8322

About PDQ

PDQ is a comprehensive cancer database available on NCI's Web site.

PDQ is the National Cancer Institute's (NCI's) comprehensive cancer

information database. Most of the information contained in PDQ is available

online at

_NCI's Web site_ (http://cancer.gov/) . PDQ is provided as a service of the

NCI. The NCI is part of the National Institutes of Health, the federal

government's focal point for biomedical research.

PDQ contains cancer information summaries.

The PDQ database contains summaries of the latest published information on

cancer prevention, detection, genetics, treatment, supportive care, and

complementary and alternative medicine. Most summaries are available in two

versions. The health professional versions provide detailed information written

in

technical language. The patient versions are written in easy-to-understand,

nontechnical language. Both versions provide current and accurate cancer

information.

The PDQ cancer information summaries are developed by cancer experts and

reviewed regularly.

Editorial Boards made up of experts in oncology and related specialties are

responsible for writing and maintaining the cancer information summaries. The

summaries are reviewed regularly and changes are made as new information

becomes available. The date on each summary ( " Date Last Modified " ) indicates

the

time of the most recent change.

PDQ also contains information on clinical trials.

Before starting treatment, patients may want to think about taking part in a

clinical trial. A clinical trial is a study to answer a scientific question,

such as whether one treatment is better than another. Trials are based on

past studies and what has been learned in the laboratory. Each trial answers

certain scientific questions in order to find new and better ways to help

cancer

patients. During treatment clinical trials, information is collected about

new treatments, the risks involved, and how well they do or do not work. If a

clinical trial shows that a new treatment is better than one currently being

used, the new treatment may become " standard. "

Listings of clinical trials are included in PDQ and are available online at

_NCI's Web site_ (http://cancer.gov/clinical_trials) . Descriptions of the

trials are available in health professional and patient versions. Many cancer

doctors who take part in clinical trials are also listed in PDQ. For more

information, call the Cancer Information Service 1-800-4-CANCER

(1-);

TTY at 1-.Physicians version: _CDR0000062726_

(http://www.meb.uni-bonn.de/cancer.gov/CDR0000062726.html)

Date last modified: 2005-01-12

____________________________________

Sponsors:

The following organisations have financed parts of our PhD research project

on improving the quality of online cancer information.

* The Commission of the European Communities, Directorate General XIII

by contract INCO 962100 (ARGONAUTA)

* Health on the Net Foundation (Geneva)

* Landesregierung NRW (im Rahmen von HSP III)

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In a message dated 6/29/2005 10:54:12 A.M. Eastern Daylight Time,

jasonsmom285@... writes:

Heck, all I get on all of these is This page cannot be found, maybe because

of the parenthesis, and I dont have time to change them all. I'd like to know

what I'd if I was working, I cant keep up with my life now. Taking mom to

her regular doc this afternoon and for a blood test. Now trying to cut up

material to make a rug, I have yards and yards of it to do. ~~Dianna

Hi Dianna... yep, just hi-lite the address without the parenthesis...copy

and paste in to the address thingy at the top of your screen and then click on

go...and you'll be there...

Let us know how all goes at the drs. for Mom today!!!

Donelle

Caregiver to Glenn

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