What to expect from chemotherapy before surgery for rectal cancer

This approach is called neoadjuvant chemotherapy. Medicines travel through the bloodstream to treat cancer cells in the rectum and elsewhere in the body that may not be visible on scans. The aim may include reducing the tumour, treating possible microscopic spread and making the overall treatment plan clearer. Your oncologist will explain whether chemotherapy is given alone or alongside radiotherapy, and when surgery is expected to be considered.

At each visit, the team may check your symptoms, examination findings and blood counts. Common effects can include tiredness, nausea, appetite changes, altered bowel habits, mouth soreness, hair changes or a lowered ability to fight infection. The exact pattern depends on the medicines used, and supportive medicines can ease several effects.

Keep a written list of medicines, symptoms and temperature readings if your team asks you to monitor them. Take anti-sickness medicines as prescribed, drink regularly unless your clinician has restricted fluids, and choose small meals with protein and energy when appetite is low. Gentle movement and planned rest can help you manage fatigue.

Before treatment starts, ask how to contact the oncology unit outside clinic hours. Tell the team about new medicines, dental problems, numbness, diarrhoea, constipation or difficulty eating so adjustments can be considered early. Do not stop treatment medicines without advice.

Contact your oncology team urgently for a fever or feeling suddenly unwell, because chemotherapy can reduce infection-fighting cells. Seek prompt advice for repeated vomiting, inability to keep fluids down, severe or persistent diarrhoea, unusual bleeding, breathlessness, chest pain, confusion or rapidly worsening weakness. Use the emergency service for severe breathing difficulty, collapse or heavy bleeding.

Ask which medicines you will receive, how they are given, how the team will judge the response, which side effects need a same-day call, and how chemotherapy affects the timing of surgery. Ask whether a port or other access device is needed and what support is available for work, food and bowel symptoms.