When is radiotherapy recommended for rectal cancer?

The team reviews MRI and other scans, the tumour's position in the rectum, how deeply it extends, and whether nearby lymph nodes are involved. Treatment before surgery can shrink or control the tumour and help the surgeon plan an operation. Radiotherapy may be combined with chemotherapy, given in a shorter planned course, or considered after surgery when the findings indicate a local treatment need. If cancer cannot be removed or causes bleeding, pain, or narrowing, radiotherapy may help ease those problems.

The bowel, bladder, and reproductive organs lie near the treatment area. Possible effects include loose stools, urgency, discomfort when passing urine, tiredness, and skin irritation. Some bowel or sexual effects can continue after treatment and should be discussed early.

Ask how radiotherapy will be timed with surgery and chemotherapy, and whether a temporary stoma is part of the surgical discussion. Tell the team about bowel habits, bleeding, urinary symptoms, sexual function, fertility plans, and previous abdominal treatment. Follow instructions for planning scans, bladder filling, or bowel preparation if provided.

Call the treatment team promptly for persistent diarrhoea, inability to drink, fever, increasing rectal bleeding, severe abdominal swelling, or worsening pain. Seek emergency help for heavy bleeding, repeated vomiting, fainting, or inability to pass stool or gas with severe pain.

Ask what the scans show, whether treatment is before or after surgery, and how chemotherapy fits in. Discuss bowel, bladder, sexual and fertility effects, nutrition, stoma planning, symptom relief, follow-up scans, and who to call outside clinic hours.