Treatment Options

Treatment Options

At Seattle Cancer Care Alliance (SCCA), your cancer care team has access to all the standard treatment options and possibly new therapies available only in clinical studies. This is one advantage of seeking treatment at SCCA.

Making Treatment Choices Together

Your team will recommend a treatment plan based mainly on the stage, size, and location of your cancer. The stage depends on whether or not your cancer has spread from its original site and how far it has spread. Your treatment also depends on your overall health and the ways different treatments can be combined.

Ask your team to explain which treatment options make the most sense for you, why, and what to expect so that you and your team can choose the best course of treatment together.

Standard Treatments

Treatment of rectal cancer often begins with several weeks of radiation therapy along with oral chemotherapy to shrink the cancer.  After having some time to heal, the next step is surgery to remove the cancer. Most people have more chemotherapy after surgery to reduce the risk of the cancer coming back (recurring).

If rectal cancer has already spread (metastasized) to another area of the body, then doctors usually do not do surgery because usually it’s not possible to remove all the cancer. Instead, they use chemotherapy and targeted therapies to control the disease. Surgery may be done, if there’s a chance of removing all the cancer. Radiation therapy may be helpful for treating specific spots where cancer has spread.

There are many similarities between rectal cancer and colon cancer, but there are some differences in the ways they are usually treated. For information about colon cancer, visit the section on colon cancer treatment options.

Newly Diagnosed

Studies have shown that the first treatment you receive for cancer is by far the most important. Rectal cancer is a serious illness. Seattle Cancer Care Alliance has the experience and specialists to treat it.

Radiation Therapy

Radiation therapy uses high-energy X-rays or other types of radiation to kill cancer cells. For rectal cancer, doctors most often use intensity-modulated radiation therapy (IMRT).

Proton Therapy

Proton therapy is a precise form of radiation treatment that targets protons at tumors to kill cancer cells, while significantly limiting radiation exposure to surrounding healthy tissue.


Chemotherapy is often given with radiation therapy. It is used again after surgery to complete the treatment. It is the main treatment for people who aren’t having surgery.


Most people with rectal cancer have surgery. A procedure called total mesorectal excision—the most advanced treatment for rectal cancer—is available at SCCA.

Targeted Therapy

Biological therapies that target cancer cells may be used against metastatic colorectal cancer.

Follow-Up After Treatment

SCCA provides comprehensive follow-up care once you complete your cancer treatment, including visits with the same team who treated your cancer. Our patients say they find it reassuring to see the same team when they come for their follow-up visits.