Management of stage IV rectal cancer: palliative options

World J Gastroenterol. 2011 Feb 21;17(7):835-47. doi: 10.3748/wjg.v17.i7.835.


Approximately 30% of patients with rectal cancer present with metastatic disease. Many of these patients have symptoms of bleeding or obstruction. Several treatment options are available to deal with the various complications that may afflict these patients. Endorectal stenting, laser ablation, and operative resection are a few of the options available to the patient with a malignant large bowel obstruction. A thorough understanding of treatment options will ensure the patient is offered the most effective therapy with the least amount of associated morbidity. In this review, we describe various options for palliation of symptoms in patients with metastatic rectal cancer. Additionally, we briefly discuss treatment for asymptomatic patients with metastatic disease.

Keywords: Endorectal stenting; Laser ablation; Malignant bleeding; Malignant obstruction; Palliative therapy; Rectal cancer.

Publication types

  • Review

MeSH terms

  • Hemorrhage / etiology
  • Hemorrhage / therapy
  • Humans
  • Intestinal Obstruction / etiology
  • Intestinal Obstruction / therapy
  • Laser Therapy
  • Neoplasm Staging
  • Palliative Care / methods*
  • Rectal Neoplasms / complications
  • Rectal Neoplasms / pathology*
  • Rectal Neoplasms / therapy*
  • Stents