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Surgery is the cornerstone of rectal cancer treatment. Oncological cure and overall survival continue to be the main goals, but sparing of the anal sphincter mechanism and functional results are also important. The modern management of rectal cancer is a multidisciplinary approach, and pre-operative staging is of crucial importance when planning treatment in these patients. Pre-operative staging is used to determine the indication for neoadjuvant therapy prior to surgical resection or to determine whether local excision is an option in carefully selected patients with early rectal cancer. Surgery in the form of total mesorectal excision (TME) has become the standard of care for mid and distal rectal cancers. Early rectal cancers do not require neoadjuvant therapy. For locally advanced cancers of the lower two-thirds of the rectum, the combination of surgical resection with chemoradiotherapy decreases local recurrence rates and probably improves overall survival. Whereas in the past local excision was only contemplated in patients who were unfit for radical surgery or for local palliation in cases of metastatic disease, over the last number of years there has been increasing interest in local treatment with curative intent in early rectal cancer. [ABSTRACT FROM AUTHOR]

Introduction: Colorectal cancer (CRC) is one of the most common cancers in the UK. Quality of life (QoL) is increasingly being recognised as an important endpoint in the management of CRC.Methods: Publications describing QoL in CRC were identified using Medline (PubMed) and PsychINFO. Reference lists of these articles were used to identify other relevant publications.Results: Seventy-two publications described QoL changes in CRC. These were grouped into three categories: studies of psychological and psychiatric morbidity in CRC patients, QoL and survival in CRC and effects of psychological intervention on QoL and survival.Conclusion: Assessment of QoL is becoming increasingly important but is not routinely performed in CRC. Standard, validated and reliable questionnaires to evaluate the impact of cancer and its treatment in patients are available. There is an increasing need to establish comprehensive biopsychosocial databases to evaluate the relationship between QoL and survival in CRC. [ABSTRACT FROM AUTHOR]