How treatment is planned

A group of experts called a multidisciplinary team (MDT) will meet to discuss your treatment. After the meeting, your specialist will talk to you about the types of treatment you may be able to have. This will depend on the stage of the cancer and where it is in the rectum. It will also depend on your general health and what you may prefer.

Surgery is the most common treatment for rectal cancer, but other treatments may also be used to reduce the risk of the cancer coming back. It is important to understand why your treatment has been suggested and what side effects it may cause. It may help to make a list of questions you want to ask them. You might also want to take a relative or friend with you when the treatment is first explained.

You will need to give permission (consent) before you start your treatment, but you can also decide not to have it. Take as much time as you need to make your decision.

Multidisciplinary team (MDT)

In most hospitals, a team of specialists called a multidisciplinary team (MDT) will talk to you about the treatment they feel is best for your situation.

This MDT will include a:

  • surgeon who specialises in bowel cancers
  • medical oncologist who specialises in chemotherapy and targeted therapies
  • clinical oncologist who specialises in radiotherapy, chemotherapy and targeted therapies
  • radiologist who helps to interpret x-rays and scans
  • pathologist who advises on the type and size of the cancer
  • colorectal cancer nurse specialist who specialises in cancers of the colon and rectum, and offers support and information
  • stoma care nurse who helps to care for a stoma when someone has had a colostomy or ileostomy operation.

It may also include other healthcare professionals, such as a gastroenterologist (doctor who specialises in bowel problems), dietitian, physiotherapist, occupational therapist, psychologist or counsellor.

If the cancer has spread to your liver, you may also be referred to an MDT that specialises in surgery for secondary cancer in the liver. In this situation, the two MDTs will work together to plan your treatment.

Your specialist team will consider a number of factors when advising you on your treatment options. These include your general health, the stage of the cancer and if it has spread to other parts of the body.

How does an MDT work?

How the team is organised will depend on where you live - they may be slightly different across the UK. Some MDTs discuss patients from different hospitals. Specialists may be on teams for a number of different types of cancer.

How often an MDT meets may also vary. This could mean that you have to wait a bit longer to get all the results of your scans and a treatment plan from your doctor. This can be frustrating and worrying - but the pooling of different types of expertise should mean the best possible decisions are made about your treatment and care.

If waiting for results is making you anxious, you may find it helpful to talk about how you’re feeling with a partner, your family or close friends. You can also talk things over with one of our cancer support specialists on 0808 808 00 00.

Benefits of an MDT

The National Institute for Health and Care Excellence (NICE) recommend that people with cancer should be managed by a multidisciplinary team. People cared for by an MDT are more likely to:

  • receive accurate diagnosis and staging
  • be offered a choice of treatments decided by a group of experts, rather than by one doctor
  • receive better coordination and continuity of care through all stages of the cancer
  • be treated in line with locally agreed policies and national guidelines
  • be offered appropriate and consistent information (because the person giving the information should be aware of the team’s strategy for your care)
  • have their psychological and social needs considered – communication between different team members is better where they have a formal working relationship.

Giving consent

Before you have any treatment, your doctor will explain its aims. They will ask you to sign a form saying that you give permission (consent) for the hospital staff to give you the treatment.

No medical treatment can be given without your consent.

Before you are asked to sign the form, you should be given full information about:

  • the type and extent of the treatment
  • its advantages and disadvantages
  • any significant risks or side effects
  • any other treatments that may be available.

If you don’t understand what you’ve been told, let the staff know straight away, so they can explain again. Some cancer treatments are complex, so it’s not unusual to need repeated explanations.

It’s a good idea to have a relative or friend with you when the treatment is explained, to help you remember the discussion.

You may also find it useful to write a list of questions before your appointment.

People sometimes feel that hospital staff are too busy to answer their questions, but it’s important for you to know how the treatment is likely to affect you. The staff should be willing to make time for your questions.

You can always ask for more time if you feel that you can’t make a decision when your treatment is first explained to you.

You are also free to choose not to have the treatment. The staff can explain what may happen if you don’t have it. It’s essential to tell a doctor or the nurse in charge, so they can record your decision in your medical notes. You don’t have to give a reason for not wanting treatment, but it can help to let the staff know your concerns so they can give you the best advice.

Back to Who will be involved in my treatment decision?

Getting a second opinion

There are many reasons for wanting a second opinion about your treatment. Speak to your specialist or GP.

Making a complaint

If you are unhappy with the treatment or care you have received, you may want to make a complaint.