Neo adjuvant therpay has an established role in the treatment of patients with rectal cancer. There is some controversy in surgical circles about whether the beneficial effects of neoadjuvant therapy in `earlier' rectal cancers is only because of in-adequate surgery.
Patients with rectal cancers in the middle and lower third should have the disease staged using MRI and/or endoluminal ultrasound. If the lesion appears to be a T3-T4 lesion, then the patient is considered for neo-adjuvant therapy in the form of combined radio therapy and chemotherapy, following which they undergo surgical resection. Further adjuvant therapy is considered based upon the presumed stage of the lesion.