Study of Non-Surgical and Surgical Treatments for Rectal Cancer in Rural Areas Monitoring Patient Outcomes and Treatment Choices

What this Trial Is About

Researchers are evaluating different treatment approaches for patients with newly diagnosed rectal cancer, focusing on those in rural settings. The study observes patients who choose either surgical or non-surgical management after neoadjuvant therapy, aiming to understand patient preferences, adherence to follow-up, and quality of life over approximately six years. Surgery for rectal cancer can have significant side effects, and emerging evidence suggests some patients with complete response to initial treatment may avoid surgery without worsening outcomes, though this is still under study especially in rural populations. Patients will receive one of three standard treatment options involving chemotherapy and radiation before any surgery decision. Following neoadjuvant therapy, patients are restaged using physical exams, imaging, and blood tests to assess tumor response. Those with complete response may choose between surgery or intensive non-operative follow-up, which includes frequent endoscopy and imaging. Treatment interruptions may occur for severe side effects. Operative patients undergo surgery followed by chemotherapy or surveillance, while non-operative patients complete chemotherapy or begin surveillance directly. Participants will have clinic visits and complete surveys on pain, quality of life, and satisfaction at multiple points before, during, and after treatment. Monitoring includes blood tests, endoscopy, MRI or ultrasound, and CT scans at scheduled intervals for up to five years. Researchers will measure patient treatment preferences, adherence to surveillance, and quality of life outcomes. The study is observational, tracking how these treatments impact patients in a rural healthcare context over time.

Feasibility of Non-Operative Management of Rectal Cancer in a Rural Population