Surgery is the primary form of treatment for rectal cancer, although radiation and chemotherapy may also be administered before surgery (neoadjuvant therapy) or following surgery (adjuvant therapy). The type of surgery used depends on the stage of the cancer, its location in the rectum, and the goals of treatment. Tap each type of surgery on the left-hand side of the chart for more information on that type of surgery.

Polypectomy and local excision	Polyps in the rectum and small cancers in the rectal wall that do not involve the full thickness of the wall can be removed during colonoscopy.
Local transanal resection	Early Stage I cancers located close to the anus can be removed with instruments inserted through the anus. All layers of the rectal wall are removed along with a margin of normal tissue before the hole in the rectal wall is repaired. Local lymph nodes are not removed.
Transanal endoscopic microsurgery	Similar to a local transanal resection, but performed endoscopically for cancers that are higher up in the rectum.
Low anterior resection	Surgery is performed through the abdominal wall to remove Stage I or Stage II or III cancers in the upper part of the rectum. Lymph nodes and surrounding tissues are removed, and the colon is reattached to the remaining portion of the rectum.
Proctectomy with colo-anal anastomosis	Some Stage I – III cancers in the lower part of the rectum require the removal of the entire rectum (a proctectomy). Local lymph nodes and surrounding tissues are also removed. The colon is then reattached to the anus.
Abdominoperineal resection	Used for Stage I – III cancers that require the removal of the rectum as well as the anus and sphincter muscles. This requires the creation of a permanent colostomy.
Pelvic exenteration	A major operation that removes the rectum and nearby organs such as the bladder and prostate or uterus, used for cancers that are growing into adjacent organs. This also requires the formation of a permanent colostomy. If the bladder is removed, a urostomy is also needed.