### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
My friend (aged 43),(mother died of breast cancer aged 57), has been diagnosed with rectal cancer, (located15cm within her rectum), that has been within her body for 12/18 months, key hole surgery has been ruled out and she is waiting for a CT scan to find out if this has spread. It is seen to be an infected area as opposed to a tumerous mass, but it is a rather large area thats involved. Can you tell me if this in your opinion, can be surgically removed without leaving her with a stoma or if it can be cured with radiotherapy and chemotharapy?  RegardsAnita

### output:

A rectal tumor which is located 15 cm from anal verge in the rectum can be removed surgically with an anterior resection without the need of a permanent stoma. Other factors have to be considered prior to this surgery including:1. Is the tumor localized or has distant Mets. A CAT scan of abdomen and pelvis and a chest radiograph would give the stage of the disease and confirm or rule out metastasis.2. Negative circumferential resection margins (CRM) can be obtained or not. An MRI of rectum will settle this issue. If patient has no distant metastasis and no perirectal extension (extension through rectal muscle into surrounding tissue) or perirectal lymph adenopathy (enlarged lymph nodes around rectum) then upfront surgery with anterior resection can be done. If there is perirectal extension (T3 tumor) or perirectal lymph nodes then neoadjuvant (pre-surgery) chemoradiation therapy needs to be given prior to anterior resection. If there are distant metastases then it's a palliative case requiring palliative surgery, chemotherapy or radiotherapy. I hope I have answered your query. You can discuss it with the treating oncologist. If you have any further questions I will be more than happy to answer.