Elevating Individualized Care on Colorectal Cancer Awareness Month

During National Colorectal Cancer Awareness Month in March, Brandon Mancini, MD, MBA, FACRO, spoke with Krishan R. Jethwa, MD, MPH, about key themes that have emerged with the use of radiotherapy in the field. Among several topics discussed in this episode of RadOnc on the Run, the experts highlighted how the treatment paradigm has evolved to encompass more individualized treatment decision-making, particularly for patients with rectal cancer.

More than a decade ago, the standard of care for patients with locally advanced rectal cancer entailed a “cookie cutter” treatment pathway consisting of long-course chemoradiotherapy, surgery, and adjuvant systemic therapy, according to Jethwa. Over time, the field began to adopt more personalized treatment algorithms depending on patient goals, wishes, and values to optimize cancer control while protecting long-term quality of life and function. 

Jethwa also touched upon strategies for mitigating acute and long-term toxicities, which range from fatigue and diarrhea in the short term to incontinence and bowel-related issues later down the line. Other topics of conversation included the evolution of imaging, genomics, and genetics in the field, as well as the potential next steps for researching risk stratification. 

“Rectal cancer is a highly heterogeneous disease [with] a broad spectrum of local risk and a broad spectrum of risk for distant metastasis. Having the optimal treatment approach does require multidisciplinary care,” Jethwa said. “In 2026 and beyond, the care of patients is no longer one-size-fits-all. It's very much tailored to the individual. Contemporary practice utilizes all sorts of tools from a genomics imaging perspective, as well as multidisciplinary treatment approaches. It’s important for us to work together as colleagues and teammates to best care for our patients.”

Mancini is the medical director at Bold Advanced Medical Future Health, a clinical associate professor in the Department of Radiology at Michigan State University College of Human Medicine, and the editor at large for RadOnc Review, a supplement of the journal ONCOLOGY®. Jethwa is an assistant professor of Radiation Oncology at Mayo Clinic Rochester.