Shared Decision-Making for Rectal Cancer Treatment: A Path Forward

Patients diagnosed with cancer of the rectum face very difficult surgical decisions–whether to have a colostomy or a colorectal anastomosis. Despite significant advances in surgical techniques and improved oncologic outcomes, this decision is far from easy. Many patients can find the idea of a permanent colostomy untenable. On the other hand, other patients find that restorative reconstruction is associated with significantly impaired bowel function. Most will agree that patient preferences should play a major role to improve decision quality and minimize decisional regret for the treatment of colon and rectal cancer. However, there is very little evidence that patients are informed, involved, and understand the potential challenges that they face with both these surgical methods. In many clinical fields, the idea of shared decision-making and the use of patient decision aids have emerged to try and address this issue.