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Courtesy of Robin Noel The cancer is first staged by physical exam when the doctor examines the anal canal to assess the size of the tumor and where it is growing. They are well-versed in the treatment of both benign and malignant diseases of the colon, rectum and anus and are able to perform routine screening examinations and surgically treat conditions if indicated to do so. In addition, some cancers that recur despite treatment may be successfully treated with surgery if they are caught early, so patients are encouraged to report any concerning symptoms to their treating physicians right away. In the rectum, the muscularis propria is formed by the inner circular layer and the outer longitudinal layer. Tumor regression and down-staging resulted from neoadjuvant LCCRT may also help complete resection of the tumor and may make a sphincter-saving procedure possible in low rectal tumors , - For cancers located in the distal rectum without invasion to the anal sphincter, a very low anterior resection VLAR or ultra low anterior resection ULAR have been recommended
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