Rectal cancer is a serious diagnosis that requires expert care and precision. Dr. Albert Chung, a highly trained colorectal surgeon in Santa Margarita, CA, specializes in advanced rectal cancer surgery, including minimally invasive and robotic-assisted procedures. If you or a loved one has been diagnosed with rectal cancer, call (714) 988-8690 to schedule a consultation and explore your treatment options.
The rectum is the final section of the large intestine, where waste is stored before exiting the body. When abnormal cells in the rectal lining grow uncontrollably, they can form tumors that, if left untreated, may spread to nearby organs, lymph nodes, or beyond. More than 44,000 new cases of rectal cancer are diagnosed in the United States each year, which is why early detection and skilled treatment matter so much.
Rectal cancer often develops without warning, but when symptoms do appear, they typically include:
These symptoms overlap heavily with hemorrhoids, IBS, and other benign conditions, which is why a proper evaluation is essential rather than self-diagnosis.
Several factors raise the likelihood of developing rectal cancer.
Dr. Chung will conduct a thorough evaluation, which may include:
Treatment is tailored to the stage of cancer, location of the tumor, and your overall health. For most patients, surgery is the primary treatment, often combined with chemotherapy, radiation therapy, or immunotherapy depending on the case.
A low anterior resection (LAR) removes the cancerous portion of the rectum while preserving bowel function. For tumors located lower in the rectum, a proctectomy with anastomosis reconnects healthy sections of the digestive tract. The goal whenever possible is to remove the cancer while preserving the patient's quality of life and avoiding a permanent colostomy.
Three main approaches are used in rectal cancer surgery, each with different tradeoffs.
Dr. Chung specializes in robotic-assisted rectal cancer surgery using the da Vinci surgical system. The technology gives him a level of precision and visualization that traditional approaches simply can't match, particularly when operating in the tight confines of the pelvis.
Compared to traditional approaches, robotic-assisted surgery may offer:
Robotic-assisted surgery offers many advantages, but it isn't the right answer for every case. The best approach depends on tumor size, location, stage, and your overall health. Dr. Chung will assess your specific situation and recommend the treatment plan that gives you the best chance of full recovery and quality of life.
The question every rectal cancer patient asks first is whether they will need a permanent bag. For most, the answer is no. A low anterior resection removes the rectum and reconnects the colon to the remaining rectum or directly to the anal canal, preserving the sphincter muscles that control continence. Even tumors within a few centimeters of the anus can often be treated with sphincter preservation when chemoradiation shrinks them first and the surgeon can work precisely in the narrow pelvis, which is where robotic instruments make the most difference. Abdominoperineal resection with a permanent colostomy is reserved for tumors that invade the sphincter itself or sit so low that removing the cancer with a clear margin would leave no functioning muscle.
When the colon is joined very low in the pelvis, especially after radiation, the connection needs time to heal without stool passing through it. A temporary loop ileostomy diverts stool into a small pouch on the abdomen for about eight to twelve weeks. It is not a colostomy and it is not permanent: once imaging confirms the join has healed, it is closed in a short second operation and bowel function is restored. An ostomy nurse teaches you to manage the pouch before you leave the hospital, and most patients find it far more manageable than they feared.
Treatment for locally advanced rectal cancer has shifted in the last several years. Total neoadjuvant therapy delivers both chemotherapy and radiation before surgery rather than splitting them around it, which improves the chance that the tumor shrinks completely. A meaningful proportion of patients have no detectable tumor left when treatment finishes. In carefully selected cases, those patients can be offered a watch-and-wait approach with close surveillance instead of immediate surgery, keeping the rectum intact. Dr. Chung discusses this option with patients whose response justifies it and follows them on a strict examination and MRI schedule, with surgery held in reserve.
The rectum's job is storage, and after part or all of it is removed, bowel habits change. Frequent, clustered bowel movements, urgency, and difficulty telling gas from stool are common in the first months, a pattern called low anterior resection syndrome. For most patients it improves substantially over six to twelve months with fiber, timed toileting, pelvic floor therapy, and sometimes medication. Dr. Chung addresses this at every follow-up rather than waiting for patients to raise it, because it is treatable and it is the part of recovery that most affects quality of life.
Rectal cancer surgery is the operation where a colorectal fellowship and robotic experience matter most, because the pelvis is narrow, the nerves that control bladder and sexual function run alongside the rectum, and the difference between a permanent colostomy and a preserved sphincter is often a matter of millimeters. Dr. Chung performs these operations robotically for patients from across Orange County.
Dr. Chung sees patients at 30212 Tomas, Suite 365, Rancho Santa Margarita, CA 92688, off the 241 toll road in South Orange County. Patients come from Mission Viejo, Lake Forest, Irvine, Laguna Hills, Laguna Niguel, Aliso Viejo, San Juan Capistrano, Ladera Ranch, Trabuco Canyon, Santa Ana, and across Orange County. Most new patients are seen within days, and a first visit usually includes the exam, a plain-language explanation, and a treatment plan the same day.
Not ready for an in-person visit? Dr. Chung also offers online video consultations. Read what patients say on the reviews page.
Most patients do not. Sphincter-preserving surgery (low anterior resection) is possible for the majority of rectal cancers, including many low tumors after chemoradiation. A permanent colostomy is needed only when the tumor involves the sphincter muscles or sits so low that a clear margin cannot be achieved otherwise.
A colostomy brings the colon to the skin; an ileostomy brings the small intestine to the skin. After rectal cancer surgery, a temporary loop ileostomy is often used for two to three months to protect the healing join, then closed. A permanent colostomy is created only when the anus is removed.
Most rectal cancers beyond stage I are treated with chemoradiation, and often chemotherapy, before surgery. This shrinks the tumor, lowers the chance of local recurrence, and increases the odds of sphincter preservation. Stage I rectal cancers may go straight to surgery or, for very small tumors, local excision.
Three to five days in the hospital, two to four weeks to return to desk work, and six to eight weeks to full activity. Bowel function continues to improve for six to twelve months. If a temporary ileostomy was used, its closure adds a second short hospital stay a few months later.
The nerves controlling both run along the pelvic sidewall next to the rectum. Robotic surgery's magnified 3D view and precise instruments allow those nerves to be identified and preserved in most cases. Temporary changes are common in the first weeks; permanent dysfunction is uncommon with nerve-sparing technique. Dr. Chung discusses this candidly before surgery.
In selected patients whose tumor disappears completely after total neoadjuvant therapy, a watch-and-wait approach with intensive surveillance is an option. Roughly a quarter to a third of patients treated this way have a complete response. It requires strict follow-up, and surgery remains available if the tumor regrows.
Whether you're navigating a new rectal cancer diagnosis or seeking a second opinion on your treatment plan, Dr. Chung can help you understand your options and choose the approach that's right for you.
Book a consultation Call (714) 988-8690Prompt diagnosis and treatment greatly improve colorectal cancer outcomes. Call Dr. Albert Chung’s colorectal clinic in Orange County.
