American Board of Internal Medicine (ABIM) Certification Practice Exam

What initial treatment is indicated for stage I rectal cancer?

1. Chemotherapy

2. Surgical resection

3. Radiation therapy

4. Combined chemotherapy and radiation

The correct answer is: Surgical resection

In stage I rectal cancer, the most appropriate initial treatment is surgical resection. This stage typically indicates that the cancer is confined to the rectal wall without evidence of lymph node involvement or metastasis. The primary goal of treatment for this early stage is to completely excise the tumor, which can often be achieved with surgical techniques such as a low anterior resection or an abdominal-perineal resection, depending on the tumor's location. Surgical removal is considered curative for stage I rectal cancer, and further treatments like chemotherapy or radiation are generally reserved for more advanced stages or specific cases where the cancer invades certain structures or has specific risk factors that warrant additional therapy. By removing the cancerous tissue surgically, patients can often achieve a good prognosis, with high rates of survival and lower likelihood of recurrence when followed by appropriate monitoring.