American Board of Internal Medicine (ABIM) Certification Practice Exam

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What should be avoided in patients with stage I rectal cancer post-surgery?

Chemotherapy
Regular check-ups
Follow-up imaging
Dietary restrictions

The correct answer is: Chemotherapy

In patients with stage I rectal cancer after surgery, chemotherapy is generally not recommended as part of the standard postoperative approach. Stage I rectal cancer is characterized by the cancer being confined to the rectal wall without lymphatic invasion or metastasis. The primary treatment for stage I rectal cancer is usually surgical resection, potentially followed by observation. The low risk of recurrence in this stage means that the benefits of added chemotherapy, which can entail significant side effects and toxicity, often do not outweigh the risks. Therefore, routine adjuvant chemotherapy is avoided in this situation. On the other hand, regular check-ups, follow-up imaging, and dietary considerations may be beneficial for monitoring the patient's recovery and addressing any concerns about nutrition or gastrointestinal function post-surgery.