Malignant, Frail but Not Fading, Treating Rectal Cancer in the Vulnerable Elderly

Saturday, May 9, 2026

1:15 PM - 2:05 PM ET

Co-Moderator(s)

FF

Fergal Fleming, MD MPH FRCSI FACS

Associate Professor of Surgery and Oncology
University of Rochester Medical Center
University of Rochester Medical Center
Rochester, NY, United States

All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no relevant financial relationships.
HK

Hiroko Kunitake, MD MPH

Associate Professor
Harvard Medical School, Massachusetts General Hospital
Harvard Medical School, Massachusetts General Hospital
Boston, MA, United States

All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no financial relationships to disclose

CME .75 hours
Self-Assessment .75

Treating rectal cancer in older adults with baseline frailty presents a complex clinical challenge. Balancing the imperative for effective oncologic control against the heightened risks of treatment-related toxicity demands a nuanced, patient-centered approach. This symposium will delve into cutting-edge strategies for optimizing care in this vulnerable population, emphasizing comprehensive geriatric assessment, shared decision-making tailored to individual patient goals, innovative methods to minimize treatment toxicity, and evolving roles for non-operative management. Attendees will gain insights into delivering "just enough" treatment, maximizing benefit while preserving quality of life.

Learning Objectives:

Upon completion of this activity, participants should be able to:

Describe the role of geriatric assessment in evaluating treatment risks and aligning therapy with patient-centered goals in rectal cancer management.
Explain the evidence supporting prehabilitation as a strategy to optimize physical resilience and reduce toxicity during rectal cancer treatment in frail patients.
Critically assess the emerging role and indications for non-operative management in frail elderly patients with rectal cancer, including when surgery may be safely deferred.

Presentations:

1:15 PM - 1:20 PM ET

Introduction
1:20 PM - 1:30 PM ET

Prehabilitation in the Frail Patient Undergoing Rectal Cancer Therapy: Progress or Placebo?
Faculty: Christy Cauley, MD, MPH (she/her/hers) – Mass General Brigham
1:30 PM - 1:40 PM ET

Role of Non-Operative Management in the Frail Rectal Cancer Patient: Is Total Mesorectal Excision (TME) Obsolescent?
Faculty: Colleen Donahue, MD (she/her/hers) – Medical University of South Carolina
1:40 PM - 2:05 PM ET

Case Discussion