Prof. Dr. Geerard Beets Is Specialist In De Wait And See Behandeling

“Watch and wait” for rectal cancer

Many patients with rectal cancer will be treated with chemoradiation therapy (a combination treatment of radiation therapy and chemotherapy) before their surgery. Chemoradiation therapy can shrink the tumor. We use an MRI scan and/or sigmoidoscopy to check the tumor size prior to the surgery. Some patients are completely tumor-free as a result of the treatment. These patients can choose for a “Watch and wait” procedure as an alternative to the surgery.

"Watch and wait" means that we wait to see if the tumor stays away. You will not have surgery, but will have to come in for regular screenings. This helps us avoid the risks that come with surgery, permanent ostomy, and less problems with incontinence or sexual health than you would after surgery. Professor dr. Geerard Beets from the Netherlands Cancer Institute is the national expert in the “watch and wait” strategy for rectal cancer. 

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"Watch and wait" strategy - what to expect?

The treatment aims to be an organ sparing alternative to surgery after chemoradiation therapy. You avoid the risks associated with surgery such as a permanent ostomy, and less incontinence or sexual health problems. Instead of surgery, you will come in for regular screenings for five years in order to detect a possible recurrence at an early stage. You will have to come in for MRI scans, sigmoidoscopies, physical examinations, and blood tests. 

Who is eligible for the “Watch and wait” strategy?

Only patients whose tumor has completely disappeared from the rectum and surrounding lymph nodes after chemoradiation therapy are eligible for this strategy. Before the start of the treatment, we will make an MRI scan and a sigmoidoscopy. If we find any remaining tumor tissue after the chemoradiation therapy, “watch and wait” will not be possible for you. 

Not (yet) sure if the tumor is completely gone?

If only a small part of the tumor remains, or if we are not (yet) sure whether the tumor is entirely gone, ‘Transanal Endoscopic Microsurgery’ (TEM) may be an option for you. During this treatment, your surgeon will remove the part of the rectum with the tumor. The difference between this treatment and regular surgery for rectal cancer is that no incisions need to be made in the abdomen, and you will not require a colostomy. 


There will be a chance of tumor recurrence. We will evaluate the situation through additional diagnostic tests, and find the best treatment option for you. 

More information

For more information about the “Watch and wait” strategy, please contact the Clinical Nurse Specialist GE between Monday and Friday between 09:00-11:00 at our general phone number, +31 (0)20 512 9111.