In patients with active IBD and rectal cancer, do you take any precautions before starting TNT?

First, I would be sure that the patient really needs TNT. If a patient has active inflammatory bowel disease, they will not tolerate TNT very well. If a patient has inactive IBD, there is not likely to be much added morbidity. I would be very hesitant to use TNT if someone has really active IBD. The...

I agree with @Dr. First Last's comments and would add that the value of the current widespread trend of the use of TNT is in the realm of non-operative management. If that is not the plan, giving all the treatment upfront is often over-treatment. I would make sure there is an indication for radiatio...