Chemotherapy is a cyclical treatment, not something that can be done overnight. Patients with rectal cancer need to come to the hospital regularly for infusion of chemotherapy drugs, but whether chemotherapy can be done depends on whether the patient’s physical condition meets the standard, which is mainly the result of various hematological tests and physical status score of the patient. The conventional standard is that the patient’s hemoglobin is not less than 90g/L, white blood cells (3.5~4) ×1012/L, platelets (8~10) ×109/L, and albumin above 30g. These values are the minimum limits, and it is better to be higher than this index. Some patients with hemoglobin of blood in stool can hardly reach 90g/L, and patients can only be asked to come as close as possible. Zhigang Bai, Department of General Surgery, Beijing Friendship Hospital, understands the chemotherapy cycle There are two regimens of preoperative chemotherapy for rectal cancer: the two-week regimen and the three-week regimen. The two-week regimen requires only infusions and no medication. Oxaliplatin plus fluorouracil chemotherapy is used, and calcium folinic acid infusion is also required to increase the chemotherapeutic effect of fluorouracil. All three drugs are infused within 48 hours. Patients only need to be hospitalized for 2~3 days; the specific time distribution is: patients have chemotherapy on day 1-2, rest for 12 days, then start the second cycle of chemotherapy on day 15, rest for another 12 days and then have surgery; the three-week chemotherapy regimen (21-day regimen) is: patients have oxaliplatin infusion on day 1, and the infusion is finished in about 2~3 hours, followed by starting two weeks of oral chemotherapy drugs, resting for another week, and then starting the next cycle of chemotherapy. The time distribution is approximately: chemotherapy on day 1, oral chemotherapy drugs on days 1~14, rest on days 15~21, and the next cycle of chemotherapy starts on day 22. These two regimens are commonly used in chemotherapy for rectal cancer. Identifying the side effects after chemotherapy When chemotherapy is mentioned, patients are most concerned about the side effects. The most common side effect of chemotherapy is myelosuppression, which is also known as low white blood cells, low platelets, low red blood cells, etc. Besides, there are nausea, vomiting, abnormal liver and kidney functions, etc. There are also two special drug reactions in rectal cancer chemotherapy. The first one is peripheral neurosensory lesions produced after the application of oxaliplatin. With the prolongation of drug application and the accumulation of toxicity, patients will experience numbness in fingers and arms, and will feel electric shock after encountering cold stimulation, so patients should try to avoid touching anything cold (cold water, cold drinks, cold air, open refrigerator, etc.) after drug application. Due to the short cycle of preoperative chemotherapy, there is generally not much toxin accumulation, and patients have less chance of side effects. Another common side effect is hand-foot syndrome after oral capecitabine, such as dry skin on hands and feet, skin pigmentation, patients will have some scattered small black dots on the palms of hands and feet, and in severe cases, patients will come out with whole body pigmentation and their faces will turn black. However, after stopping the medication, the patient’s skin will gradually recover and the patient should not worry. Recognizing these two special side effects in advance, patients need not be alarmed when they appear.