The diagnosis and treatment of patients with locally advanced rectal cancer is complex, and a multidisciplinary approach is essential.
This functional unit aims to assess the oncological patient holistically, providing care from professionals of various specialties in a shared time and work space. This approach enables a comprehensive understanding of the pathology and facilitates shared decision-making.

Objectives
- To provide high-quality, multidisciplinary, multi-professional, and multimodal care to patients affected by rectal cancer:
a. Unifying care delivery.
b. Optimizing care pathways.
c. Determining the best therapeutic strategy for each patient.
- To serve as a reference unit for patients, offering a comprehensive understanding of their illness and respecting their preferences.
- For patients with a recent diagnosis of rectal neoplasia requiring multimodal treatment, ensure simultaneous evaluation by professionals from all relevant specialties -General Surgery, Medical Oncology, Radiation Oncology, and Nursing, if applicable- to collaboratively determine the optimal treatment and reduce hospital visits.
- To identify patients who require comprehensive assessment by the Oncology Unit and refer them to prehabilitation programs.
- To identify patients with malnutrition or at risk of malnutrition and ensure early referral to Nutrition and Dietetics.
- To assess treatment response and control toxicity after neoadjuvant therapy.
- To coordinate management of tumour-related complications during neoadjuvant therapy (e.g., bleeding, intestinal obstruction, abscess formation) that may necessitate changes in the therapeutic plan.
- To conduct a multidisciplinary evaluation of patients following neoadjuvant therapy in order to plan surgical strategy.
- To jointly assess the patient post-surgery to determine the best timing for resuming systemic treatment and, if required, to schedule optimal timing for intestinal transit reconstruction.
- In cases where an organ preservation strategy (Watch & Wait) is followed, to conduct joint patient monitoring.
- To continuously evaluate patient quality of life, adapting care to their needs and proactively diagnosing complications related to cancer.
- To detect and initiate early treatment of LARS symptoms.
- To identify patients who need referral to the Pelvic Floor Functional Unit.
- To promote professional education in multimodal rectal cancer treatment.
- To lead multidisciplinary scientific research and clinical trials related to rectal cancer.
- To encourage involvement in rectal cancer research among trainees.
- To maintain a registry of Functional Unit patients and related activities, enabling data analysis and outcome evaluation.
- To foster internal communication among professionals to enhance care pathways.
- To hold an annual multidisciplinary meeting to update advancements in rectal cancer diagnosis and treatment.
Team and Services involved
Medical Oncology
● David Páez López-Bravo
● Anna C. Virgili Manrique
● Berta Martín Cullell
● Maria Nieva Muñoz
Radiation Oncology
● Josep Balart Serra
● Joan Carles Julià Sanahuja
General i Digestive Surgery
● M. Carmen Martínez Sánchez
● Beatriz Espina Pérez
● Anna Sánchez López
● Oriol Pino Pérez
● Pol Guarner Piquet
Digestive Endoscopy
● Patrícia Pedregar Pascual
● Jordi Gordillo Ábalos
Radiodiagnosis
● Juan Carlos Pernas Canadell
● Javier Oliva Ibarz
● Miguel Ángel Ríos Vives
Nuclear Medicine
● Mònica Velasco Nuño
Pathological Anatomy
● Justyna Szafranska
● Victoria Fusté Chimisana
● Caterina Fumagalli
Oncogeriatrics
● Olga Torres
● Álvaro Santos
Case Management Nursing
● Lucía Ramírez López
Colorectal Nurse / Stomatotherapist
● Mercedes Rubio Vázquez
Multidisciplinary sessions and committees
The Colorectal Cancer Committee meets every Tuesday from 8:00 to 10:00 a.m. All colorectal cancer diagnoses are reviewed.
In the Rectal Cancer Functional Unit, patients diagnosed with rectal cancer are jointly evaluated every Tuesday from 10:00 a.m. to 12:00 p.m.