What is the recommended initial management for Duke's C2 caecal cancer?

In the case of Duke's C2 caecal cancer, the recommended initial management is to proceed directly to surgery. Duke's C classification provides a way to stage colorectal cancer, and C2 indicates that the cancer has penetrated the bowel wall and involves regional lymph nodes. In such cases, surgical intervention is critical to remove the tumor and any affected lymph nodes, as this approach can potentially lead to a cure or significantly prolong survival.

Surgery is the standard management because it allows for the complete resection of the tumor, which is paramount in achieving the best oncological outcome. Following surgery, adjuvant treatments such as chemotherapy might be considered depending on various factors including the patient's overall health, surgical margins, and any additional risk factors for recurrence, but the initial focus is on surgical intervention.

The other management options, although relevant in different scenarios, do not align with the initial treatment protocol for this specific stage of cancer. Chemotherapy is typically not administered as an upfront strategy in the context of resectable Duke's C2 disease, radiotherapy is generally not a primary treatment for caecal cancer, and palliative care is reserved for advanced cases where curative treatment is no longer feasible. Thus, the priority is surgical management to address the