The patient has developed malignant large bowel obstruction secondary to her rectal cancer. A self-expanding metal stent allows both immediate bowel decompression and subsequent palliation of the tumor. A colonic decompression tube would relieve the acute obstruction but would not provide a long-term solution for the patient. Emergency surgery could be performed but would be less than ideal given the patients comorbidities and advanced cancer. Radiation therapy is not a treatment for an acute large bowel obstruction.