The anal sphincter-preserving operation (ASP) has represented a significant improvement in surgical procedure for lower rectal cancer patients in recent years. Discussion has continued, however, on how to manage the reduced fecal function after such surgery. This case report describes how to help a patient with lower rectal cancer after ASP to overcome the problems due to changes in fecal function. Process recording was used to document the nursing process from Jan. 18 to Feb. 1, 2007. Data collected from interview, observation, and medical records, show that the patient revealed four vital nursing problems: fecal function disorder, impaired skin integrity, inappropriate regulation of diet, and powerlessness. After practicing pelvic floor exercises, adjusting her fecal behavior and modifying her food intake, the patient regained control of her fecal function and improved her quality of life.