New Treatment For Rectal Cancer May Eliminate Need For Surgery: Study

A groundbreaking study conducted by researchers at Uppsala University has revealed promising results for a novel treatment approach for locally advanced rectal cancer. This new method has the potential to significantly reduce the need for surgery, which traditionally involves the removal of part of the bowel, often resulting in a stoma or complications with bowel control. The findings, published in eClinicalMedicine, suggest that this approach not only increases the likelihood of completely eradicating the tumour but also decreases the chances of cancer recurrence.

The Current Standard of Care

Rectal cancer, a condition that affects approximately 2,000 people annually in Sweden, has long been treated with a combination of therapies aimed at reducing the tumour size before surgical intervention. Typically, patients undergo a regimen of radiotherapy or a combination of radiotherapy and chemotherapy over five weeks. This is followed by surgery to remove the affected portion of the bowel and, in many cases, an additional six months of chemotherapy to ensure any remaining cancer cells are eradicated.

While this approach has been the standard, it comes with significant drawbacks. The surgical removal of part of the rectum often necessitates the creation of a stoma, where waste is diverted through an opening in the abdomen, or leads to difficulties in bowel control. These outcomes can greatly impact a patient’s quality of life, making the potential to avoid surgery a significant development in the treatment of rectal cancer.

A New Hope: Tumor Disappearance Without Surgery

The study conducted at Uppsala University explored a different treatment paradigm. Instead of rushing to surgery after the initial radiotherapy and chemotherapy, patients were given an extended period of these treatments first. Surgery was then performed only if necessary. The results were compelling: the chance of the tumour disappearing completely was significantly higher, which in turn increased the likelihood of patients being able to avoid surgery altogether.

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“If the tumour disappears completely during treatment, surgery is not required. This means that the rectum is preserved, and the need for a stoma is eliminated,” explained Professor Bengt Glimelius, a senior consultant at Uppsala University Hospital and a key figure in the study. He further noted that preserving the rectum not only avoids the physical challenges associated with a stoma but also maintains the natural function of the rectum, reducing the frequent and often urgent need to use the toilet that many patients experience after traditional surgery.

The Role of Chemotherapy in Tumor Reduction

The study also delved into the specifics of the treatment regimen that led to these positive outcomes. Four years ago, a randomized study introduced a new treatment model where patients received one week of radiotherapy followed by over four months of chemotherapy before surgery. This approach resulted in more cases where the tumour disappeared completely and fewer instances of metastasis. However, there was a slight increase in local recurrences, which caused some concern.

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In response, Uppsala University adapted this treatment by shortening the chemotherapy period to three months, aiming to maintain the benefits of the new approach while minimizing the risk of recurrence. The recent study confirmed that this modified treatment not only doubled the rate of tumour disappearance from 14 per cent to 28 per cent but also did so without increasing the rate of local recurrences after nearly five years of follow-up.

Implications for the Future of Rectal Cancer Treatment

The findings from this study are significant for both patients and healthcare providers. The possibility of avoiding surgery altogether could transform the standard of care for rectal cancer, offering patients a less invasive treatment option with fewer long-term side effects. Additionally, the absence of an increased recurrence rate in this study suggests that the new treatment model is both effective and safe, making it a viable option for widespread implementation in everyday healthcare.

Professor Glimelius emphasized the importance of these results, noting that “It is important to show that experimental treatments also work in everyday healthcare.” The success of this approach in a real-world setting, outside of the controlled environment of clinical trials, suggests that it could soon become a standard treatment for locally advanced rectal cancer.

Bottomline

The study conducted at Uppsala University marks a significant step forward in the treatment of rectal cancer. By potentially eliminating the need for surgery in a significant number of cases, this new approach offers hope for improved outcomes and quality of life for patients. As further research and clinical trials continue, this treatment could become a new standard in the fight against rectal cancer, providing patients with a less invasive, yet highly effective, option for managing their condition.