A new treatment for rectal cancer could eliminate the need for surgery, a study says

A new treatment for locally advanced disease rectal cancer Treatment with corticosteroids is showing promising results that could allow some patients to avoid surgery altogether. This new approach also reduces the likelihood of cancer recurrence. According to a study conducted at Uppsala University and published in eClinicalMedicine, the treatment method has proven to be effective in everyday healthcare settings. tumor “The cancer disappears completely more often, which increases the chance of avoiding surgery and preserving the rectum and its normal function. In addition, there is less metastasis,” said Bengt Glimelius, Professor of Oncology at Uppsala University and Senior Consultant at Uppsala University Hospital.

Rectal cancer affects about 2,000 people a year in Sweden, and about a third of those cases are at high risk of recurrence. Traditional treatment usually involves removing part of the bowel, which can lead to complications such as the need for a stoma or bowel control problems. Patients typically undergo radiotherapy or a combination of radiotherapy and chemotherapy for five weeks, followed by surgery and often additional chemotherapy for up to six months.

However, the Uppsala University study suggests that giving all radiotherapy and chemotherapy before any possible surgery could double the chances of avoiding surgical removal of the bowel. “If the tumor disappears completely during treatment, surgery is not necessary. This means that the rectum is preserved and the need for a stoma and a new rectum is eliminated,” Glimelius explained. He noted that preserving the rectum avoids the problem of a reconstructed bowel frequently sending signals to the brain about the need to go to the bathroom.

The study included data from 461 patients collected through the Swedish Colorectal Cancer Registry (SCRCR), with contributions from numerous physicians, researchers and research nurses. Traditionally, treatment for locally advanced rectal cancer has included radiotherapy and chemotherapy, followed by surgery and additional chemotherapy.

Four years ago, a randomized trial indicated that a treatment regimen of one week of radiation therapy followed by four-plus months of chemotherapy resulted in more cases of complete tumor clearance and fewer distant metastases, although it showed a slight increase in local recurrences over time.

Uppsala was the first region to adopt this new treatment approach, initially shortening the chemotherapy period to three months. Several other regions subsequently adopted the strategy. The latest study confirms these findings, but crucially points out that the increase in local recurrences seen in the earlier study was not observed here. “With the old treatment, the randomised study found no tumour in 14 per cent of patients who underwent surgery. The new model doubled that figure to 28 per cent.

“The new Swedish study had the same results, but without an increase in the local recurrence rate after almost five years of follow-up,” Glimelius said, emphasizing the importance of verifying the effectiveness of experimental treatments in real-world health care settings.