Rectal cancer is more likely to spread to the lymph nodes in younger patients, according to new findings that Fox Chase Cancer Center researchers will be presenting on October 29 at the American Society for Radiation Oncology's 54th Annual Meeting. The results—which are the first of their kind—suggest that doctors should search for spreading more aggressively in these patients.
Once rectal cancer has spread to the lymph nodes, it is more likely to return to the pelvis following surgery. Administering chemotherapy and radiation before surgery reduces that risk, so before the procedure doctors typically perform a scan—ultrasound, PET, or MRI—to search for signs of cancer in the lymph nodes.
These findings suggest that doctors should hunt for affected lymph nodes more aggressively in younger patients, by perhaps performing multiple scans, says study author Joshua Meyer, MD, attending physician in the Radiation Oncology Department at Fox Chase.
"When doctors have younger patients, they might think twice before being confident rectal cancer has not spread to the lymph nodes," says Meyer. "It makes a lot of sense to be more aggressive in checking for lymph node involvement in people younger than 50."
This is the first study to show that age is associated with the risk that rectal cancer will spread to the lymph nodes, says Meyer. The idea for the project came out of an observation by his collaborator Steven Cohen, MD, chief of gastrointestinal medical oncology at Fox Chase, who noticed a couple of young patients with an early stage of rectal cancer that had unexpectedly spread to the lymph nodes—"which is not something one would expect," says Meyer. "Because of that, he said, 'I wonder if the risk of spread is somehow connected to their age.' I said, 'Well, this is something we can test.'"
Indeed, the researchers had access to a massive database of information about cancer patients run by the National Cancer Institute. They reviewed the case history of more than 56,000 patients diagnosed with rectal cancer between 1988 and 2008. Approximately 2% of patients were ages 20-39; 7.5% were in their 40s.
Overall, the younger patients were, the more likely it was that their cancer had spread to their lymph nodes—regardless of the stage of their tumors. For instance, among those whose tumors were the least invasive into the rectal wall (stage T1), 22.3% of 20-39 year-olds had affected lymph nodes, versus only 10.8% of patients ages 60-69. The same differences appeared in people whose tumors were more invasive—in T3 tumors, the most common presentation, 60.7% of younger patients had tumors that had reached the lymph nodes, versus 49.4% of those in their 60s.
It's not clear why age might influence the spread of rectal cancer, notes Meyer. Perhaps the tumors of younger patients are simply biologically different from those of older patients, rendering them more likely to spread, he speculates.
Even though the researchers reviewed data collected from tens of thousands of patients, these initial findings should be followed up by more research, notes Meyer. "Since this is a first study, I don't think you can definitively say that age is directly related to risk of lymph node involvement in rectal cancer. But it is something one should keep in mind."
Consequently, when young people are diagnosed with rectal cancer, it makes sense to ask their doctors to thoroughly check their lymph nodes for signs of spread before skipping chemotherapy and radiation prior to surgery. "I think it's worth talking about with your doctor."
Meyer's and Cohen's co-authors include Michael Hall, Elin Sigurdson, and Karen Ruth from Fox Chase.
Fox Chase Cancer Center, part of the Temple University Health System, is one of the leading cancer research and treatment centers in the United States. Founded in 1904 in Philadelphia as one of the nation's first cancer hospitals, Fox Chase was also among the first institutions to be designated a National Cancer Institute Comprehensive Cancer Center in 1974. Fox Chase researchers have won the highest awards in their fields, including two Nobel Prizes. Fox Chase physicians are also routinely recognized in national rankings, and the Center's nursing program has received the Magnet status for excellence three consecutive times. Today, Fox Chase conducts a broad array of nationally competitive basic, translational, and clinical research, with special programs in cancer prevention, detection, survivorship, and community outreach. For more information, visit Fox Chase's Web site at www.foxchase.org or call 1-888-FOX CHASE or (1-888-369-2427).
3D images of cancer cells in the body: Medical physicists from Halle present new method
16.05.2018 | Martin-Luther-Universität Halle-Wittenberg
Better equipped in the fight against lung cancer
16.05.2018 | Friedrich-Alexander-Universität Erlangen-Nürnberg
At the LASYS 2018, from June 5th to 7th, the Laser Zentrum Hannover e.V. (LZH) will be showcasing processes for the laser material processing of tomorrow in hall 4 at stand 4E75. With blown bomb shells the LZH will present first results of a research project on civil security.
At this year's LASYS, the LZH will exhibit light-based processes such as cutting, welding, ablation and structuring as well as additive manufacturing for...
There are videos on the internet that can make one marvel at technology. For example, a smartphone is casually bent around the arm or a thin-film display is rolled in all directions and with almost every diameter. From the user's point of view, this looks fantastic. From a professional point of view, however, the question arises: Is that already possible?
At Display Week 2018, scientists from the Fraunhofer Institute for Applied Polymer Research IAP will be demonstrating today’s technological possibilities and...
So-called quantum many-body scars allow quantum systems to stay out of equilibrium much longer, explaining experiment | Study published in Nature Physics
Recently, researchers from Harvard and MIT succeeded in trapping a record 53 atoms and individually controlling their quantum state, realizing what is called a...
The historic first detection of gravitational waves from colliding black holes far outside our galaxy opened a new window to understanding the universe. A...
A team led by Austrian experimental physicist Rainer Blatt has succeeded in characterizing the quantum entanglement of two spatially separated atoms by observing their light emission. This fundamental demonstration could lead to the development of highly sensitive optical gradiometers for the precise measurement of the gravitational field or the earth's magnetic field.
The age of quantum technology has long been heralded. Decades of research into the quantum world have led to the development of methods that make it possible...
02.05.2018 | Event News
13.04.2018 | Event News
12.04.2018 | Event News
22.05.2018 | Trade Fair News
22.05.2018 | Trade Fair News
22.05.2018 | Life Sciences