New approach offers hope to patients with rectal cancer

The European Society for Medical Oncology (ESMO)

The outlook for patients with advanced rectal cancer is looking more promising with a new treatment approach developed by Professor Andres Cervantes’ team in Spain. The results of a trial of chemo-radiation followed by surgery were presented at the European Society of Medical Oncology’s conference in Edinburgh today (20 June), demonstrating how to prevent a recurrence of the cancer.

Rectal cancer is a very difficult condition to treat because of the high risk of relapse. New growths are likely to occur in the same area so the key to successful treatment lies in controlling the cancer locally.

At the University Hospital Clinic in Valencia, Professor Cervantes and his multi-disciplinary team of oncologists, radiologists, surgeons and pathologists treated 50 patients with chemo-radiation, followed by surgery and further chemotherapy.

Thirty-six men and 14 women, whose average age was 61 years old, were carefully selected for the trial. Magnetic resonance imaging and ultrasonography were used to predict their risk of relapse and if it seemed high, they received chemo-radiation therapy for five weeks before having an operation to remove the tumour. Six weeks after surgery, they had further chemotherapy for 16 weeks.

“The results were excellent,” said Professor Cervantes. After two years, none of the patients had suffered a local relapse.” However, he cautioned, the cancer spread elsewhere in the body in 12 people although this would be expected with rectal cancer. One of the main advantages of the new treatment strategy was that these patients did not necessarily require a colostomy.

“Our results suggest that chemo-radiation given before surgery can control the disease,” said Dr Cervantes. Until recently, radiotherapy was considered to be the standard form of treatment after an operation, but his research has shown that given with chemotherapy before surgery, in selected patients, helps to control the development of cancer in the same area.

“Now that we know that it is possible to control cancer locally, we need to carry on with our research to find ways to control the spread of cancer to other parts of the body,” he said.

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