Scientists develop promising new treatment for rectal cancer

A promising new treatment for locally advanced rectal cancer could reduce the need for surgery and lower the risk of recurrence, according to a recent study conducted at Uppsala University. Published in eClinicalMedicine, the research confirms that this innovative method increases the chance of avoiding surgery altogether while preserving normal rectal function.

The study's findings offer hope for the roughly 2,000 people in Sweden diagnosed with rectal cancer each year. Among them, approximately one-third face a high risk of cancer recurrence.

Currently, patients diagnosed with rectal cancer often undergo a combination of radiotherapy and chemotherapy before surgery, with the potential need for a stoma—an opening that diverts waste from the body—or ongoing issues with bowel control. In addition, many patients endure months of further chemotherapy after surgery, which can take a significant toll on quality of life.

In the study, researchers explored the potential of a new approach: administering all radiotherapy and chemotherapy upfront before determining whether surgery is necessary. According to Professor Bengt Glimelius, a leading oncologist at Uppsala University and a senior consultant at Uppsala University Hospital, this strategy can dramatically increase the chances of avoiding surgery altogether.

“The tumour disappears completely more often, thereby increasing the chance of avoiding surgery and retaining normal rectum and rectal function,” says Glimelius. He emphasizes that the new method also reduces the occurrence of metastases, the spread of cancer to other parts of the body.

The study's data was gathered from 461 patients through the Swedish Colorectal Cancer Registry (SCRCR). Researchers compared the outcomes of patients who received the traditional treatment plan—five weeks of radiotherapy combined with chemotherapy, followed by surgery and additional chemotherapy—with those who followed the newer protocol.

Traditionally, surgery has been necessary to remove part of the bowel, which can lead to a permanent stoma or challenges with bowel function. This is because the surgically created "new rectum" may not fully adjust to its role, often sending frequent signals to the brain that the patient needs to use the restroom, even when unnecessary.

Glimelius points out that avoiding surgery prevents these complications: "If the tumor disappears completely during treatment, surgery is not required. This means that the rectum is preserved, and the need for a stoma and a new rectum is eliminated."

The research builds upon a randomised study conducted four years ago, which demonstrated that a shortened course of treatment—one week of radiotherapy followed by just over four months of chemotherapy—resulted in more complete tumour disappearances and fewer distant metastases.

However, some patients experienced a higher rate of local recurrences, meaning the cancer returned in the same area. In response, the Uppsala team modified the treatment protocol, shortening the chemotherapy period to three months, and implemented the new strategy in several regions across Sweden.

The new study not only confirms the earlier results but also reveals an important improvement: the feared increase in local recurrence did not materialize. After nearly five years of follow-up, patients treated with the new method saw no rise in local cancer recurrence rates.

“With the old treatment, the randomized study failed to find any tumor in 14 percent of patients who underwent surgery,” says Glimelius. “The new model doubled that figure to 28 percent. The new Swedish study had the same results, but without an increase in local recurrence rate after almost five years of follow-up. It is important to show that experimental treatments also work in everyday healthcare.”

This breakthrough demonstrates how targeted adjustments to treatment protocols can lead to significant improvements in patient outcomes. By reducing the need for surgery, doctors can help patients avoid the physical and emotional challenges of living with a stoma or coping with compromised bowel function. It also highlights the value of real-world healthcare data in validating experimental treatments outside the confines of clinical trials.

A large team of doctors, researchers, and research nurses contributed to the study, which underscores the collaborative effort involved in advancing cancer treatment. While more research is needed to confirm these findings on a broader scale, the results so far are promising.

For patients facing a diagnosis of rectal cancer, this new approach offers hope for a future where more people can retain their rectum and experience a better quality of life after treatment.

Note: Materials provided above by The Brighter Side of News. Content may be edited for style and length.

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