A new study has shown that rectal cancer patients may be able to avoid radiation, receiving the same results as those who undergo radiation therapy, but with fewer negative side effects. This could eliminate a toxic treatment for over 10,000 patients every year in the United States alone. According to Dr. Eric Winer, President of the American Society of Clinical Oncology, the results represent a new direction for cancer researchers away from intensifying treatment and towards improving patients’ quality of life. This study was focused on patients whose cancer had spread to the lymph nodes or tissues around the bowel, but not to other organs. This type of cancer affects approximately half of the 800,000 newly diagnosed rectal cancer patients across the world.
It has been typical to use pelvic radiation for this type of cancer for decades, despite the negative side effects of radiation including long-term infertility, sexual dysfunction, and bowel problems such as chronic diarrhea. The study showed that radiation treatment did not improve outcomes and that patients who underwent chemotherapy before surgery generally fared better than those who underwent radiation, surgery, and subsequent chemotherapy. Patients in the radiation group reported higher levels of fatigue, impaired sexual function, and neuropathy.
The study took eight years to enroll 1,194 patients at 200 medical centers across the United States. It was regarded as a de-escalation study, as the researchers took away a standard treatment (radiation) to see if it was necessary. The National Institutes of Health was initially hesitant to support the study fearing that no patients would enroll, or that those taking part would risk their health.
For rectal cancer specialists, the results provide an opportunity to rethink cancer treatments. The study shows that a more precise treatment plan, reconsidering what patients actually need, could improve their quality of life. Researchers focused on what elements of successful treatment could be eliminated to achieve this end. The study proves that de-escalating treatment can be an effective approach and can contribute to the well-being of patients.
