Tag Archives: rectal cancer

Gene Panel May Predict Who Needs Rectal Cancer Surgery

Surgeons at M.D. Anderson Cancer Center in Houston have identified 87 genes that someday may tell doctors whether or not rectal cancer patients need surgery after chemotherapy and radiation.  The panel of genes predicted patients whose cancer appeared to be completely destroyed by the combination of chemotherapy and radiation before surgery, what is called pathological complete response. Before it can become routine practice, the gene panel will need to be checked in another group of patients and clinical trials will need to be conducted to see if patients who have pathological complete responses and no surgery do as well as those who do have surgery.

Laparoscopic Surgery a Safe Choice for Rectal Cancer

In the hands of experts, laparoscopic surgery for rectal cancer was as successful as an open abdominal operation.  Cancer free survival after five years wasn’t any different, and cancer was no more likely to return in and around the rectum. Even if surgeons had to change their approach during the operation and convert from laparoscopic to open surgery, outcomes were not affected.

ASCO Research Highlights: Rectal and Anal Cancer

Researchers tried to push the envelope in treating rectal and anal cancer by adding new or different chemotherapy to standard chemoradiotherapy.  However, two trials in rectal cancer and one in anal cancer were not able to improve complete response rates for chemoradiation.  Adding extra chemotherapy after radiation was finished didn’t improve relapse-free survival for anal cancer either.

Rectal Tumor Regression After Presurgical Chemoradiation Predicts Survival

The more tumors shrink during chemotherapy and radiation before rectal cancer surgery, the better the chance that patients will survive and be cancer-free five years later. Doctors in Ireland developed a simple, three point, tumor regression grade or TRG, to measure the amount of change during chemoradiotherapy before surgery to remove rectal cancer.  After five years, all patients with the best tumor regression grade — complete or near complete response to chemoradiation — were alive and disease-free.

Response to Radiation Treatment Before Surgery Improves Rectal Cancer Survival

Patients whose tumors shrink in response to radiation therapy before surgery for rectal cancer have both improved overall survival and improved disease-free survival.  However, even patients who responded to presurgical radiation did not reach survival rates for stage I rectal cancer patients treated with surgery alone.

How to Treat Rectal Cancer after Surgery? A Clinical Trial

Focus on Clinical Trials Can adding Avastin® (bevacizumab) to FOLFOX therapy after surgery and presurgical chemoradiotherapy reduce recurrence and improve survival for patients with rectal cancer? A clinical trial to answer this question is underway and is looking for participants.  Led by a team of researchers from several clinical trials cooperative groups, the E5204 study randomly assigns patients who have already completed a course of chemoradiotherapy and had their rectal cancer removed surgically to either FOLFOX or FOLFOX plus Avastin.

Incidence of Rectal Cancer Increasing in Patients under Forty

Update from the 2009 Gastrointestinal Cancer Symposium Incidence of rectal cancer in younger patients is increasing, although there is no similar pattern with colon cancer or in older rectal cancer patients.  The reason for the trend is unclear. First observed in a single cancer center, the trend toward more rectal cancer in patients under forty was confirmed in review of the Surveillance Epidemiology and End Results (SEER) database.

Radiation Before Surgery Can Increase Bowel and Sexual Problems

Although giving radiation before rectal cancer surgery reduces the risk that cancer will return in the rectum and nearby tissues, it does so at a cost.  Quality-of-life studies that accompanied a trial of a short course of radiation therapy before surgery  found more sexual and bowel problems with presurgical radiation.

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