Health Watch
  • Colorectal cancer is the third leading cause of cancer death in the world.
  • Radiotherapy followed by rectal surgery is usually the treatment method for rectal cancer. This method may result in certain adverse side effects.
  • Adverse effects of rectal cancer surgery can be reduced by combining a short-course preoperative radiotherapy with delayed surgery.

A short-course preoperative radiotherapy when combined with delayed surgery may reduce the adverse side-effects of rectal cancer surgery without affecting its efficacy, finds a research team from Karolinska Institutet in Sweden.

The results were presented in the journal The Lancet Oncology.
New Treatment Method Reduces Adverse Effects of Rectal Cancer Surgery

Rectal cancer or the colorectal cancer is referred to as bowel cancer which leads to the abnormal growth of cancer cells in the colon and the rectum. It is found to affect around 2000 men and women in Sweden every year.

Preoperative radiotherapy usually involves the use of high-energy radiations to shrink the tumor before performing the surgery. This is commonly used for the treatment of rectal cancer.

The introduction of preoperative radiotherapy in 1990s has improved the prognosis of rectal cancer patients and has also reduced the risk of local recurrence.

Anna Martling, a senior consultant surgeon and professor at Karolinska Institutet's Department of Molecular Medicine and Surgery, said, "Back then we showed that preoperative radiotherapy reduces the risk of local recurrence by over 50 per cent for patients with rectal cancer."

"Thanks to our results, radiotherapy is recommended to many rectal cancer patients."

Adverse side-effects associated with radiotherapy method and the period between the method and the surgery has raised.

The research study now published in The Lancet Oncology is now based on the claim that adverse effects of radiotherapy for rectal cancer treatment can be reduced by administering low doses of radiation for longer time or by increasing the time interval between radiotherapy and surgery.

Research Study
The patients with rectal cancer were randomly assigned to three different treatments

  • Standard therapy - involves a short-course radiotherapy followed by a direct surgery within a week.
  • Delayed Surgery - involves a short-course radiotherapy that is followed by surgery after 4-8 weeks.
  • Delayed Surgery - involves a long course radiotherapy followed by surgery after 4-8 weeks.
Findings of the Study
The study findings found that patients with delayed surgery had fewer complications with good improvements in cancer outcomes.

The study also showed that there was no difference between long-course and short-course radiotherapy, except that long-course treatment was found to lengthen the time for the treatment.

Professor Martling, said, "The results of the study will give rise to improved therapeutic strategies, fewer complications with a sustained low incidence of local recurrence, and better survival rates for rectal cancer patients."

"The results can now be immediately put to clinical use to the considerable benefit of the patients."

Interesting Facts on Rectal Cancer
  • Around 90% of colorectal cancers are adenocarcinomas (Cancer formed in the mucus-secreting glands) which initially was a polyp that further developed to cancer.
  • Around 40,000 people in the United States develop rectal cancer every year.
  • Colorectal cancer is the third leading cause of cancer death in the world.
  • The incidence and mortality rate of colorectal cancer is highest among African American men and women.
  • Rectal cancer is more common among people above the age of 50 years.
  • Following regular exercises, maintaining healthy weight, and avoiding cigarettes and alcohol can reduce the risk of rectal cancer.
  1. Johan Erlandsson, Torbjörn Holm, David Pettersson, Åke Berglund, Björn Cedermark, Calin Radu, Hemming Johansson, Mikael Machado, Fredrik Hjern, Olof Hallböök, Ingvar Syk, Bengt Glimelius, Anna Martling. Optimal fractionation of preoperative radiotherapy and timing to surgery for rectal cancer (Stockholm III): a multicentre, randomised, non-blinded, phase 3, non-inferiority trial. The Lancet Oncology, 2017; DOI: 10.1016/S1470-2045(17)30086-4
  2. Colorectal Cancer Facts & Figures - (
  3. Rectal Cancer Facts - (

Source: Medindia

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