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Second study, patients who do not undergo surgery reach a survival rate of 93% in 3 years
Brazilian researchers found that the removed part of the intestine of the intestinal tract of the intestinal tract, (iStock / Getty Images)
Rectal cancer: a new treatment eliminates surgery
A new treatment for rectal cancer offers the patient the option of not having to undergo surgery for excision of the lymphadenopathy. intestine after concomitant chemotherapy and radiotherapy
According to a study published this weekend in the British medical journal The Lancet, international researchers, including two Brazilian, found that many patients with rectal cancer did not do not do it. radical surgery achieved a three-year survival rate of 93%, while those who underwent the procedure reached a standard procedure rate for treatment of most cases of rectal cancer [19659007] Exclusion from surgery
The standard procedure for the treatment of the majority of cases of rectal cancer is the simultaneous use of radio and chemotherapy followed by surgery for the 39 Elimination of residual tumor in the resected bowel, usually scheduled even before the results of cancer regression.
the Brazilian doctor Angelita Habr-Gama and other Brazilian researchers realized in the 1990s that in many cases the removed part of the intestine did not show any residual tumor and that it so it was possible that some patients did not need to be operated on, since the initial treatment could be successful.
From then on, the team decided to wait for the assessment of the response to treatment before surgery, so clinicians could determine which patients would show signs of complete clinical regression of the rectal tumor, excluding the need for surgery .
New discoveries
In the early years of publication of the results, however, as the results proved promising, more researchers began to reconsider the new findings, seeking to observe the response of patients who were not able to see the results. have not had surgery.
The acceptance allowed the discovery of a new chemotherapy and radiotherapy that could ensure even greater numbers of patients who would respond well to initial treatment. The increase in the dose of cancer drugs proposed by the researchers was aimed at improving the indices of complete response to treatment, thus avoiding surgery.
According to Rodrigo Oliva Perez, coordinator of the Colorectal Surgery Center Oncology Group of the Oncology Center of BP – Beneficência Portuguesa de São Paulo, a hospital that offers treatment, prior to the. increased doses, 20% to 25% of patients had positive results. Now this number is almost 50%. The findings of the observations were published in the Journal of the American Society of Colorectal Surgery (ASCRS)
Benefits and Risks
The exclusion of surgery, which presents a risk of complications, is one of the main advantages of this new proposal for the treatment of rectal cancer. The fact of not having surgery also avoids the need for a definitive colostomy – use of an artificial pouch placed in the belly through which the intestine has to function – or from an intestinal reconstruction which may compromise the function of evacuation. In addition, it is possible to rescue patients from functional sequelae such as impotence and urinary dysfunction.
For patients in whom the tumor does not completely disappear (about 24% of cases), surgery is mandatory. "The data from published studies show that the fact that the patient was operated on later, when there is already evidence that the tumor has returned to growth, does not seem to cause any harm.The risk is the same as those that are operated on immediately, "said Perez.
As this therapeutic alternative requires technical knowledge and adequate equipment, not all Brazilian institutions are willing to offer the new treatment. 19659011] Another data shows that the three-year survival rate of non-operated patients is 93%; even those who do the operation immediately are 90%, confirming that postpone the operation until the existence of concrete information about the return of the tumor does not compromise patient survival.
However, Perez explains that the new treatment is not yet able to interfere with the disease although it may improve the quality of life. This is the reality of many other therapeutic alternatives that have been discovered in recent years for the treatment of various types of cancer.
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