A new and less invasive treatment developed by Cancer Research UK researchers is safer than standard major surgery for early-stage rectal cancer, giving patients a better quality of life with fewer life-altering side effects, results from a pilot study show.
Results from the TREC trial show that a combination of local keyhole surgery and radiotherapy, rather than major surgery that removes the whole rectum, prevents debilitating side effects, such as diarrhoea, or the need for a permanent colostomy bag.
Patients reported a better quality of life with the new treatment, with less impact on their family and social life, and felt more positive about their body image and the way their bowels work.

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The findings are published in The Lancet Gastroenterology & Hepatology today (Thursday)*, and a clinical trial is now open to eligible patients who wish to receive this new treatment**.
Every year, 11,500 people in the UK are diagnosed with a tumour located in the rectum,*** the last part of the intestine which connects to the anus. Standard treatment is a major operation to remove the whole rectum, even if the cancer is early stage. About 25% of these major surgeries are done on small, early-stage tumours, and while it is effective, the operation can lead to long-term side-effects that seriously impacts quality of life for survivors.
43% of rectal cancers are caught at an early stage (stage 1 and 2) and doctors need better, less invasive treatments for these tumours.
Mr Simon Bach and his team at the University of Birmingham, along with collaborators at the University of Leeds, have developed a new treatment approach called 'organ preservation' for early-stage rectal cancer that uses radiotherapy followed by local keyhole surgery 8-10 weeks later to remove only the part of the rectum affected by cancer.
Mr Simon Bach, lead researcher, says: "We took a lot of inspiration from progress against breast cancer. In the early 90s, most people with breast cancer would have a mastectomy, where the whole breast is removed, as the first part of their treatment. But now, due to awareness campaigns, the breast screening programme and new treatments, mastectomy is much rarer. We wanted to test a similar approach for our rectal cancer patients."
To test whether organ preservation treatment could be a suitable alternative to major surgery for early-stage rectal cancer, 123 patients were enrolled in the TREC trial****.
Doctors gave the new treatment to 61 patients for whom the major surgery would have been considered unsafe.