Patients across the country diagnosed with rectal cancer can now be offered the chance to avoid surgery, following pioneering research by The Clatterbridge Cancer Centre NHS Foundation Trust.
The National Institute for Health and Care Excellence (NICE) has published new guidance recommending that fit patients with early-stage operable rectal cancer of less than 3cm in size can be offered a choice of non-surgical treatment, which includes an alternative therapy called Papillon, or surgery – with surgery being an option later if non-surgical treatment fails.
By not having surgery, patients avoid the potential need for a stoma, an opening in the body which allows waste to be diverted into a small pouch on the abdomen.
Papillon is a form of x-ray brachytherapy, or CXB, pioneered in the UK by Professor Sun Myint, Consultant in Clinical Oncology at The Clatterbridge Cancer Centre. Prof Myint led a clinical research trial, called OPERA, which discovered that the Papillon technique, when used in combination with chemo and radiotherapy, substantially improves quality of life for patients with early-stage rectal cancer by avoiding the potential need for a stoma.
Sharon Price is one patient who was successfully treated on the clinical trial. The NHS worker, who herself cares for cancer patients, was 45 when she was diagnosed with rectal cancer and became one of the patients to join the research study.
“I was faced with the possibility of surgery, which would mean that I’d have to live with a stoma for the rest of my life,” said Sharon. “That was devastating – I was just too young to have to go through that. I was offered the chance to join the clinical trial, and I decided to do it immediately.”
Sharon, of Newcastle-under-Lyme in Staffordshire, was given the all-clear after treatment and monitoring for over five years, and she has had no lasting side effects from her treatment. She said: “It is fantastic news that this treatment is now set to be offered across the NHS to patients in the position I was in. I was very fortunate to have the chance to take part in the clinical trial as I am now back to work fully and my life is back to normal – which may not have been the case if I’d had surgery and a stoma to cope with.
“I am really pleased for Prof Myint and his research team, whose dedication and expertise will now bring new hope of a better quality of life to people like me who are diagnosed with rectal cancer.”
Colorectal cancer is one of the most common cancers in the UK, with rectal cancer accounting for a third of them – more than14,000 new cases are diagnosed each year.
CXB uses a low energy internal radiotherapy and gives patients hope of being cured without invasive surgery to remove the cancerous growth in the rectum, which can mean an avoidance of a stoma.
Prof Myint said: “I am absolutely delighted that Papillon is now being recommended upfront as an option for patients with rectal cancer across the NHS – and this recommendation will influence other healthcare systems and institutions across the world, which will benefit over half a million patients.
“It is wonderful that patients will now be given a choice of treatment and many of them will have a much better quality of life later because of it.”
Prof Myint, who is still working as a consultant at the age of 77, added: “I have been treating patients with this therapy for more than 33 years, which equates to about 3,000 people. This decision is a great victory for patients who will now have a choice for the treatment they prefer. I feel that I have done my job and I can now hang up my gloves, but not until this treatment is embedded as the standard of care in the NHS and across the world.”
The OPERA study followed patients for five years and showed a striking increase in organ preservation rates of 93% with the CXB therapy in early rectal cancer less than 3cm, which are increasingly been diagnosed through the UK’s National Bowel Cancer Screening Programme, which was established in 2006.
Dr Caroline Brammer, Medical Director at CCC, said: “We are delighted that Prof Myint’s work and research have provided randomised trial evidence for this NICE guidance, giving patients more choice in their cancer treatment.
“Prof Myint is a world authority on the Papillon technique and thousands of Clatterbridge patients have benefited from this non-surgical treatment over the decades. It is heartening to know that many more patients across the NHS will now have the same opportunity.
“We would like to congratulate Prof Myint personally, as this NICE decision is testament to his dedication in progressing this form of therapy throughout his distinguished career, which will benefit patients with rectal cancer.
“This development will help reduce surgical waiting lists and costs to the NHS and improve quality of life for many patients with rectal cancer.”
