The booming technological development of radiotherapy in combination with advanced surgical techniques, offer today higher rates of recovery from rectal cancer, that is from cancer in the last part of the intestine and, moreover, with reduced side effects.
One third of intestinal cancers develop in this area and are characteristically located close to the sphincter. Radiotherapy in rectal cancer plays a role, depending on the needs of the patient. Before surgery, the goal of pre-operative radiotherapy is to shrink the tumor so that it becomes operable, to spare the sphincter even in small tumors that are however located low, and to preserve the normal function of the last part of the intestine. Sphincter sparing ranges from 39% to 94%.
In some patients, pre-operative radiotherapy and chemotherapy may lead to the elimination of the cancer and an experienced multidisciplinary team may decide to avoid surgery, of course subjecting the patient to systematic tests and checks.
The assessment is performed through the clinical examination, magnetic resonance imaging (MRI) or even transrectal endoscopic ultrasound scanning (EUS). Pre-operative radiation in patients with locally advanced rectal cancer has more favorable results according to international studies.
The daily presence of patients with rectal cancer in the radiotherapy department allows us to monitor them closely and take care of them. After surgery, post-operative radiotherapy has a role to play, aiming at reducing the possibility of cancer recurrence in the area. Radiotherapy is precisely applied in the cancer area, while protecting at the same time the neighboring healthy tissues such as the urinary bladder and the healthy intestine and is adapted to the anatomical particularities of the patient.
Advanced techniques such as intensity modulated radiotherapy (IMRT) are feasible at all stages of rectal cancer and there is the possibility of escalation of the radiation dose to the targeted tumor.
Thus, the therapeutic outcome, which depends on the total radiation dose, is safely increased by administering a complementary radiation dose (simultaneous integrated boost SIB), to the targeted rectal cancer tumor or even to possibly enlarged lymph nodes, which were positive in PET-CT scanning or in magnetic resonance imaging.
At the same time, the total radiotherapy time of the patients is also reduced.
The experience of the radiation oncologist is crucial.
The total radiotherapy time in combination with chemotherapy is 5 weeks. In special cases of an initially small tumor, residual rectal cancer disease and locoregional cancer recurrence, stereotactic radiotherapy (SBRT) is applied locally, in the form of a short 5-day scheme.
Initially cancer cells are harmed so that they cannot multiply and subsequently the cancer cells die and are naturally removed by the human body itself through the blood.
Early diagnosis of rectal cancer and the appropriate combination of treatments (surgery, radiotherapy and chemotherapy) achieve high cure rates.
In early stages the five-year survival exceeds 90% which is reduced in the advanced non-metastatic stages to 40%.
We have modern machines, know-how, and we provide safe treatments with low side effects. I am fortunate to operate state-of-the-art equipment, that offers my patients the best results with the lowest possible side effects. Cancer is no longer an incurable disease. Since the 1970s, the patients who recovered from cancer have increased sixfold globally. Radiotherapy is the most personalized treatment because it is designed and carried out according to the needs of each patient. We are here to offer treatment and care, individually for each patient.