Radical surgery versus organ-sparing treatment in rectal cancer. An international study that BDRF supported through its very early stages of conception through the Delphi Exercise This has now gone on to a major clinical trial funded by Cancer Research UK.
Can we Save the rectum by watchful waiting or TransAnal surgery following (chemo)Radiotherapy versus Total mesorectal excision for early REctal Cancer?
The aim of the STAR-TREC study is to find the best way of treating a small rectal cancer. STAR-TREC will compare three different approaches. The “gold standard” treatment involves a large operation (called radical surgery) to remove the whole rectum. Two new approaches are designed to avoid the need for major surgery, we call these the “organ saving” treatments. These organ saving treatments use different types of radiotherapy to try and shrink the cancer as much as possible. How much the cancer shrinks will guide what happens next. In some patients the cancer disappears completely after radiotherapy and no further treatment is needed. In others a small lump remains after radiotherapy, and this is then removed by ‘keyhole’ surgery through the anus. Only the part of bowel wall affected by cancer is removed, most of the rectum and the anus are left alone. Finally, if the cancer does not shrink sufficiently we recommend that the patient has radical surgery to remove the rectum. While we believe that these new approaches are likely to have fewer side effects than the “gold standard” treatment, not many patients have received organ saving treatment, so we do not know if it will be as effective at curing cancer. In addition, some patients may have organ saving treatment and still need major surgery at some point. We will learn more about the new organ saving treatments such as how often treatment successfully saves the rectum, what side effects occur and how patients feel after treatment; particularly how well their bowels work.
This project looks at Polyp Cancers – Another project that arose out of the Delphi Exercise
- Can we improve outcomes for patients with POLCA?
- How do patients’ and doctors’ choice inform the plan?
- What is optimum follow up/assessment of POLCA?
- Health economic impact of resection vs watchful waiting
- Who should we operate on? Who has active surveillance?
- Can we increase the positive resection rate but decrease the overall resection rate & maintain disease control?
- Can we prospectively validate a risk score?
- Can we recruit to a cohort study?
- Can we randomise to surveillance or surgery?
Improving Management of Patients with Advanced Colorectal Tumours
The IMPACT study seeks to improve outcomes for patients with advanced bowel cancer, cancer that has spread beyond the bowel or that has returned after initial treatment. We want to do this by increasing early access to specialist advice and services where appropriate, but also using expertise closer to home wherever possible. The idea is to tailor services to the needs of each individual patient. IMPACT has highlighted areas where new research is essential to improve treatments for patients in the future.
In May 2017, BDRF brought together 120 of the leading medical professionals working in the field of coloproctology along with other charities working in the field in a truly momentous gathering of minds to flesh out the foundations of this project. A fantastic example of the collaborative approach that BDRF takes in it’s work.