New treatment strategy cuts risk of bowel cancer returning by 28%

UK trial across three countries finds that giving patients chemotherapy before surgery was more effective

Giving bowel cancer patients chemotherapy before surgery cuts the risk of it coming back by 28%, according to the results of a trial experts are hailing as “fantastic”.

As many as one in three patients diagnosed with the disease see it return after surgery, a figure described as “far too high” by cancer specialists who have spent years searching for new treatment strategies. In the UK, someone dies from bowel cancer every 30 minutes.

But a clinical trial has found that giving chemotherapy before surgery for early-stage bowel cancer cuts the chance of the disease returning by 28%. Hundreds of thousands of patients worldwide could benefit from the breakthrough every year, experts said. The research was published in the Journal of Clinical Oncology.

“It’s wonderful to see such positive results from this robust trial, which we have been following with great interest,” said Genevieve Edwards, the chief executive of Bowel Cancer UK. “It’s fantastic news that has the potential to make a real difference to the lives of the thousands of people diagnosed with earlier stage bowel cancer every year.”

The FOxTROT trial, led by the universities of Birmingham and Leeds and funded by Cancer Research UK, involved 1,053 patients across 85 hospitals in the UK, Denmark and Sweden.

Chemotherapy is normally given after surgery to kill any stray cancer cells that could lead to the disease coming back. But under the new regime patients would receive six weeks of chemotherapy, have surgery and then 18 weeks more chemotherapy.

During the study, the first group of patients received six weeks of chemotherapy, followed by surgery, then 18 weeks of chemotherapy. The second group had normal treatment for bowel cancer, also known as colon cancer, which involved surgery followed by 24 weeks of chemotherapy.

Patients who had chemotherapy before surgery were much less likely to see their cancer come back. Scientists believe the new approach could be adopted across the NHS and in countries worldwide.

“A growing body of evidence is showing the value of pre-operative chemotherapy in several other cancers, and we believe that our results could transform how we approach colon cancer in the clinic,” said Dr Laura Magill, an associate professor at the Birmingham clinical trials unit.

Geoff Hoggard, from Leeds, who took part in the trial, said it came as a “huge shock” when he was diagnosed with bowel cancer in 2016. “I was willing to take any opportunity to get the most effective treatment,” he said.

Hoggard described having chemotherapy before and after surgery as “hard going”. Brain fog and severe tiredness took its toll on him, he added. “I kept going, thanks to the support of friends, family and my local church, who were a constant source of strength.

“Eventually, it was all worth it. I’ve had no complications since the surgery, and there were no signs of cancer in the months and years after. Six years on, I’m back living life to the full.”

Prof Matthew Seymour, of the University of Leeds, said timing was “everything” when it comes to treating bowel cancer. “The simple act of bringing forward chemotherapy, giving it before instead of after surgery, delivers some remarkable results.

“Scaling up this treatment worldwide, including in low and middle income countries, could transform cancer care and save many thousands of lives.”


Andrew Gregory Health editor

The GuardianTramp

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