Thousands of British bowel cancer patients should receive radiotherapy before having surgery, according to cancer specialists who found the treatment dramatically boosts their chances of survival.

Scientists believe that giving patients radiotherapy before surgically removing tumours nearly eliminates the risk of the disease returning in later years. Of the 35,000 cases of bowel cancer diagnosed in Britain each year, around one third who develop rectal cancer stand to benefit from the procedure.

Traditionally, doctors treat cancer in the lower part of the bowel by surgically removing the tumour. But the operation can leave cancerous cells, leading to an incurable recurrence in a majority of patients.

A trial of 1,350 patients in the UK, Canada, South Africa and New Zealand revealed that radiotherapy before surgery had a marked effect on the chances of the disease returning. One group of patients was given five daily blasts of radiotherapy before having the tumour surgically removed within two weeks. A second group underwent surgery, with 10% receiving a five-week course of chemo-radiotherapy afterwards if doctors suspected some cancerous cells may have been left behind.

The trial, called CR07, showed that five years later, cancer had returned in only 5% of patients who received radiotherapy before surgery and 75% were still alive. In the second group, cancer had returned in 17% of patients and 67% were still alive. When combined with the best surgical procedures, pre-operative radiotherapy reduced the risk of cancer recurring to 1%.

David Sebag-Montefiore, a consultant clinical oncologist from Leeds, who led the study, said: "There are approximately 35,000 cases of bowel cancer diagnosed every year in the UK alone. The results of the CR07 trial show that giving a patient radiotherapy before rectal cancer surgery gives them the best chance of avoiding re-growth of the cancer and of survival in the longer term.

"This is good news for patients and clinicians alike and could lead to an increase in the use of pre-operative radiotherapy in the UK. The trial results show that patients should have the opportunity to discuss the benefit of radiotherapy before rectal cancer surgery."

The research was presented yesterday at the National Cancer Research Institute conference in Birmingham.

Last year, a team of international scientists lead by the Dunn Human Nutrition Unit in Cambridge delivered a long-awaited verdict on red meat and cancer, based on the eating habits of half a million people. They concluded that beef, lamb, pork, veal and processed varieties such as ham and bacon increase the risk of bowel cancer. People who eat two portions of red meat a day a day - the equivalent of a bacon sandwich and a fillet steak - increase their risk of bowel cancer by 35% over those who eat just one portion a week, the study found. The World Health Organisation called for people to eat less meat and more fish.

This year, Britain's leading cancer charity, Cancer Research UK, accused the government of a "gross betrayal of trust" for dragging its feet over a national bowel cancer screening programme due to start in March.

Useful links
bowelcanceruk
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