Due to the nature of rectal cancer compared to colon cancer, preoperative "chemoradiotherapy" Currently, it is commonly used to treat patients with advanced rectal cancer, with 10-15% of patients "complete remission," Where the cancer is completely gone.  (Credit: Getty Images)
Due to the nature of rectal cancer compared to colon cancer, preoperative “chemoradiotherapy” is now commonly used to treat patients with advanced rectal cancer, with 10-15% of patients suffering from cancer. The patient has achieved “complete remission,” in which the symptoms completely disappear. . (Credit: Getty Images)


Unlike colon cancer, rectal cancer has unique characteristics that make preoperative chemoradiotherapy a common treatment option, with 10 to 15 percent of patients with advanced rectal cancer achieving complete remission. ”, which means that cancer can be completely eradicated.


Unlike the colon, the rectum does not have an intestinal lining and has many blood vessels around it, so rectal cancer has a higher risk of spreading widely and quickly than colon cancer.


On the other hand, since rectal cancer is located in the pelvis, it is difficult to surgically remove a wide area like colon cancer, so preoperative chemotherapy is used to reduce the size of the tumor and increase the possibility of preserving the anus. Radiation therapy is often used. This is why some patients with advanced rectal cancer are cured without surgery.


Dr. Hwang Dae-young, a professor at the Colorectal Cancer Center at Konkuk University Medical Center, said, “About 10 to 15 percent of rectal cancer patients can be completely cured with prior radiation therapy and chemotherapy,” meaning one in seven patients. pointed out that the proportion of patients with rectal cancer was high. Ten patients with advanced rectal cancer who had received prior radiation therapy and chemotherapy achieved complete remission.


In the past, upfront chemotherapy and radiation treatments removed the cancer, but surgery was promoted because it was believed that cancer cells were still present, even if they were invisible. However, according to Professor Huang, this is no longer the case.


Studies have shown that patients can be cured of rectal cancer with prior chemotherapy and radiation therapy, so current treatment approaches require doctors to completely eliminate rectal cancer after prior chemotherapy and radiation therapy. He explained that it was to have them do a follow-up to confirm what they were doing.


“When we published data on this at Sloan Kettering Cancer Center in the US in 2015, we found that 75 per cent of such patients remain in stable disease. In about 25 per cent, the tumor does not return. But it wasn’t too late for surgery,” Huang said.


In addition to endoscopy, he also recommended a proctectomy to determine if the rectal cancer had completely disappeared after previous chemotherapy and radiation therapy.


“Feeling where you feel is the most important thing,” Huang said.


He explained that the medical community has come to the conclusion that in the absence of rectal cancer, in addition to endoscopy, observation of the rectal cancer area should continue. However, the problem of confirming that it is completely gone remains a challenge for medical professionals.


Of course, 25 percent of patients with advanced rectal cancer who go into complete remission after upfront chemotherapy and radiation therapy may have their cancer grow back, and identifying which patients with advanced rectal cancer will have their cancer grow back Because this is not possible, all patients must be followed up at: Visit the hospital regularly.


“One of the patients went into complete remission after prior chemotherapy and radiotherapy, but about a year later the cancer grew back and he had to have surgery to expose his entire anus,” said Huang. said, emphasizing that the patient’s condition is good.


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