Rectal cancer affects 50 thousand Italians a year, '3 out of 10 curable without surgery'

Rectal tumors: today it is possible to do without the scalpel. “In recent decades we have managed to maximize responses to the combination of medical therapy and radiotherapy before surgery, so much so as to increase the percentage of patients who achieve a complete response and can therefore avoid surgery by around 30%. This was explained by the scientific leaders of the regional meeting of the Italian Society of Surgery (Sic) 'Current events in the field of integrated therapies for rectal tumors', scheduled for tomorrow 19 April at the European Institute of Oncology (Ieo) in Milan. At the center of the work is a form of cancer that affects 50,500 Italians every year, growing and increasingly younger.

“In most cases, however, surgery is necessary, but the progress of intervention techniques, including robotics, has made it possible to reduce destructive interventions, thus avoiding or reducing the post-resection syndrome of the rectum, which can be very disabling for the patient. Furthermore, molecular screening of rectal tumors and the introduction of various immunotherapy drugs into clinical practice have opened new frontiers for the treatment of this tumor even in the early stages”, underline Luigi Boni, General and Mini Surgery invasive, Irccs Policlinico Foundation, University of Milan; Uberto Fumagalli Romario, Digestive system surgery and neuroendocrine tumors, Irccs Ieo Milan, both Sic delegates, and Maria Giulia Zampino, Gastrointestinal medical oncology and neuroendocrine tumors, Ieo Milan.

“It must always be remembered – stated Fumagalli Romario – that the most powerful tool in the hands of each of us remains early diagnosis. The recommendation that applies to everyone is therefore to adhere without reservations to screening for occult blood starting from 45- 50 years and, if necessary, perform a colonoscopy.”

“The concrete possibility of avoiding surgery” in rectal cancer “was also demonstrated in Ieo – reports Zampino – where 46 patients were treated as part of the Italian NoCut study, coordinated by colleagues from Niguarda, which involved the use of induction chemotherapy followed by standard chemo-radiotherapy, resulting in complete remission of the disease in 38% of cases. The results of the study will soon be published”, anticipates the specialist.

“The interaction between surgeon, oncologist, radiotherapist, with the innovative contribution of endoscopic and radiological diagnostics – highlights Fumagalli Romario – have become increasingly important for the optimal management of patients with rectal adenocarcinoma, a tumor in constant increase, even in patients under the age of 50, and with possible significant consequences on the patient's quality of life, especially in the case of rectal resection. For this reason, it is essential that those who have a diagnosis or a suspected diagnosis contact a specialized oncology center, because Early, cutting-edge treatment can make a lifelong difference.”

“We are in a moment of great progress – Boni remarks – both from a technological and purely oncological point of view, with increasingly personalized therapies, even at a genetic level, and surgical approaches which, in compliance with oncological radicality, become increasingly less invasive for patients our patients. These developments mainly concern rectal cancer; updating and multidisciplinary discussion is therefore essential.”