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Moffitt research to benefit rectal cancer patients

Doctors are now able to offer a less complicated method of treatment for rectal cancer patients, according to an H. Lee Moffitt Cancer Center study.

At the beginning of September, the cancer team at the Moffitt Cancer Center released the results of a new study that may allow rectal cancer patients to avoid a major surgery and a permanent colostomy.

In April, seven years after the project began, a team of doctors led by Dr. Jorge Marcet introduced the results of the study to the American Surgical Association, and it is now being recognized as a breakthrough in colorectal cancer research.

?We believe more and more doctors will soon be accepting this procedure in hospitals nationwide,? Marcet said.

Marcet said this breakthrough is a two-step process. Using chemoradiation, the process shrinks tumors which allows doctors to perform a minor surgery through the anal cavity, rather than a drastic operation that includes an incision in the abdomen.

This could result in the removal of the patient?s entire rectum, consequently, leaving them with a permanent colostomy, a small bag attached to a person?s lower abdominal area that collects their fecal matter.

?What we are shooting for here is a much simpler surgery that is not as invasive as the original treatment,? Marcet said.

In addition to avoiding a serious and possibly damaging surgery, Marcet said that this new chemoradiation treatment is shorter, therefore, a less expensive process. Marcet also said that a patient would go through one month of treatment followed by the operation one month after that. The operation would require an overnight hospital stay. This means that because of the short duration spent in the hospital and the simple operation, the process is cheaper than the normal operation.

?Since the operation is paid by the patients? insurance company, they will be paying less based on the shortened hospital stay,? Marcet said.

The gastrointestinal tumor program team at the Moffitt Center has treated 95 colorectal cancer patients with the new chemoradiation process. Out of those, 26 had their tumors disappear completely and could then undergo the less drastic of the two operations.

The problems that arose with the other two-thirds of the patients led to the usual abdominal-entrance operation.

One of those patients was 76-year-old Frank Acurso.

?The radiation process was simple,? Acurso said. ?And I went through the surgery like gangbusters. When it was done, I didn?t even realize it had been performed yet.?

Marcet and his teammates are now concentrating on making this process successful for a larger majority of patients. Marcet said that when a person has cancer cells, a protein called P-53 is used to try to regulate them. In some patients, this growth regulator may mutate, causing the chemo radiation to be ineffective. Marcet said that many of the patients who saw this process succeed had minimal or no cell mutation. This has led the team to further the study with a new drug that could make a patient more sensitive to the treatment. Marcet said he is ?optimistic about furthering the treatment.?

Marcet explained that one out of 20 people will be diagnosed with colorectal cancer, which is the third most common cancer in the United States.

Moffitt cancer research studies have estimated that there will be 37,200 new diagnoses and 8,600 deaths from rectal cancer in 2001.

Contact Nick Margiassoat