When does radiation therapy help rectal cancer patients? When radiotherapy is useless? Radiotherapy only induces toxicity? How to use radiotherapy in rectal cancer correctly? “Radiation therapy is a powerful tool for the advanced rectal cancer cases. But if you don't have to use radiotherapy, you shouldn't do it.” Colorectal cancer radiation therapy. Adjuvant radiotherapy for rectal cancer. Dr. Anton Titov, MD. Radiation treatment for locally advanced rectal cancer. Leading Swedish rectal cancer surgeon discusses rectal cancer treatment. Medical second opinion confirms that rectal cancer diagnosis is correct and complete. Medical second opinion also confirms that rectal cancer radiation therapy is required. Dr. Anton Titov, MD. Best treatment options for rectal cancer. Medical second opinion helps to choose the best radiotherapy treatment for rectal cancer. Get medical second opinion on rectal cancer and be confident that your treatment is the best. Best rectal cancer treatment center and cancer surgeon. Video interview with leading expert in rectal cancer treatment. Colorectal cancer radiation therapy treatment. Radiotherapy complications in colorectal cancer. Dr. Anton Titov, MD. Treating cancer is a multimodality team exercise by a team of medical oncologists, cancer surgeons, radiation oncologists. You have extensive experience in combining radiation therapy treatment of rectal cancer together with the surgical excision in rectal cancer. Dr. Anton Titov, MD. Please speak about your experience in combining radiotherapy with surgical therapy in rectal cancer patients. Dr. Torbjorn Holm, MD (Rectal Cancer surgeon, Professor, Karolinska Institute, Stockholm). Again we have to remember our history. Rectal cancer treatment was not good in Sweden and internationally until the mid-1990s or late 1990s. We have to remember that the risk of local recurrence of rectal cancer was about 25% to 30%. Even though rectal cancer surgeons thought they had done a radical operation. Local recurrence means that rectal cancer comes back in the pelvis after operation. Risk of rectal cancer recurrence was very high. In 1980 we started a clinical trial in Stockholm to learn how we could improve rectal cancer recurrence rates. We started clinical trials of radiotherapy in rectal cancer. Then we started the Swedish rectal cancer trials. We randomized rectal cancer patients to have surgery directly. Other patients had radiation therapy for rectal cancer followed by surgical operation. Dr. Torbjorn Holm, MD (Rectal Cancer surgeon, Professor, Karolinska Institute, Stockholm). We did rectal cancer clinical trials because surgical treatment results were so poor. We could show that giving the patient with rectal cancer radiation therapy before surgery reduced the risk of local recurrence of rectal cancer by 50%. So risk of rectal cancer coming back locally after surgery went from about 25% down to maybe 12%. This happened after patient had preoperative radiotherapy for rectal cancer. But then Professor Bill Heald taught us how to do total mesorectal excision for rectal cancer. Then we showed that combining radiation therapy with total mesorectal excision of rectal cancer reduced local recurrence rates to less than 5%. Then we have reassessed our rectal cancer treatment options. We now think that the most important option to treat colorectal cancer is surgical operation. Sometimes you do a good surgery for rectal cancer. Then you don't need radiation therapy. It is especially true for rectal cancer that is discovered at earlier stage. So the pendulum has come back again. Before we thought that every rectal cancer patient had to have radiation therapy before surgical operation. Dr. Torbjorn Holm, MD (Rectal Cancer surgeon, Professor, Karolinska Institute, Stockholm). Now we realize that with good surgery you don't need to give radiotherapy to everybody with rectal cancer. You need to give radiation therapy to some rectal cancer patients. They have locally advanced rectal cancer. Today the practice of treating rectal cancer is this. Sometimes you have a more advanced rectal cancer that invades mesorectal fascia. Or you have several lymph nodes involved with colorectal cancer. Then you should give the rectal cancer patient radiotherapy. Often you have to combine radiation therapy with chemotherapy. Then you do rectal cancer surgery after chemotherapy and radiation therapy. Some patients have superficial rectal cancer tumor. It could be easy to resect this tumor. Then cancer surgeon does not need to give rectal cancer patient radiation therapy. Because radiation therapy for rectal cancer can also induce in a lot of complications. Dr. Anton Titov, MD. Complications after radiation therapy for rectal cancer can be both early complications and late complications. Dr. Torbjorn Holm, MD (Rectal Cancer surgeon, Professor, Karolinska Institute, Stockholm). Radiation therapy is a powerful tool for the advanced rectal cancer cases. But if you don't have to use radiotherapy, you shouldn't do it. Because radiation therapy can give complications to colorectal cancer patients in the short term and in the long term. Colorectal cancer radiation therapy update - video interview with leading Swedish rectal cancer surgeon. When radiotherapy for rectal cancer needed? When not?
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