New treatment helps rectal cancer patients avoid surgery
Barts Health has become the first NHS trust in London to offer a treatment for early rectal cancer that could help patients avoid major surgery and a permanent stoma.
The therapy, known as Papillon, uses low‑energy X‑rays delivered directly to the tumour. It is a form of brachytherapy, a type of internal radiotherapy in which radiation is placed inside the body in direct contact with the tumour to destroy cancer cells.
During the procedure, a small X‑ray tube is carefully inserted through the anus into the rectum to deliver a precise dose of radiation to the tumour.
Papillon is recommended by the National Institute for Health and Care Excellence (NICE) for patients whose tumour is located in the lower or mid‑rectum, is 3cm or smaller, and who either choose not to have surgery or are considered high‑risk surgical candidates. Avoiding surgery also means patients may not require a stoma - an opening in the abdomen that diverts waste into a bag - which NICE notes can “substantially improve” quality of life.
A recent update to NICE guidelines means thousands more cancer patients may now have the option of avoiding invasive surgery and a permanent stoma or colostomy bag.
The first patients received Papillon treatment in January at the Barts Cancer Centre at St Bartholomew's Hospital. The service, delivered by the hospital’s Radiotherapy department, initially plans to treat around 30 patients per year.
The Papillon machine was supported by a grant from Barts Charity through its Advancing Healthcare Scheme, which also funded the equipment and staffing needed to establish the service.
Pablo Nenclares, consultant clinical oncologist in lower gastrointestinal cancers and recipient of a Barts Charity Advancing Healthcare Scheme award, said: "This service will ensure that our patients continue to access the highest‑quality oncological care with improved outcomes; enabling Barts Health to remain a leading cancer care provider."
Angela Baker, head of radiotherapy, added: “This is a huge step forward for our patients. They now have a treatment option that could help them avoid major surgery and live with a better quality of life. I’m really proud that we can offer Papillon here at Barts.”
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