Groundbreaking research at The Clatterbridge Cancer Centre is revolutionising the treatment of rectal cancer – giving patients a chance of a better quality of life by significantly reducing the need for life-changing surgery.
The results of an international study, the OPERA trial, led by a team at Clatterbridge, has shown that using contact X-ray brachytherapy (CXB), combined with chemo-radiotherapy, significantly improves organ preservation rates for patients with early-stage rectal adenocarcinoma.
This innovative approach, which uses specialist internal radiotherapy, is providing new hope for those affected by this challenging condition. It gives patients hope of being cured without invasive surgery to remove the cancerous growth in the rectum, which can mean the need of a permanent stoma. Colorectal cancer is one of the most common cancer in the UK, with rectal cancer accounting for a third of these cases.
The clinical trial – led in the UK by Clatterbridge consultant Professor Sun Myint – followed patients for five years and showed a striking increase in organ preservation rates, from 56% in current standard treatment to 79% in the CXB group.
One patient, who had successful treatment on the clinical trial, is an NHS worker who herself cares for cancer patients.
Sharon Price was just 45 and only recently married when she was given the devastating news that she had rectal cancer. She became one of the first patients to join the research study.
“I was faced with the possibility of surgery, which would mean that I’d have to live with a stoma for the rest of my life. That was devastating – I was just too young to have to go through that and live with the consequences of how it can change what you’re able to do. Many people do live with a stoma but for me, there would be no reversal of it, and I found it very difficult to contemplate that.
“I was offered the chance to join the clinical trial and I decided to do it immediately. It gave me the chance not to have invasive surgery, but if it did not work, I could still have that standard treatment.”
Sharon, who lives in Newcastle-under-Lyme in Staffordshire, started on the trial in December 2019 and had three rounds of CXB before 25 sessions of standard chemotherapy and radiotherapy. This eradicated her cancer and it was followed up with intensive monitoring for three years before she was given the all-clear.
“I’m so glad I went for it,” said Sharon, a Lung Cancer Navigator at Leighton Hospital, in Crewe. “The OPERA trial has meant I have had a normal, healthy life after being diagnosed with cancer. It has had no lasting impact on my life – and I wonder if that would have been the case if I had not joined the research.”
Prof Myint, a pioneer and world expert in the field of rectal cancer treatment, emphasises how important the research findings are. He said: “This study is a significant milestone in rectal cancer management. The ability to preserve organs in nearly 80% of cases without compromising bowel function or long-term quality of life is a game-changer for patients.”
The OPERA trial involved 141 patients with rectal cancer who were given external beam radiotherapy (EBRT) and chemotherapy and were then either given a further boost of EBRT (arm A – standard of care) or the CXB (arm B – experimental treatment).
CXB attacks the tumour directly while minimising side effects. Low level X-rays are placed directly on the cancer and a high radiation dose kills the tumour cells, while preventing damage to the normal, healthy bowel around the tumour.
The Clatterbridge Cancer Centre is one of the world’s leading centres for this type of treatment for rectal cancer, called Papillon, and was the first hospital to offer it in the UK when it was established by Prof Myint in 1993.
“For many patients, the prospect of a permanent colostomy is life-changing,” said Prof Myint. “This technique not only spares the organ but also preserves dignity and quality of life.”
Prof Myint says the study findings showed that bowel function was not worsened by the CXB boost, further supporting its role as a safe and effective treatment option.
He says the results set a new benchmark for early rectal cancer treatment and is optimistic about the broader application of this technique in other cancers, marking a significant step forward in precision oncology.
Professor Myint said: “These results should encourage wider adoption of contact X-ray brachytherapy as part of standard care for eligible patients. It’s a beacon of hope for those battling rectal cancer.”
Sharon added: “I’m really pleased this research has had so much success – Professor Myint and his team are brilliant. It is a type of treatment that should be offered to anyone who develops rectal cancer at a young age.”
