A non-surgical approach to organ preservation has arrived

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Typical rectal cancer treatment protocols are intensive and involve several steps, including invasive surgical intervention.1 The surgical removal of rectal tissues is a standard procedure to treat rectal cancer, in addition to chemotherapy and radiation therapy.2

Image Credit: Shutterstock.com/chainarong06

This aggressive strategy can pose a risk to the health outcomes of rectal cancer patients. Many patients are over 65 years of age, and finding safe and effective alternative treatments is essential for reducing the risk of morbidity and mortality and improving organ preservation.

There is an urgent need for non-invasive cancer therapies that improve medical outcomes for patients. One emerging approach is the Watch and Wait (W&W) protocol, which avoids surgery and relies on regularly monitoring patients with no visible tumors after radiation and chemotherapy treatments.

There is a pressing need to improve the Watch and Wait protocol due to concerns with tumor recurrence post-treatment and consequent mortality risk caused by some cancer cells not being destroyed during the initial treatment.

One solution, which can strengthen Watch and Wait efficacy, is contact X-ray brachytherapy (CXB), also know as the Papillon technique. This approach benefits early-stage cancer patients who would otherwise be unsuitable surgery candidates.1

This article will focus on how contact X-ray brachytherapy (CXB) offers a non-surgical method to treating rectal cancer and improving organ preservation. The piece will also discuss how a contact X-ray brachytherapy (CXB) boost could enhance the Watch and Wait protocol.

Contact X-Ray Brachytherapy boosts rectal cancer response rate

Contact X-ray brachytherapy (CXB), also known as Papillon CXB, is a form of brachytherapy that specifically targets visible tumors with high dose, low energy X-rays instead of radioisotopes. This technique penetrates only a few millimeters past the tumor, ensuring non-cancerous tissue is unaffected by radiation and the health of surrounding organs is preserved.1

Multiple studies have demonstrated that contact X-ray brachytherapy boosts rectal cancer response rate during the Watch and Wait approach. Research by North Cumbria University Hospitals in the UK reviewed 17 patients treated for rectal cancer over six years with contact X-ray brachytherapy boost.3

Of the 14 remaining patients, 79% exhibited a complete (no tumors visible) or partial response to the treatment. Contact X-ray brachytherapy boost led to sustained therapeutic response over time in advanced disease levels and high-risk patients.3

A French study examined the impact of contact X-ray brachytherapy on organ preservation in 112 rectal cancer patients.4 Three experimental groups were studied:

  • Local tumor removal followed by CXB
  • CXB with chemoradiotherapy
  • CXB and chemoradiotherapy before complete rectal tissue removal 

The first group displayed 96% organ preservation, with the second group displaying 89% organ preservation and a complete clinical response in 96% of patients. Some organ preservation occurred in 86% of patients in the third group. 

The scientists concluded that contact X-ray brachytherapy could increase organ preservation and boost other rectal cancer radiation treatments4. The clinical approach is suitable for surgical-appropriate and non-surgical patients. 

Another clinical study looked at dose escalation effects on tumor regression in 83 rectal cancer patients.5 This involved 90 Gy of CXB in three fractions over four weeks (a fraction every two weeks). The study used a multi-modal approach, combining CXB treatments with radiation therapy and external beam chemoradiation therapy. 

Most of the study’s patients observed a complete clinical response, suggesting that contact X-ray brachytherapy could be an effective alternative to aggressive and invasive surgical procedures.5 

The results of a Phase 3 trial of Organ Preservation for Early Rectal Adenocarcinoma revealed that CXB, also referred to as the Papillon boost, in addition to the Watch and Wait protocol, increases complete clinical response to over 80%.6 

The Papillon boost can act as a legitimate non-surgical alternative that impacts the general quality of life and mental well-being of rectal cancer patients. 

Innovating Contact X-ray Brachytherapy treatments for organ preservation in rectal cancer therapeutics

Contact X-ray brachytherapy is a non-surgical method that supports organ preservation and lowers patient risk in rectal cancer treatment.

Leading life sciences companies, including Ariane Medical Systems, provide innovative contact X-ray brachytherapy technologies to improve patient health outcomes.

Ariane Medical Systems has developed the Papillon+ X-ray Brachytherapy system that can be adapted to numerous applications, including breast and superficial skin cancer treatment, and performing contact X-ray brachytherapy treatment for rectal cancer.7

The Papillon+ X-ray Brachytherapy system is an all-in-one workstation created to prioritize ease of use and safety.7

The company’s system delivers an efficient method to treat tumours and prevent the need for intensive surgery, particularly for rectal cancer.7

The Papillon+ X-ray brachytherapy system from Ariane Medical Systems provides a non-surgically invasive approach that emphasizes patient comfort and positive health outcomes.

Ariane Medical Systems is a frontrunner in clinical cancer solutions, offering global technology solutions and services. 

Clinicians provide patients with individualized treatments using innovative tools such the Papillon+ X-ray brachytherapy system, which complements clinical approaches, such as the Watch and Wait protocol, and amplifies organ preservation. 

More information about Ariane Medical contact X-ray brachytherapy technologies and additional medical solutions can be found on the company website. If you are interested in learning more about contact X-ray brachytherapy treatment, contact a member of the Ariane Medical team today.

References

  1. Sun Myint et al. (2019) Treatment: the role of contact X-ray brachytherapy (Papillon) in the management of early rectal cancer Colorectal Disease 21 pp 45-52 [online] Available at: https://doi.org/10.1111/codi.14507
  2. News-Medical. (2020, October 27). New approach can prevent aggressive operation in certain rectal cancer patients. News-Medical.net. https://www.news-medical.net/news/20201027/New-approach-can-prevent-aggressive-operation-in-certain-rectal-cancer-patients.aspx
  3. Smith, F.M et al. (2016) Contact radiotherapy boost in association with “watch and wait” for rectal cancer: initial experience and outcomes from a shared programme between a district general hospital network and a regional oncology centre. Colorectal Disease, 18(9), 861–870 [online] Available at: https://doi.org/10.1111/codi.13296
  4. Frin, A.C et al. (2017) Organ or sphincter preservation for rectal cancer. The role of contact X-ray brachytherapy in a monocentric series of 112 patients. European Journal of Cancer, 72, 124–136. [online] Available at: https://doi.org/10.1016/j.ejca.2016.11.007
  5. Sun Myint et al. (2018) Dose Escalation Using Contact X-ray Brachytherapy After External Beam Radiotherapy as Nonsurgical Treatment Option for Rectal Cancer: Outcome From a Single-Center Experience. International Journal of Radiation Oncology*Biology*Physics 100(3) pp. 565-573 [online] Available at: https://doi.org/10.1016/j.ijrobp.2017.10.022
  6. Myint, A. S., et al. (2022). New hope from OPERA trial for surgically fit rectal cancer patients who wish to have organ preservation. Colorectal Disease. [online] Available at: https://doi.org/10.1111/codi.16286
  7. Brachytherapy System | Papillon Therapy. (2022, July 22). Ariane Medical Systems. [online] Available at: https://www.arianemedicalsystems.com/products/papillon-therapy

Article originally published on https://www.news-medical.net/whitepaper/20221213/A-non-surgical-approach-to-organ-preservation-has-arrived.aspx on Dec 13 2022

Treating Cancer in Elderly Patients

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Cancer is a disease that impacts a multitude of people around the world. While cutting-edge cancer research seeks to combat the globally significant disease, specific populations are not always considered. Treating cancer in elderly patients poses unique challenges to biomedical scientists and healthcare professionals due to the lack of data on the particular age cohort.

Conventionally, elderly patients are under-treated and less likely to be included in clinical trials than younger patients, leading to underrepresentation in cancer treatment papers1. This lack of scientific attention to treating cancer in elderly patients creates a space for innovative solutions to address and improve existing therapeutics.

Reports from the National Cancer Intelligence Network show evidence that cancer treatments like surgery and radiotherapy are offered at different rates to differently aged patients2. As a patient ages, their chances of receiving effective and appropriate treatment dwindles, based on this information. Furthermore, questions of whether or not cancer treatment is appropriate for a specific elderly patient’s case, is actually offered, is accepted by the patient, or is accurately recorded remain2. This gap in the data makes treating cancer in elderly patients in great need of personalized and forward-thinking healthcare plans.

This article will focus on treating cancer in elderly patients with specific attention to important considerations for researchers and caregivers to consider when developing cancer therapeutics – including the patient’s personal situation. Additionally, this piece will highlight multiple applications of brachytherapy technology as an efficient method of treating cancer in the elderly and the importance of a holistic view of cancer treatment and healthcare for cancer in elderly patients.

Important Considerations for Improving Treatments of Cancer in the Elderly

When treating cancer in elderly patients, an important question to ask is: is the patient’s personal situation being taken into account or just the treatments of the cancer itself? To effectively treat cancer in the elderly, which poses specific social and medical challenges to care, the conditions in which a patient exists must be accounted for and assessed. Key features of effective therapeutics for cancer in the elderly include the type of cancer treatment and the speed of treatment delivery, the need for surgery, and the impact of patient decision-making.

Understanding and addressing drivers of patient decisions is crucial to the improvement of treatments of cancer in elderly patients. For example, will an older woman with breast cancer have a breast removed because she is unable to make the commute to and from hospital? In a study published in Annals of Surgical Oncology in 2017, researchers measured the effect of travel distance and time to radiotherapy on the likelihood of receiving a mastectomy for elderly patients with breast cancer3. The paper found that the distance and time needed to travel to a radiotherapy facility for treatment were barriers to treating breast cancer in elderly patients and impacted whether or not they chose to undergo standard cancer care, including techniques like breast conservation surgery and whole-breast irradiation3.

For example, patients residing further than 9.2 miles from a radiation facility were over 40% more likely to receive a mastectomy compared with those residing closer than 9.2 miles. In addition, patients requiring more than 19 minutes of travel time were 36 % more likely to receive a mastectomy than those traveling less than this amount of time3.

Moreover, consider the impact on an elderly patient’s quality of life when fitted with a stoma, a type of treatment for anal or bowel cancer. Are they physically able to change the stoma? What happens with the onset of dementia in elderly patients on the ability to manage a stoma? Also, will there be physical scarring to the skin from surgical removal of small superficial skin cancers? With all of these important considerations around the unique conditions in which an elderly patient exists, it is vital for cancer researchers and caregivers alike to embrace a multidisciplinary approach to develop and execute individualized treatment of cancer in the elderly1.

Can X-Ray Brachytherapy Help Treat Cancer in Elderly Patients?

Often, complications and survival rates in surgery rise with a patient’s age and decrease the suitability of surgical intervention as a treatment option for cancer in the elderly. Thus, radiotherapy offers an alternative treatment option for cancer in elderly patients. For example, using data around rectal cancer in elderly patients, scientific experts suggest that while there are limited results around treating cancer in elderly with contact radiotherapy ­– also known as Papillon radiotherapy or X-ray brachytherapy – the method has great potential to be effective and safe in elderly patients with early-stage rectal cancer4.

Radiotherapy is an emerging solution to treating cancer in the elderly and can address many of the specific social and circumstantial constraints on this unique population of patients. Specifically, intra-operative radiotherapy delivers large doses of radiation targeted to tumors or tumor beds, maximizing treatment to cancerous cells while simultaneously minimizing radiation to healthy cells, all whilst the patient is under anesthetic5. Due to its very nature, a single radiotherapy “boost” to the tumour bed offers an alternative to the multiple fractions needed when delivering partial or full breast irradiation when undertaking breast-conserving surgery for the treatment of breast cancer in elderly patients.

Continuing to Innovate Solutions for Cancer in the Elderly

The Papillon+™ X-ray Brachytherapy system by Ariane Medical Systems has three main clinical applications – combatting colorectal cancer, executing breast intra-operative radiotherapy, and treating superficial skin cancer6. Due to its flexibility in duration, dose, and brachytherapy fractions, this system can tailor treatments for cancer in the elderly to meet personalized patient care needs.

Furthermore, the Papillon+ ™ X-ray Brachytherapy system is designed with consideration of drivers around patient decisions, ultimately increasing cancer treatment accessibility, usability and comfort6. In cases of colorectal cancers, this platform can treat tumors with little to no physical invasion of the patient through surgery. Regarding breast cancer in the elderly, the Papillon+ can increase the speed of treatment delivery and reduce repetitive hospital visits. Thirdly, the system can non-invasively and effectively target superficial skin cancer tumors with little scarring or cosmetic damage to an elderly patient’s more fragile skin6. By reducing the need for surgery to treat cancer in elderly patients, Ariane Medical Systems‘ Papillon+™ X-ray Brachytherapy solution prioritizes patient choice and care.

In summary, existing treatments for cancer in elderly patients need to be examined with a critical eye and consider both clinical outcomes as well as individual consequences. Furthermore, patient circumstances such as where they live, their caring obligations, and their mental health carry as much weight in developing a treatment plan as the default go-to choice of a “gold standard” treatment option. Barriers like distance and time and resulting quality of life for patients are significant factors to think about while creating treatment plans for cancer in the elderly. 

Ariane Medical Systems is a leader in targeted cancer therapeutics and offers services globally. The biomedical experts and oncologists at Ariane Medical Systems provide patients with individualized treatments using innovative techniques such as the Papillon+™ X-ray Brachytherapy system, which is particularly effective in treating cancer in the elderly. If you are interested in learning more about cancer in the elderly and our holistic, multidisciplinary approach to ensuring individualized healthcare, please contact a member of our team today.

References:

  1. Millan, M., Merino, S., Caro, A., Feliu, F., Escuder, J., & Francesch, T. (2015). Treatment of colorectal cancer in the elderly. World Journal of Gastrointestinal Oncology, 7(10), 204. https://doi.org/10.4251/wjgo.v7.i10.204
  2. The Age Old Excuse: The Under Treatment of Older Cancer Patients. ‌(2022). Macmillan Cancer Support. https://www.macmillan.org.uk/documents/getinvolved/campaigns/ageoldexcuse/ageoldexcusereport-macmillancancersupport.pdf
  3. Goyal, S., Chandwani, S., Haffty, B. G., & Demissie, K. (2014). Effect of Travel Distance and Time to Radiotherapy on Likelihood of Receiving Mastectomy. Annals of Surgical Oncology, 22(4), 1095–1101. https://doi.org/10.1245/s10434-014-4093-8
  4. Contact radiotherapy for elderly patients with early low rectal cancers. (2020). British Journal of Hospital Medicine. https://www.magonlinelibrary.com/doi/abs/10.12968/hmed.2013.74.7.391
  5. Intra Operative Radiotherapy | Alternative Cancer Treatment. (2022, April 20). Ariane Medical Systems. https://www.arianemedicalsystems.com/patients/?doing_wp_cron=1653938536.2735350131988525390625
  6. News-Medical. (2022, February 15). Improving X-Ray brachytherapy treatment using the Papillon+TM. News-Medical.net. https://www.news-medical.net/whitepaper/20220215/Using-the-Papillon2be284a2-to-Improve-X-ray-Brachytherapy-Treatment.aspx

Brachytherapy for Rectal Cancer

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Rectal cancer surgery is complicated by the proximity of the rectum to other organs and structures. Patients often have to make the difficult choice between radical resection, which requires subsequent use of a stoma, or sphincter preservation surgery that maintains quality of life but carries a higher risk of recurrence. Brachytherapy for rectal cancer is now available as a potential alternative to surgery for patients with low-lying small rectal tumors.

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Treatments for Non-Melanoma Skin Cancer

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Non-melanoma skin cancer is a term used for all the cancer types that happen in the skin but are not melanoma. This includes several types of skin cancer including squamous cell skin cancers and basal cell carcinoma. In this article, we discuss some of the key non-melanoma skin cancer treatments and their key characteristics. 

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Alternative Breast Cancer Treatments – What Works?

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Receiving a breast cancer diagnosis can be extremely worrying and intimidating for patients. Very few of us are well informed regarding the different treatment options available for breast cancer, and as such we may not be aware of some of the alternative breast cancer treatments available.

Knowledge is power and making informed choices under the guidance of a doctor regarding the treatment route you choose is important. This article aims to explain some of the alternative breast cancer treatments available and which of them actually work.

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Rectal Cancer Treatments, by Stage

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Rectal cancer is a type of cancer in which malignant cancer cells form in the tissues of the rectum. There is a range of rectal cancer treatments that can be carried out, varying concerning the cancer stage. This article will discuss the key stages of the disease and which rectal cancer treatments should be offered accordingly.

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Improving Patient-Centered X-ray Brachytherapy Treatment with Papillon+™

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A 2020 report from The International Agency for Research on Cancer (IARC) estimated that as many as 1 in 5 people globally would experience a form of cancer during their lifetime.

Global aging populations and a range of socio-economic risk factors represent some of the key drivers of this increase. There is an ever-increasing demand for cost-effective, accessible, efficient, and patient-centered cancer therapy and treatment.

Ariane’s Papillon+™ system offers medical practitioners a turnkey solution to successful rectal, superficial and intraoperative X-ray brachytherapy via a range of treatment modalities.

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