Yes – today more patients survive their bowel cancer and liver metastases for longer with a better quality of life and Pelican has been central in these advances. If we could send everyone back 25 years you would see very different surgery – if the surgeon heard a suction sound as the bowel was removed it was thought to be a good operation, liver surgery was a bloody and dangerous operation. Pelican has promoted precision surgery and the role of the multi-disciplinary cancer team to work with patients to select the best treatment.
Pelican’s work has been about the introduction of planning and precise treatment for primary and secondary bowel cancers:
- both the surgeon and nurse specialist discussing the case with the patient
- imaging that aids selection of the appropriate treatment
- surgery that carefully removes the cancer
- selective use of radiotherapy and chemotherapy
- precise histopathology that provides prognostic details of future disease
Whilst billions of pounds have been spent on drugs and DNA research the real advances in this dangerous cancer have been through developing precise surgery, making MRI mandatory for every rectal cancer, reducing the number of rectal cancers that recur and only giving chemo radiotherapy to those patients who will benefit. No drug or radiotherapy has given such a great benefit for bowel cancer patients.
We aren’t there yet, too many patients die within 5 years of bowel cancer treatment (up to 54%). Patients who receive curative treatment have better outcomes – we know that in some hospitals 80% of patients survive more than 5 years. What Pelican will do in 2013 – 2018 is fund research and education that can help increase the number of people who survive their cancer more than five years after treatment.
There are six areas of bowel cancer that we will work on in the next four years:
- Support developments in precision rectal and liver cancer surgery.
- Bowel cancer screening has led to more patients presenting with early stage rectal cancer (T1 and T2). We will organise meetings and support studies looking at staging, planning and treatment options for these early rectal cancer.
- Quality of life after bowel cancer surgery is the priority for patients. We will fund research looking at the quality of life after different rectal cancer treatments, including post radiotherapy.
- England has worse outcomes for patients over 70 years of age than other developed countries We will organise meetings and support studies to help more patients receive optimal treatment regardless of age.
- 40% of bowel cancer patients develop secondary liver cancer and we want to help clinicians identify which patients will develop metastases sooner and which treatment gives the greatest benefit.
- Colon cancers – 30% of all bowel cancers are found in the sigmoid colon, many of which are in the pelvis. We will support meetings and research on the definition, staging, treatment and quality of life for patients with sigmoid cancers.
The objective of Pelican’s work is to make changes in clinical practice that will result in patient’s having more precise treatment to survive for longer with a good quality of life. Whilst bowel cancer is the focus of Pelican’s work we have supported a number of prostate cancer initiatives which have made a major impact on prostate cancer treatment.
Historically men with prostate cancer have had very difficult decisions to make as the diagnosis method (PSA testing) for this disease is notoriously imprecise and there have only been two treatment options – do nothing or radical treatment. Pelican’s objective is to make diagnosis and treatment more precise so that men avoid both over treatment and under diagnosis.
Pelican supported the first feasibility studies into focal therapy using high intensity focus ultrasound (HIFU) to ablate the prostate cancer which has led to large multi-centre trials. As well as focal therapy Pelican has supported the improvement of imaging (MRI) for prostate cancer, again this has led on to large Phase II multi-centre trials. We are now organising international master classes for urologists and radiologists on the use of MRI before biopsy for prostate cancer.
In the next four years Pelican will:
- Support educational master classes and meetings to promote alternatives to TRUS biopsy, in particular greater use of MRI for low to medium risk prostate cancers.
- Support innovative feasibility studies on imaging and focal therapy.
If you want your donation to medical research make a difference then support Pelican’s work. We are a small charity working directly with clinicians carrying out robust clinical research and then working with the whole cancer team to develop precise diagnosis and treatment.
Pelican’s work makes a difference for today’s cancer patients.