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Trimodal Therapy Underused in Rectal Cancer Treatment

Increasing the odds for survival of rectal cancer patients is the point behind a three-step treatment process that begins and ends with chemoradiotherapy. While the increased likelihood of survival is significant when trimodal therapy is used, research is showing that only about half of eligible patients actually go through the entire process.

The therapy in question involves the use of neoadjuvant chemoradiation therapy prior to surgery, surgery and then adjuvant radiotherapy. When this trimodal process is used, the five-year survival rate is about 72 percent for patients with stage II and stage III rectal cancer. When it is not, the five-year survival rate drops to about 70 percent. For patients who only receive surgery or chemoradiotherapy, the survival rates drop down into the 40-percent range.

Researchers recently looked at the number of patients who had received the three-prong treatment and determined the usage rate was rather low at about 50 percent. The incidence rate of underutilization was especially high among those who are black, older, have a larger primary tumor size, suffered from comorbidities and had a lower median income. Lack of usage was also noted among those who did not have private insurance and those who were treated at lower volume facilities. The study was based on information related to more than 66,000 patients who were treated between 2004 and 2012.

With data backing the use of the three-step approach, researchers say the need is high for clinicians to recommend it and help their patients follow through. With a higher than 70 percent survival rate, the trimodal approach tends to produce the best outcomes for patients, making it important for practitioners and patients to identify and eliminate any barriers that may stand in the way.

The American Cancer Society estimates just under 40,000 new cases of rectal cancer are diagnosed annually in the United States. This form of cancer, when caught early, can be highly treatable, making routine screening important. For those diagnosed in later stages, evidence shows that the trimodal approach may offer the best survival chances.

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