"For rectal tumors located less than 7 centimeters from the anus, the patient is often submitted to radiochemotherapy during five weeks, having a subsequent recovery period of another eight to 10 weeks before the surgical intervention," explains Nuno Figueiredo, head of the Champalimaud Surgical Centre and a colorectal surgeon at the Digestive Cancer Unit of the Champalimaud Clinical Centre, and one of the co-authors of the new study, together with his colleagues Marit Van der Sande and Geerard Beets, from the Netherlands Cancer Institute. These could, in turn, have devastating post-operative consequences, such as suture defects leading to peritonitis. This pre-operative treatment comes with its own side effects, increasing the probability of urinary and sexual dysfunction, worse bowel function or even a deficient healing process. But the fact is that, for complicated locations of the tumor in the rectum, a previous course of radio-chemotherapy before surgery is required, because in these cases, it is necessary to reduce the size of the tumor that might already be invading the pelvic wall structures or even other organs. Surgery still is, today, the frontline classical treatment protocol for rectal cancer cases, which represent about 30% of all colorectal cancers, or about 6 million new cases per year worldwide, according to 2018 estimates. In other words, no precious time will have been wasted by waiting and watching the patient. Agreeing instead to submit to a very close and strict surveillance of their condition during a period of at least two years in a "watch-and-wait" strategy, they might even evade surgery without any negative impact on their health outcome, since (around two-thirds of these patients do not show any regrowth of the tumour after the first two years.Īccording to the scientists, it is notable that of the remaining patients (around one-third), who do experience tumour regrowth within those first two years and who undergo exactly the same surgical procedure as was initially planned for them, 97% show the same outcome as if the surgery had been performed immediately after radio-chemotherapy.