JGH Foundation funding kickstarted a study showing that targeted radiation therapy can prevent the need for bowel surgery for patients with early rectal cancer.

Dr. Té Vuong is on a mission to prove that rectal cancer can be cured effectively without surgery, thus avoiding the life changing side effects of surgery, especially for patients with low rectal cancer. What’s more, she believes she can do so at a lower cost to the healthcare system.

“Our results are very encouraging so far and the rest of the world is taking notice,” she said. In fact, global leaders in researching and treating rectal cancer will be in Montreal in mid-October for a conference at the JGH to discuss the treatment options currently available to achieve a cure without surgery for patients with rectal cancer, and to discuss the work and findings of Dr. Vuong’s research team. The efficacy of each of these options will be discussed in order to reach a consensus for collaboration and achieve a cure with better quality of life.

“Our results are very encouraging so far
and the rest of the world is taking notice.” – Té Vuong

Dr. Vuong’s team is finding that they can successfully treat patients with early stage rectal cancer given 5 weeks of external radiation, followed by light chemotherapy and then by targeted radiation called brachytherapy. This is done on an out-patient basis without the need for the hospital stays surgery entails, and without the potentially serious side effects of more intense chemotherapy. Patients can avoid compromised bowel function or the need to use colostomy bags that often results from surgery.

What’s more, they can provide this effective treatment at a cost of $12,000-$15,000 per patient, compared to about $34,000-$36,000 for standard admission and surgery.

“Our work was kickstarted by donations to the JGH Foundation,” said Dr. Vuong. “It solved the big obstacle in research of getting started – you need to provide preliminary safety and efficacy data or no one will fund you, but the JGH Foundation did and now our research is getting noticed and having results.”

JGH Foundation funding provided state-of-the-art equipment

JGH Foundation support allowed for the purchase of state-of-the-art radiation and endoscopy equipment. It funded the required personnel and the additional medical scans and tests on patients, which are part of the research process and are not covered by regular government healthcare funds.

The result is the MORPHEUS study, a formal clinical trial to evaluate the effectiveness of using escalated doses of brachytherapy to treat rectal cancer. Brachytherapy means using sources of radiation that are delivered internally at the tumour site. This is used in addition to standard external beam radiation therapy.

The study is ongoing at the JGH as well as at hospitals in Quebec City, Longueuil (Hôpital Pierre Boucher) and Gatineau. Dr. Vuong hopes more sites will be added in the near future, including internationally, so the study can achieve its planned total number of patients as soon as possible.

An interim review of the results of the study thus far was published in July and showed very promising results, with 90 per cent of patients in the brachytherapy group achieving a complete clinical response and more than three-quarters not requiring bowel surgery over a two-year follow-up. The study continues, with both ongoing observation of current patients and recruitment of new ones. Dr. Vuong is hopeful the study will complete recruitment over the next year or two, possibly sooner if non-Canadian hospitals join in.

The ability to conduct this type of world-leading research at the JGH has a direct positive impact on patients, added Dr. Vuong. “Because of all the additional care, tests, scans and follow-up they receive as part of the research protocol, which are funded by the research grants, our patients in the study are getting the highest level of care of any patients anywhere.”

“Our work was kick-started by donations to the JGH Foundation … now our research is getting noticed and having results.” – Té Vuong

Another study initiated by Dr. Vuong’s team aims to learn more about how patients evaluate different treatment options they are presented with and how they weigh the pros and cons of each. This study allows patients being treated for rectal cancer at the hospital to respond to two questionnaires that record their socio-demographic information and ask about their health, cancer management and the chosen treatment. The study seeks to understand patients’ treatment preferences. Preliminary results will be presented at the October meeting.

This international meeting is being sponsored in part by the JGH’s Lady Davis Institute for Medical Research, which has flourished over the past half-century as one of Canada’s leading centres for ground-breaking research.

Research has implications for other cancers

While Dr. Vuong specializes in rectal cancer, her work on refining the use of radiation therapy will have implications for the treatment of other cancers in which radiation is an option, including skin and breast cancer. “With the advances we have made in radiation therapy, imaging techniques, equipment and software, there is great potential to make brachytherapy a more common, useful and affordable treatment in other cancers,” she said.

Unfortunately, there is no shortage of patients with colorectal cancer, which is the third most common cancer diagnosed in Canada. “The risk of colorectal cancer increases greatly with age, often as a result of diet and other lifestyle factors that accumulate as people grow older,” said Dr. Vuong.

“We are now seeing a large number of colorectal cancer cases in the baby-boom generation so it’s vital for us to do the research to develop the best treatment strategies and give them options tailored to their situation. That’s what our work is all about, thanks to the JGH Foundation’s support. I’m really excited about what we are doing!”

To make a donation to the JGH Foundation, please go to www.jghfoundation.org