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Thursday, 6 July, 2000, 23:17 GMT 00:17 UK
UK 'missing out' on life-saving surgery
The new technique could save lives
A cancer surgery technique pioneered in the UK could save 1,800 extra lives a year - but now doctors must be persuaded to use it.

Surgeons in Sweden treating patients with rectal cancer have been using "Total Mesorectal Excision" (TME) for some time, and the rate of recurrence has plummeted as a result.

In addition, the procedure is far less likely to damage nerves controlling sexual function, or leave the patient needing a colostomy.

However, despite the fact that the technique was developed by a British expert at a hospital in Basingstoke, UK patients are highly unlikely to receive the operation.

Professor Bill Heald, who pioneered TME, taught it in a series of seminars to the Swedish surgeons.

He is amazed that charity cash may be required to organise a similar teaching programme for UK surgeons.

100,000 more to be saved

He said: "The government wants to save 100,000 extra lives of cancer patients.

"Little attention is being paid to the thing that is likely to save them."

The technique is already included in a book of recommended procedures from the Royal College of Surgeons, but Professor Heald wants it to be appraised by the National Institute for Clinical Excellence, the government's advisory body.

Professor Bill Heald
Professor Heald: "Terrific challenge"
This could lead to Department of Health guidance telling surgeons to use it.

Rectal cancer is one of the more common in the UK, with approximately 10,000 new cases a year, and the disease comes back in more than 50% of patients following old-style surgery.

This is because the surgeon, often working unsighted, is not removing enough of the cancerous tissue.

In addition, it is all too easy to cut into key nerves which can leave the patient permanently damaged.

Professor Heald's precision method, carried out using advanced video camera equipment, takes out the entire part of the rectum in which the cancer grows - but nothing else.

"It's a terrific challenge for the surgeon," he said.

However, he feared it could be decades before the technique was accepted best practice among all surgeons doing colorectal surgery.

The charity, Pelican Centre, is trying to raise 5m to speed up this process.

The study, published in The Lancet medical journal, involved almost 500 people treated using the technique.

Local recurrence rates - where the cancer comes back in the original location - were halved, and cancer-related deaths fell from 15% to less than 10%.

The number of people who needed permanent colostomies following surgery dropped from 60% to just 27%.

Professor Heald said: "Rectal cancer is certainly very treatable, particularly if in the early stages."

However, once it had recurred, he said, the outlook was bleak for the patient, often leaving them in worsening pain for as much as five years with no possible treatment for the cancer.

It is estimated that every death from rectal cancer in the US costs the economy $500,000 in lost earnings, benefits and medical support. The figure would be similar in the UK.

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19 Nov 99 | Medical notes
Bowel cancer
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