Surgery aids advanced cancer patients with blocked bowel.
Surgery aids advanced cancer patients with blocked bowel.
Surgery Recommended Sooner for Bowel Obstructions in Patients with Advanced Abdominal Tumors
Malignant bowel blockages, a common occurrence in patients with advanced abdominal tumors, particularly ovarian or colon cancers, have shown promising results in a clinical trial. The trial suggests that surgery should be offered earlier during their hospital stay to improve symptoms and quality of life, despite not significantly increasing the number of days patients are alive and out of the hospital.
Principal investigator Dr. Robert Krouse, a professor at the University of Pennsylvania Perelman School of Medicine and chief of surgery at the Veterans Affairs Medical Center in Philadelphia, expressed the importance of this study. “We knew enrolling patients in the hospital with this acute issue and advanced cancer would be difficult, but the questions are of great importance to clinicians, patients, and families.” The trial, led by the SWOG Cancer Research Network, involved 199 patients with major bowel obstructions (MBO), all of whom were considered candidates for surgery.
Bowel obstructions can result directly from tumors or from complications of surgery or radiation treatment. Besides being potentially life-threatening, these obstructions cause significant suffering, including vomiting, pain, and constipation. Patients with MBO are typically at the end stage of cancer and receive palliative care aimed at improving their quality of life and reducing symptoms and pain.
The trial compared two treatment options: surgery and medication. Although patients were offered the chance to be randomly assigned to a treatment type, only 25% of them agreed, while others decided with their doctors which treatment to choose. Approximately 40% of participants who chose their treatment opted for surgery.
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The study’s primary focus was to assess the number of “good days” each patient experienced during the first three months after registering for the trial. Interestingly, the number of good days did not significantly differ between the two treatment methods. Additionally, patients’ ability to eat at week five also remained the same.
However, secondary measures indicated that surgery resulted in improvements in MBO-related symptoms. At week four, surgery patients had better symptom scores for vomiting, constipation, nausea, and pain compared to those who underwent non-surgical treatment. Furthermore, the group that received surgery reported fewer MBO-related symptoms after leaving the hospital.
“We are continuing to analyze the data to allow us to make recommendations to clinicians regarding the optimal operations and other quality of life factors that may be impacted by the type of treatment received,” Krouse stated in a SWOG news release. He highlighted the network of institutions and investigators involved in the study, which will help further examine important questions in this population of cancer survivors.
The study findings were published on August 1st in The Lancet Gastroenterology & Hepatology. This research brings hope and new insights into the treatment of bowel obstructions in patients with advanced abdominal tumors.
More information
The American Cancer Society provides further information on managing advanced cancer.
Source: SWOG Cancer Research Network, news release, August 1, 2023
