Specialists at The Christie and The University of Manchester have made a breakthrough which could potentially improve detection and treatment of anal cancer, as well as have wider implications for other cancers. 

Anal cancer is a rare form of cancer, but cases have increased dramatically in recent years. Research is urgently needed to improve detection and treatment and to save lives. The findings of this project will play a crucial role in these efforts going forward.

Funded by the Bowel Disease Research Foundation (BDRF) charity, the work has been published in the Lancet Oncology journal.

The study worked with data on more than 10,000 patients, examining whether current methods of checking if anal cancer has spread to lymph nodes are giving experts an accurate picture of survival rates. The research team was led from Manchester, working hand in hand with centres in Leeds and Switzerland.

Anal cancer that has spread to lymph nodes is linked to a worse prognosis and lower chance of survival

The project's findings however have uncovered a phenomenon suggesting rates of lymph node spread are being overestimated, potentially leading to overtreatment of patients with chemo radiotherapy.

This can result in damaging side-effects, and doctors are particularly keen to avoid it in cases where it offers little benefit to the patient at potentially great cost.

The results will be crucial to future large scale trials looking at optimum care for anal cancer patients. By identifying a unique phenomenon, these results will be taken into account by future work and ultimately could lead to better diagnosis of tumour stage and thus better treatment.

Christie consultant, Professor Andrew Renehan, who leads the Manchester Cancer Research Centre (MCRC) Anorectal Organ Preservation Research Group, said: "These high-profile results will play a vital part in improving patient care. Our research team has done a wonderful job highlighting an important and as yet unrecognised issue in the staging of cases of anal cancer.

“These findings will help us to better understand how anal cancer patients should be treated, ultimately improving survival rates and quality of life. It is crucial that we tackle what is becoming an increasingly common form of cancer through research studies like this. These findings could provide learnings for other cancers too.”

Christie patient Jill De Nardo, who is 58 from Buxton, was diagnosed with anal cancer in 2010. She said: “My first thought on diagnosis was that I wanted to survive, I gave little thought to long term or late effects of treatment. Fortunately my treatment has been successful and seven years on my own late effects are manageable but will only get worse. Many are not so fortunate and live daily with the discomfort and impact of side effects such as joint pain and continence issues.”

Jill adds: “Anal cancer is on the increase and those of us who have been through what at times was gruelling radiotherapy regimen, welcome this study and the impact it will have on the treatment plans of patients in the future.”

The full article entitled, ‘Nodal stage migration and prognosis in anal cancer: a systematic review, meta-regression, and simulation study’, can be accessed here - http://thelancet.com/journals/lanonc/article/PIIS1470-2045(17)30456-4/fulltext)

The Christie NHS Foundation Trust has been ranked ‘Outstanding’ by the health regulator the Care Quality Commission (CQC) which referred to it as ‘exceptional’ and ‘a leader in its field’. It not only commended the Trust for its effectiveness and care, but highlighted its work in shaping the future of cancer care and noted the reach and influence of its clinical research projects. The CQC also rated The Christie the best specialist trust in the country, and one of the top three trusts overall in England.