New treatment offers hope for some bowel cancer patients

Dr Gopalakrishnan Srinivasan, Paul Geater and Specialist Nurse Charlotte Durrant.

Dr Gopalakrishnan Srinivasan, Paul Geater and Specialist Nurse Charlotte Durrant. - Credit: Charlotte Bond

A new treatment for a small number of bowel cancer patients is now being used at Ipswich Hospital - and it is starting to show encouraging results for some who have run out of other options.

Immunotherapy, an alternative to chemotherapy, encourages the body's own immune system to fight cancer cells - and can produce great results with fewer side-effects than more traditional treatments.

I know. Last summer I was the first person at Ipswich Hospital to be given the immunotherapy drug Pembrolizumab after signs that the bowel cancer I had removed in 2018 was starting to return.

Since then I have made three-weekly visits to the Woolverstone Day Unit at the hospital to get an infusion. All the blood tests and scans I have had since then seem to show that it is doing the trick and I feel fine.

Paul Geater

Paul Geater was the first person in Ipswich to recieve ground-breaking new Cancer Treatment. - Credit: Charlotte Bond

My only side-effect has been a slight rash on my hands which quickly cleared up with some Hydrocortisone cream.

My consultant oncologist Dr Gopalakrishnan Srinivasan (known in the unit as Srini) has just reduced the frequency of my visits to every six weeks because the results are so encouraging.

One thing I've learned over the last few years, though, is that bowel cancer can take many different forms - and what is suitable for one patient may not be suitable for another.

Srini explained that this type of immunotherapy is only suitable for those whose tumour has a particular genetic make-up, about 5-8% of bowel cancer patients.

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He said: "It is very important to study the genetic make-up of all bowel tumours so we can identify those whose genetic make-up shows they would respond to this kind of treatment."

For me that was particularly important - my cancer was caused by a genetic condition called Lynch Syndrome which runs in one side of my family and Lynch cancers can be resistant to chemotherapy so the fact it could be treated by immunotherapy was vital.

Immunotherapy was first approved for some bowel cancer patients three years ago and Pembro - as it is known - was approved by the National Institute for Care Excellence (NICE) for bowel cancer last year. It had already been approved for some lung cancer and melanoma patients.

What is particularly positive about immunotherapy is that in some cases where the treatment has been stopped, the cancer has not come back.

Srini said there had been reports of patients who had had surgery to remove cancers after immunotherapy treatment and when the tumours were removed they were found to be only harmless scar tissue - the cancerous cells had gone.

However, he is aware that while immunotherapy is effective against those cancers with the particular genetic make-up, it is not at present suitable for the vast majority of bowel cancer cases.

That might change in the future - a great deal of research is being undertaken into immunotherapy and Srini agrees with colleagues who believe it could replace chemotherapy in the treatment of many different cancers over the next few decades.

Over the last three years, he has treated 18 people with immunotherapy and 14 of them are still alive and living normal lives. I was fortunate in that I was still generally well when I started on the treatment - others were very seriously ill.

He said: "One of the first people who received it as a special case three years ago had been given just a few weeks to live. They are still alive today - living a full life."

I met Srini with Macmillan support nurse Charlotte Durrant, who has been my main contact with the Woolverstone Unit ever since I was first diagnosed with cancer in 2018.

Dr Gopalakrishnan Srinivasan and Specialist Nurse Charlotte Durrant.

Dr Gopalakrishnan Srinivasan and Specialist Nurse Charlotte Durrant. - Credit: Charlotte Bond

They were both keen to get the message across that while bowel cancer is a very serious condition, there are stories of hope that can come out of it.

I know that. I have two close friends who had bowel cancer more than a decade ago. Both made a full recovery and are among the most active people of my generation that I know.

And Srini told me one fact that I hadn't realised - the number of younger people with bowel cancer has been rising steadily over recent years and experts don't really know why. 

"Younger" people are those under 50 - until recently it was seen mainly as a disease linked to age with the greatest incidence among the over-70s.

He said: "It could be environmental or lifestyle factors but people have to be aware this is condition that can affect them at any age."