title: Local effects of colorectal cancer are well palliated by endoscopic laser therapy.
abstract: We review the results of treating the local effects of 26 cases of inoperable colorectal cancer with Nd:YAG laser. There were 16 men and 10 women of mean age 75, with 17 (65%) rectal, eight (31%) sigmoid and one (4%) ascending colon cancer. They presented with symptoms primarily of obstruction in 12 patients (46%), bleeding in 10 (39%) and diarrhoea in four (15%). Initial therapy to relieve symptoms required a mean of 1.5 (1-3) laser treatments over a mean of 1.5 (1-2) weeks. Twelve patients (46%) had total relief and 12 (46%) had partial relief. Sixteen patients received follow-up maintenance therapy, with laser treatments performed over a mean interval of 7.3 (1-20) weeks. One died at first follow-up treatment; all but two of the others were well maintained by laser treatment alone. Three patients (12%) suffered complications, with two deaths (8%), one due to cardiac failure and the other due to stercoral perforation of the colon. Four patients remained alive after a mean follow-up period of 51 (9-84) months. The mean survival of the others was 5 (0-23) months. Laser palliation for colorectal cancer is efficacious and relatively safe, allows improved quality of survival in 92% of patients after initial treatment, and, alone, can satisfactorily keep patients relatively free of local symptoms in 88% of patients surviving into the follow-up period.
authors.affiliation: Gastroenterology Unit, Derby City General Hospital, UK.
authors.forename: C C
authors.initials: CC
authors.lastname: Tan
authors.forename: S Y
authors.initials: SY
authors.lastname: Iftikhar
authors.forename: A
authors.initials: A
authors.lastname: Allan
authors.forename: J G
authors.initials: JG
authors.lastname: Freeman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000150:complications / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D053685:Laser Therapy; D007834:Lasers / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011788:Quality of Life