Contact X-Ray brachytherapy for rectal cancer

Over the past century, surgery has been the mainstay of rectal cancer management and will remain so for the foreseeable future. However, surgical mortality and morbidity is high, especially for the elderly patients. The population is ageing globally, the effect being more pronounced in Western countries. It is important to avoid extirpative surgery, especially in elderly patients, to deter surgical harm. National bowel cancer screening programmes around the world have helped to diagnose rectal cancer in its early stages. It is important to treat the early stages of the disease differently from the more advanced stages. Most protocols are bias heavily towards surgical management for rectal tumors. National and international consensus guidelines do not take into consideration the advancing age of the general population and recommend surgery as the gold standard of care. There is an urgent need to consider alternative treatment options that avoid extirpative surgery and stoma in the early stages of rectal cancer in the elderly.