Dubai: A new minimally invasive technique to treat cancer of the rectum, introduced in the UAE for the first time, is providing patients a better chance at quality of life. The Transanal Minimal Invasive Surgery (TAMIS), which has been available globally for ten years, has been introduced with success at the Fakeeh University Hospital, Dubai.
Minimal chance of local recurrence of tumour
When treated with this technique in the early stages, it offers less than three per cent chances of local recurrence as per global data on relatively new technique, which has been prevalent for ten years. A young 30-year old Iraqi woman who underwent the surgery at the FUH on December 15, has recovered very well less than 24 hours post-surgery.
Professor Dr Majid al Bassuni, Consultant Surgeon and Head of Clinical Division- Surgical Services at FUH, a pioneer in TAMIS (and all aspects of benign and malignant colorectal conditions) said, “ in this case the patient has been cured. The final verdict about cure usually takes five years but in rectal cancer, we do not usually use the word “remission”. We aim for cure or palliation.”
Early prevalence of rectal cancer in the UAE
As far as rectal and colorectal cancers go, there is a worrying trend in the UAE. According to research carried out by Al Tawam Hospital, Al Ain, 1 in 70 people in UAE suffer from rectal and colorectal cancers. Although the level of incidence is lower than the world level of one in 50, what is cause for concern is that while the age of appearance of cancer in the rest of the world is 70 years and above, in the UAE 30 per cent of these cancers appear in individuals before the age of 50.”
Why TAMIS is preferred?
Conventionally, a malignant tumour in the rectum was treated with the complete removal of the rectum while retaining the anal canal. Besides being a lengthy four-hour procedure with long recovery period, it meant losing a vital organ with important functions for the patients. It also meant the creation of a new ‘rectum’, which unfortunately had problems replicating the functions of the original organ.
Organ preservation a major advantage
Elaborating on the technique, Prof Dr Bassuni, said, “In the TAMIS procedure, we excise the tumour in the rectum in a minimally invasive way, preserving the rectum. This is not only proving to have a high success rate, but also provides quick recovery as within 50 minutes post-surgery, the patient is able to consume solid food and water. She was also fully mobile immediately after surgery, as she only received Regional anaesthesia and did not need to go to sleep”
The surgery is carried out in patients in stage one and two or rectal cancer and in advanced stages where surgery is critical or patients do not want surgery, TAMIS is used to partially excise the tumour and provide the patient a better quality of life said Dr Bassuni.
Early stage rectal cancer treated effectively
Dr Bassuni said TAMIS worked effectively in early stages of rectal cancer. “In conventional surgery, where the entire rectum was removed, the chance of local recurrence of the cancer was 40 per cent. Later, in the mid-eighties, with a combination of selective radiotherapy and improvement of surgical technique conventional surgery the chances of local recurrence was 25 per cent. Now with TAMIS with radiotherapy the chances of local recurrence is less than 3 per cent.”
• Poor diet low in fibre, sedentary lifestyle main causes of exacerbation
• Regular exercise of 30-45 minutes daily can reduce your risk of colorectal and rectal cancers by 29 per cent
• Habitual smokers and those who consume alcohol regularly have a 42 per cent higher risk of rectal cancers
• UAE government has been conducting regular screening in hospitals for colorectal and rectal cancers since 2012, due to early incidence of these cancers in the UAE
• TAMIS as a new surgical technique has been practised globally for 10 years. It has recently been introduced in the UAE
However, Dr Bassuni added the earlier the patient came to them the higher were the chances of recovery with this technique. “In Stage One cancer when the cells are just present in the lining of the rectum, TAMIS present a 96 per cent chance of total cure. In stage two when the tumour is spread deep in the rectum, with radiotherapy of six weeks followed by rest for another six weeks, we excise the tumour and the chances of recovery are very high,” explained Dr Bassuni.
Dr Bassuni further said the technique also worked for patients in advanced stages where cancer had spread to other organs. “In cases where surgery is not possible or patients are too old to withstand the surgery, we are able to use this technique to conduct partial excision of the tumour and provide the patient a higher quality of life and much better chance of survival.”
Speaking to Gulf News, Faeq Ahmed, the Iraqi patient’s brother-in-law, expressed his relief at her recovery “We are incredibly happy with the surgery. Now, she enjoys physical activities, goes out and is more social. She is happier due to her restored health, and her quality of life has improved immensely. Our family could not ask for anything more. We are very grateful to Dr Majid and the hospital staff for their exceptional care and consideration.”