Some patients with bowel cancer should be given six weeks of chemotherapy before having surgery, according to the findings of a major UK study.
Doctors say they can now identify which patients will benefit from this approach.
The technique has been used for other kinds of cancer – but has been thought too dangerous for bowel cancer because further growth of the tumour can be fatal.
Doctors prefer to shrink the tumour before surgery to make the procedure safer. They say the trial suggests that it can also help prevent spread of the cancer.
Writing in Lancet Oncology, researchers say modern CT scanning can be used to identify patients for whom the treatment would work.
The findings come from a pilot study at Birmingham University, UK, involving some 150 patients. All the patients had advanced tumours that had grown through the gut into other organs.
94 of the patients received chemotherapy before surgery. In two cases the tumours disappeared while the tumours reduced significantly in 29 patients.
Researcher Professor Dion Morton said: “These feasibility results show that pre-operative chemotherapy can be delivered safely and efficiently, paving the way for a larger phase III study which, if successful, could completely change the way we treat colon cancer within five years.
"Shrinking the tumours beforehand makes them easier to remove, reducing the chances of any of the tumour being left behind.
"Importantly, all of the patients we treated in this way were well enough to proceed with their surgery and they were no more likely to have complications that extended their hospital stay afterwards."
Patient Alan Sugden, aged 64, from Kidderminster, Worcestershire, said: "The trial definitely helped me. Having the chemotherapy before my operation helped shrink my tumour which made it easier for the surgeon. I think it’s essential that people keep signing up to these type of trials to push forward the research.
"I have since become a granddad for the first time and am enjoying spending time with my beautiful new baby granddaughter. I continue to travel and have just come back from another lovely holiday to Portugal. Life goes on and you have to make the most of things and keep on going."
Liz Woolf, of Cancer Research UK, which backed the research, said the aim was to recruit 1,000 patients for a full-scale trial.
She said the initial results were "very encouraging".
FOxTROT Collaborative Group. Feasibility of preoperative chemotherapy for locally advanced, operable colon cancer: the pilot phase of a randomised controlled trial Lancet Oncology October 31 2012; doi: 10.1016/S1470-2045(12)70348-0
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