Organ preservation is close to our hearts.

The diagnosis of rectal cancer and the possible need for a stoma – an artificial intestinal outlet – are very stressful for those affected. Studies show that surgery with a terminal stoma and functional disorders such as Low Anterior Resection Syndrome (LARS) leads to a significant reduction in quality of life for some patients. Organ-preserving strategies such as Papillon can reduce these risks.

The GITZ is strongly committed to improving the quality of life of colorectal cancer patients. The preservation of organs is therefore our main priority.

Organ preservation is teamwork

Organ preservation requires an extraordinarily high level of interdisciplinarity: a team of experts from different specialisms work closely together and must know exactly what is important. Although organ preservation receives little attention in many hospital structures, we place the patient at the centre and are intensively committed to this method.

The potential of organ preservation is far from exhausted and we are learning more every day. Discussions about organ preservation are an essential part of our tumour board. Our aim is to continuously keep our network at the highest and most up-to-date level of knowledge, which is why we organise regular training courses for specialists free of charge.

In addition, our network offers an interdisciplinary organ preservation consultation for patients with rectal cancer.

What is Papillon?

Our network offers an alternative treatment method, Papillon contact radiotherapy, which can help avoid an operation and its potential consequences in certain cases. Papillon 50 is a device that is only available twice in Switzerland and which enables contact-based radiotherapy. According to the Papillon method, soft X-rays are applied directly on the surface of the tumor. This technique allows precise dosing with minimal side-effects on the surrounding tissue. Studies show that the Papillon technique offers better healing rates and causes fewer side-effects than conventional methods.

Current research shows that the use of the Papillon technique combined with radiotherapy and (if indicated) chemotherapy achieves very high rates of organ preservation. In randomised studies (e.g. OPERA study), the contact X-ray boost compared to external radiotherapy alone results in significantly higher organ preservation, especially in smaller tumours.

What are the benefits?

The previous gold standard in the treatment of rectal cancer was often a combination of radiotherapy and chemotherapy, followed by surgery. Potential disadvantages are a higher radiation dose and thus potential damage to surrounding tissue, as well as a temporary or permanent stoma. The Papillon treatment avoids the need for a stoma, which significantly increases patients’ quality of life.

For whom is Papillon suitable?

The treatment is generally suitable for all patients with low-lying rectal cancer. For treatment to be possible, three criteria must be met: there must be no involvement of the lymph nodes, there must be no perirectal infiltration – as these areas cannot be reached with the Papillon device – and the tumor must be physically accessible with the applicator, as the tumor sometimes lies too high in the rectum and cannot be reached. This means that the tumor should normally be in the lowest 10 cm (measured rigidly medically). However, it is advantageous if the tumour is detected early. This increases the chances that a Papillon treatment is possible and that an operation can possibly be avoided.

Typically, a Papillon treatment requires three to five sessions at intervals of one to three weeks. The procedure is carried out under mild sedation and only takes a few minutes. Patients can be discharged on the same day. The treatment is usually covered by health insurance and is significantly less expensive than an operation.

You can find more information in the videos or we would be happy to answer any questions you may have.