Finally cancer-free without surgery: new treatment options for colorectal cancer patients
At the beginning of 2022, 49-year-old Jeannette von Brietzke was diagnosed with a tumor in her rectum. During her treatment at Helios Hospital Berlin-Buch, Prof. Dr. Roger Wahba and his team were able to use organ-preserving therapy with intensified radio-chemotherapy and thus avoid a major operation with an artificial anus. This was possible thanks to the new "watch-and-wait concept" following total neoadjuvant therapy (TNT) for rectal cancer and close follow-up care. With her story, Jeannette von Brietzke wants to give other sufferers courage and confidence - and show that surgery can help even without an operation.
It all started with nagging gastrointestinal complaints - and a bad feeling. "My grandmother also had bowel cancer. So I already knew the symptoms and the progression," says Jeannette von Brietzke. When her condition worsened and she could no longer sit properly after having a bowel movement, she had herself examined by her GP at the beginning of 2022. "The result of my stool sample was then abnormal, so my GP said we should urgently have a colonoscopy. The colonoscopy diagnosed cancer in the rectum. A devastating diagnosis," reports the dental assistant from Panketal. This was followed by numerous examinations and initially radiotherapy in the south-west of Berlin. "At some point, the treatment in south-west Berlin was too strenuous for me. We traveled an hour there and back from home each time. I was glad that the entire treatment could then be carried out at a large cancer center near me. In the meantime, I was also in increasing pain and had to take strong painkillers. That's why I decided: Ok, I'll do the radiotherapy in Steglitz but not the rest of the treatment. We then went to the Helios Hospital in Berlin-Buch to the special coloproctology consultation with Dr. Baur. The findings were requested there and all the images that had already been taken, and then we initially continued with chemotherapy here."
Better quality of life thanks to modern intensified chemotherapy and watch-and-wait concept
At Helios Hospital Berlin-Buch, Jeannette von Brietzke continued to be looked after by Prof. Roger Wahba, Head Physician at the Clinic for General, Visceral and Oncological Surgery, and Dr. Miriam Baur, Senior Physician, in the special coloproctology consultation. "Of course, I then completely reviewed the case, looked at everything in detail and then discussed exactly what procedure we would recommend in our team of experts at the interdisciplinary tumor conference," explains Dr. Baur. She remembers a conversation with Jeannette von Brietzke and her husband in January 2023 very clearly: "I was very relieved to be able to suggest the watch-and-wait concept to Mrs. von Brietzke. When the diagnosis was made, it was already an advanced condition in the lower rectum, and an operation without an artificial bowel outlet would not have been feasible in this situation."
And so, following a total of six months of treatment and positive check-ups at Helios Hospital Berlin-Buch, Prof. Wahba's team and the patient decided to embark on the watch-and-wait path together - a concept without surgery, but with particularly close observation and check-ups. Prof. Dr. med. Roger Wahba explains:
"The watch-and-wait concept is a relatively new form of therapy for oncological diseases of the rectum. The published data from the first studies were very promising, but at that time no long-term data was available. What was already known, however, was that in a large number of patients with rectal cancer who had undergone preliminary radiotherapy and then surgery, no cancer cells were left. The logical thought was therefore: if we can already successfully combat the tumor with radiation, the next step with more effective chemotherapy would be to dispense with surgery. The data from the first studies pointed to this treatment option, especially when such a major operation involving the creation of an artificial bowel outlet would be necessary. This is a major gain for the patient's quality of life.
A story that gives hope and courage
Almost three years after being diagnosed and starting treatment at Helios Hospital Berlin-Buch, Jeannette von Brietzke is doing very well: "As if nothing had ever happened," she says. And Prof. Wahba and Dr. Baur confirm this: Her patient is cancer-free. However, in order to be able to react immediately in the event of any new abnormalities, Jeannette von Brietzke attended check-ups with Dr. Miriam Baur at Bucher Hospital every three months for two years, but now she only comes every six months. "We then carry out an endoscopy and photo documentation of the flat scar, which we describe in detail each time: Where is it located, how big is it? Is the scar really smooth - this is very important, as the scar sometimes looks flat, but you may still be able to feel a small bump. The MRI is then added to this so that we can precisely identify the layers and any abnormalities," explains Dr. Baur. She adds that it is important that the treatment and check-up appointments are always carried out by the same team of doctors and nurses. This works very well in a large hospital like the Helios Klinikum Berlin-Buch due to the wide range of specialist areas and the team of experts. Prof. Dr. med. Wahba confirms: "This is the advantage of such a large maximum care provider as we are. We can offer all treatment measures from a single source right from the start. Patients benefit from bundled expertise and cutting-edge medicine from a single source."
Despite the regular visits to Berlin-Buch, Jeannette von Brietzke and her family have returned to their everyday lives. When asked whether she has coped with the diagnosis as bravely as her mother, Jeannette von Brietzke's daughter replies: "Well, at the beginning it was the opposite for me, I was very scared. Like: My mother has cancer, the world is coming to an end. It was like that at first, but then it got better. My parents always explained to me what was happening and communicated very openly and that helped me so that it felt a bit more normal." And so it proves true once again: together we are stronger - something that applies to the team of experts at Helios Hospital Berlin-Buch as well as to Jeannette von Brietzke and her family.
