Information for the public
Low-energy contact X-ray brachytherapy (the Papillon technique) for early‑stage rectal cancer is safe enough and works well enough for use in the NHS for patients who cannot have surgery.
There is not much good evidence about how well this procedure works in patients who can have surgery, but have chosen not to. It should only be used if extra care is taken to explain the risks and extra steps are put in place to record and review what happens. More research on this procedure is needed and NICE may look at it again if more evidence is published.
NICE is asking health professionals to send information about everyone who has the procedure and what happens to them afterwards to the colorectal database to check how well the procedure works over time.
Your health professional should fully explain what is involved in having this procedure and discuss the possible benefits and risks with you. In particular, if you have chosen not to have surgery, they should explain the uncertainty about the evidence on how likely it is to improve your symptoms. You should also be told about other treatment options, given written information and told how to find more information about the procedure. You should only be asked if you want this procedure after having this discussion. Your health professional should ask you if details of your procedure can be collected.