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Colorectal cancer (CRC) is the third most common cancer in American men and women and accounts for 10 percent of cancerrelated deaths. There have been tremendous efforts to find a cure for CRC, but the only proven cure is prevention. Regular screening prevents CRC by finding precancerous polyps and removing them before they transform into cancers.
Also, with regular screening, there is a greater chance that detectable cancer will be found early enough to potentially cure it with surgery. It has been estimated that regular screening coupled with a healthy lifestyle could prevent more than 50 percent of all CRC deaths. Unfortunately, fewer than half of all Americans over age 50 have any CRC screening or testing done.
There are three accepted methods of screening. The first, fecal occult blood testing, detects minute amounts of blood in the stool which may be a sign of polyps or cancer. A barium enema requires the instillation of dye into colon through the rectum to outline the colon and any abnormalities of the lining on X-ray. Colonoscopy is the best method for screening since a camera is passed through the rectum into the colon to directly visualize its lining. Both barium enema and colonoscopy require cleansing of the colon before the procedure. In the future, less invasive screenings may be developed. One promising technique looks for specific cancer-related gene mutations in the colon cells that are excreted in the stool; another is virtual colonoscopy, a CAT scan that generates detailed images of the lining of the colon.
Once a colon cancer has been diagnosed, the first step in treatment typically includes surgical removal. Little has changed in regards to surgical removal of colon cancer except that recent studies have shown that laparoscopic (keyhole) removal of colon cancer is not associated with increased recurrences or worse outcomes. Therefore, more colon cancer resections will likely be done laparoscopically as more surgeons become comfortable with the technique.
Some of the biggest recent advancements in CRC treatment have been made in the field of medical oncology, specifically chemotherapy. When patients have more advanced cancers, they receive chemotherapy to kill any remaining cancer cells that cannot be removed surgically or are not yet detectable. Another advancement includes the approval of the drugs bevacizumab (Avastin) and cetuximab (Erbitux) for use in the treatment of metastatic or recurrent CRC. These drugs are antibodies that block the signals that tell cancer cells to grow; therefore, they inhibit tumor growth and spread. Even better is the fact that these drugs in combination with traditional chemotherapy improve survival without adding significant toxicity. Another similar antibody, panitumumab, is currently being investigated to determine its full role in the treatment of CRC and enrollment in the clinical trials is available locally.
Article provided by Hilton Head Hospital.
