Colorectal cancer is a disease that affects the intestinal walls of the rectum and colon of the large intestines. This cancer is second only to lung cancer in causing cancer related deaths in the U.S. But, caught early, treatment protocols are successful in effecting a high 5-year cure rate. More than 1/3 of these deaths could be avoided if people over the age of 50 had regular screening tests because 92% of these cases happen in people over 50.
Most of the colorectal cancers begin as polyps which don’t always have symptoms. Doctors believe that it is one of the most preventable cancers because of technologically advanced screening tests.
During diagnosis the cancer will be staged, which helps physicians to make effective choices in treatment of the disease and to give individuals a prognosis. During the staging process doctors determine the extent of the spread of the disease which can range from Stage 0 where cells are found only in the innermost lining of the colon to Stage IV where cells have spread to the liver and lungs.
Treatment options will depend upon the size, location and extent of the tumor as well as the patient’s general health. These options will be recommended based on the ability of the individual to withstand the side effects of the treatment, medications and surgeries. These factors will be evaluated by a team of specialists which can include a gastroenterologist, medical oncologist, surgeon, radiation oncologist, nurse clinicians and social workers.
Several different types of treatments are available, either given individually or in combination, to get the best achievement of the goal possible. The first option often approached is surgical removal of the tumor. Generally the tumor is removed with a portion of the healthy tissue and nearby lymph nodes. In most cases the doctor is able to reconnect the bowel, either during the initial surgery or in a subsequent surgery.
Individuals who suffer from a metastasis will often undergo chemotherapy to kill cancer cells. Some physicians will give prophyllatic doses of chemotherapy to kill any cells left in the body after surgery. Most of these drugs are given via intravenous therapy, an injection directly into the vein.
Radiation therapy is another choice which uses high energy x-ray to kill the cancer cells. Doctors may use radiation in order to shrink the tumor before surgery or afterwards to kill any cells that remain in the area. At larger institutions physicians are able to use intraoperative radiation therapy to deliver a concentrated beam of radiation directly on tumors while they are exposed during surgery.
New biological drugs or immunotherapy uses the body’s own immune system to fight the cancer cells. Biologicals are often used after surgery to repair, stimulate, or enhance the immune system’s natural ability to fight cancer. Most of these drugs are delivered via an intravenous route.
Currently there are clinical trials ongoing to evaluate ways to treat cancers. After recent trials, the FDA released two genetically engineered versions of antibodies to help fight foreign substances. Because of the precision of using these two drugs – Avastin and Erbitux – the side effects are fewer.
Choosing the most appropriate cancer treatment is a decision that should involve the patient, family and medical team who can make recommendations about some of the newer treatment protocols that come from research that has led to progress against this disease.
Resources:
American Cancer Society: Colorectal Cancer
National Cancer Institute: General Information Colon Cancer
http://www.cancer.gov/cancertopics/pdq/treatment/colon/Patient/page1
National Cancer Institute: Treatment Cancer Overview
http://www.cancer.gov/cancertopics/pdq/treatment/colon/Patient/page4
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