George Fisher, gastroenterology oncology specialist and professor at the Stanford University Medical Center, reviews some of the recent successes in colorectal cancer research.

In the United States, colon cancer is the fourth most common cancer and the second leading cause of death from cancer. Advances in imaging, genetics, molecular diagnostics, surgical techniques and chemotherapy are having a significant effect on our ability to prevent, diagnose and treat this serious disease.

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Cancer is the name for a disease that can affect cells from all the organs and body’s structures and is considered to be life threatening. The colon and rectum are a part of the large intestine and their function is to absorb nutrients and water from the food that passes through the intestine before it goes out of the body. Colorectal cancer is the disease that affects the cells from the colon and rectum creating a malign or benign tumor.

Treatment is possible for those who suffer of colon cancer. The treatment is based of three procedures: surgery, using radiations, and chemotherapy.

Generally the colon cancer is treated with surgery and this depends on the stage of the cancer. If the cancer is in an early stage then the doctor will take the tumor out by putting a tube that passes the rectum until it reaches the colon and only then cutting the tumor. This means that the doctor performs a local excision when the cancer is localized on a polyp than the procedure will be classified as a polypectomy. If the cancer is in a more advanced stage the doctor will have to cut that tumor out along with a part of the healthy colon. Then the two parts of healthy colon will be sewed together. The lymph nodes around the affected area will also be removed and analyzed at the microscope.

Sometimes the doctor can not sew the two heads of the colon and will be forced to make a hole on the surface of the body in order to create another anus, also known as a colostomy. This second anus will not be kept forever, it will be kept until the colon heals and can be sewed back. Sometimes if the situation is bad and the colon can not be saved, this colostomy will be permanent. The patient will further need a special bag made for collecting the body wastes. These bags are only for one use and are not able to be seen due to clothing and are easy to replace even by the patient.

Another procedure to treat cancer is radiotherapy. This therapy uses x-rays for killing cancerous cells and making the tumor stop its evolution and even shrink. Radiation therapy can be performed by special machines situated near the body and by special tubes that contain radioactive material and are placed inside the body near the intestines. The radiation therapy can be combined with surgery and other procedures for treating cancer.

Chemotherapy is also used in treating cancer. Chemotherapy uses pills or substances that go by vein in the organism. As these drugs travel the blood stream and can kill cancerous cell all over the body the chemotherapy is known to as a systemic therapy. Chemotherapy can be associated with surgery. While the surgeon removes the tumors that can be seen with by a naked eye, chemotherapy destroys those small cells that the surgeon can not remove.

Also, biological therapy can be used as it increases the forces of the organism to fight cancer and will help the body increase its defenses.

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Moderate and regular exercise substantially reduces the risk that colon cancer will return and patients currently undergoing treatment can improve their overall chance of survival.

This excellent news was reported by Dana-Farber Cancer Institute scientists in a pair of studies published in the Journal of Clinical Oncology in August 2006 but merit repeating because they show definite life prolonging impact by simple exercise in a life critical disease.

The researchers reported colon cancer patients who engaged in moderate exercise for 6 to 12 months after completing therapy had a 50 percent higher survival rate than those who didn’t exercise. The improvement took place in patients with very early and more advanced (but non-spreading) colon cancer. All patients had undergone surgery.

Jeffrey Meyerhardt, MD, MPH, [Dana-Farber] was the lead author and reported: “From previous studies we know that regular physical activity reduces the risk of developing colon cancer, but until now few studies have looked at the survival effect of exercise on people who have been treated for disease… While our work found a significant benefit for patients who exercise, it’s important that exercise be seen as a supplement to, not a replacement for, standard therapies.”

Results appear particularly robust because the two studies used different sets of data to arrive at their shared conclusion. Patients who simply exercised such as walking 6 hours a week were 47 percent more likely to be alive and free of disease than those who were less physically active.

Additionally, patients who increased their physical activity after colon cancer diagnosis had about a 50 % less chance of dying from colon cancer or from other causes than physically inactive patients.

Meyerhardt is an assistant professor of medicine at Harvard Medical School: “As with any exercise program, people should check with their doctor before increasing their degree of physical activity… to reduce the chances that colon cancer will return after treatment, as well as for overall health reasons, regular exercise is a good option for survivors to consider.”

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The earlier colon cancer is detected, the higher survival rate increase. Colon cancer can be treated successfully with early detection so the best treatment of colon cancer is being checked regularly if you have a family history of it, fall under any of the risks factors for colon cancer, or are the age 50 or above.

Depending on the size of the cancer, location, overall general health, and in what stage the cancer was detected will play a factor into what type of treatment will be discussed with you through your doctor. The most common method of colon cancer treatment is surgical removal often followed by chemo or radiation is it is felt there is any risk of cancerous cells remaining. Surgical removal of cancer in the colon often results in a temporary or permanent colostomy. Your surgeon will remove the cancer from your colon along with a certain percentage of healthy colon on each side of the cancerous growth. They will then reattach the colon. In many cases, if the cancer is not caught at onset, the surgeon will have to remove quiet a large section of the colon leading to the need of a permanent colostomy bag. A colostomy bag becomes the new exit for your bodies waste. Sometimes a patient will have to wear a temporary colostomy bag to give the colon the proper time needed to heal successfully.

Chemotherapy or radiation may follow the surgical procedure if there is any chance that cancer cells were missed or thought to be in other areas of your body. Chemotherapy medications are administered either through an IV or through a pill form. The medication kills and controls cancerous cells. If colon cancer is caught at early onset, and presents very small and isolated, your doctor may consider using just chemotherapy or radiation to eliminate the cancer.

Radiation therapy uses ionizing radiation to control malignant cancer cells either before or after surgery, or both. It can also be done solely if the colon cancer is caught early. Before surgery, it is generally used to control and/or minimize the size of the tumor to make removal of the tumor easier. After surgery it s used to eradicate any existing cancer cells that may still be present. The ionized radiation is applied directly to the tumor and a small amount of the surrounding healthy tissue to ensure that the entire tumor is treated.

Biological therapy is also being offered to patients with colon cancer. It is still on a research basis treatment; however, researches have been seeing significant results. Biologic therapy works with your body’s immune system to eliminate cancer cells. Currently there are several different types of biological therapy being tested including interferons, interleukins, colony stimulating factors, monoclonal antibodies, vaccines, gene therapy, and nonspecific immune-modulating agents. Biological therapy can be used in conjunction of more traditional means of therapy, or depending on the stage of colon cancer, it can be used solely. The different types of biologic therapies, in theory, are a means to wake up your own immune system to recognize the cancer cells as being a foreign object in your system and fight them off much like your immune system does when you get a virus. Most of the biologic therapies are used to stop the growth of cancer cells, or control or suppress the growth.

If faced with colon cancer, educate yourself to all of the options available to you and discuss them in detail with your doctor. If you fall in the risk factors of colon cancer such as over the age of 50, previous history of cancer, family history, or other colon/rectal related problems make sure you get regular check ups. Early detection is essential in the battle of colon cancer.

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Colon cancer is a silent disease that only shows its symptoms at the advanced stages. It has a long latent period, it can be detected in the precancerous stage.

Symptoms

Colon cancer early symptoms include blood in the stool or unable to pass motion suggesting that the colon is blocked. Frequent diarrhea, constipation and unexplained stomach aches are early symptoms but they may be early symptoms of other forms of cancer. Weight loss, when there have been no changes to diet or exercise routine, may be another early symptom of cancer of the colon or other digestive cancers

Risk factors

There are many studies that indicate that diet plays an important factor. A combination of a diet high in protein and fats seems to be what causes cancer of the colon. Genes also play an important role while smoking adds to the risk.

Diagnosis

A faecal occult blood test is done to determine the presence of blood in the stool. If the result shows the presence of blood, the best way to diagnosis colon cancer is by doing a colonscope.

Treatments

Treatments for cancer of the colon depend on the stage of the cancer and whether the cancer has recurred. The overall health of the cancer patient is also an important factor in determining the treatment.

It is recommended that those especially with a family history of colon cancer to undergo colorectal cancer screening earlier. The good news is that when colon cancer is detected early when it is still confined to the mucosal layer, the cure rate is up to 90% through surgery.

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