Which treatment do I need?
Every year approximately 500,000 new colorectal cancer cases are diagnosed in Europe. Incidence rates are higher in men than in women. Colorectal cancer affects the large intestines. This is the lower part of the digestive tract, the last several inches of which is known as the rectum. This part of the digestive system plays a major role in helping the body absorb nutrients, minerals and water. In addition, the colon helps rid the body of solid waste.
Colonic cancers begin as benign growths known as polyps. Over a period of years these polyps progress to invasive malignancies. In their early stages polyps can be found and removed before they pose a risk. Since they usually cause no symptoms, it is recommended that people have regular colonoscopy screenings beginning at age 50.
Types of Colonic Cancer
Between 90 and 95 percent of all colonic cancers are adenocarcinomas. More rare forms of colonic cancer include: neuroendocrine, gastrointestinal stromal tumors (GISTs), lymphoma, melanoma and leiomyosarcoma. Some of these types of cancers occur primarily in other parts of the body.
If your cancer is the most common form—adenocarcinoma—then your doctor will develop a treatment plan based on the stage of development.
A diagnostic method is the occult blood test that tests for microscopic or invisible blood in the stool. The gold standard for diagnosis remains the colonoscopy. Current recommendations are for patients over the age of 50 to have a prophylactic screening colonoscopy.
If polyps are identified or the patient has a family history of colonic cancer, then the test is repeated within 5 years. Other techniques such as CT, colonography, and capsule colonoscopy can be employed. Nonetheless, the colonoscopy provides the best option as it allows for the identification of abnormal lesions as well as biopsy for confirmation of diagnosis.
Colonic Cancer Stages
This staging of your cancer refers to how far it has spread beyond the location where it first developed. The stages begin at 0 and go up to Stage IV—the higher the number, the further the cancer has advanced. For example, Stage IV colonic cancer represents a spread to other organs.
Patients with cancers that have not spread beyond the colon or to the lymph nodes generally do not require any form of postoperative therapy. For those patients with more advanced disease post-operative chemotherapy or radiation is required.
Colonic Cancer Treatment Options
The types of treatments recommended will depend on the stage of your cancer. The three primary colonic cancer treatment options are surgery, radiation and chemotherapy.
If your cancer is caught at an early stage it is probably confined to the polyp. In this case, your doctor may be able to remove it completely during a colonoscopy. If the pathology report confirms that the cancer didn’t extend into the base of the polyp (where it attaches to the bowel wall) the likelihood of cure is very good following surgery. Larger polyps and invasive cancers might also require chemotherapeutic intervention.
Currently, common treatment strategies are based upon standard chemotherapy protocols. For colorectal cancer patients the most widely used drugs are Fluorouracil (5-FU) plus Leucovorin (FU/LV) and the closely related Capecitabine. The addition of Irinotecan and Oxaliplatin can often further improve the effect of 5-FU based therapy and Capecitabine. However, in some patients they induce unwanted side effects. Monoclonal antibodies like Erbitux, Vectibix and Avastin are also often used in combination with chemotherapy.
IndiTreat®: Individual treatment identification method
IndiTreat was developed initially for colorectal carcinoma (colonic cancer) and assists the doctor in choosing the most effective medical therapy for the patient. In order to perform the IndiTreat® test a small tissue sample is taken from the tumor. This tissue sample contains living tumor cells and is placed in a 2cureX transport container and shipped within 24 hours by courier to the nearest 2cureX laboratory.
From the tumor tissue three-dimensional microtumors consisting of approximately 300 cells are produced. The 3D microtumors are considered sensitive or resistant to each drug depending on if their growth is inhibited or not. Clinical studies have documented that the response of the microtumors to the drug treatment is comparable to the response of the patient´s tumor. By means of pre-therapeutic identification of an effective medical therapy against an individual patient’s tumor, ineffective treatment and accompanying side effects can be avoided.