Best Defenses New Treatments For Colon Cancer Abound, But Prevention Is Still The Best Medicine

It’s an exciting time for colon cancer research, according to Dr. George Bowers, a medical oncologist at Cooley-Dickinson Hospital.

 

Bowers told The Healthcare News that some recent advances in the development of colon or colorectal cancer drugs have fostered better treatment results for patients and an overall quality of life.

Still, with exciting developments in practice and more on the horizon, Bowers cautions that early detection and prevention are still the best defense against all colorectal cancers, and still one of the hardest points to sell.

Colorectal cancers (which include cancers of the colon, rectum, appendix and anus) are the second largest cause of cancer deaths in the United States next to lung cancer, according to literature provided by the National Cancer Institute. If detected early, the disease is highly treatable, and because the majority of colorectal cancer cases occur in people over the age of 50, regular screening, including stool tests and colonoscopies, are recommended. But of the 140,000-plus people diagnosed with the disease in 2004, approximately 56,000 – 40{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} – will die.

“A colonoscopy should be looked at in the same way women view mammograms – as a necessary chore,” said Bowers. “The procedure can detect early stage polyps or tumors, and there is a much higher instance of cure.”

Newer, more comfortable methods such as virtual colonoscopies, which are less invasive and do not require sedation, and genetic testing of stool samples are being developed and utilized, but battling the fear associated with colonoscopies is a hurdle that must be cleared, according to Bowers.

“Virtual colonoscopies are still an up and coming thing,” Bowers said. “They’re still experimental. Now, we stress education about the screening process and that physicians recommend it to their patients, in order to show how important it really is.”

In addition, Bowers said diet, exercise, and healthy lifestyle habits are still the best first-line of defense against any cancer, including colorectal cancers. He said the effectiveness of some diet changes in preventing colorectal cancer, such as high-fiber diets, are still under investigation, but some recommended changes are reducing cholesterol and maintaining an overall healthy weight. There is also some soft data, Bowers said, that an aspirin taken once a day can have some preventative effect; the practice has already been proven to help maintain cardiac health.

“Our society in general needs to be more healthy,” he said. “Stop smoking. Get your weight down. Exercise more. That’s really what the whole country needs to do.”

It’s Rocket Science

Bowers added that the new developments in the treatment of colon cancer and other colorectal cancers is so exciting in part because there was little change in how the disease was treated for many years, further underscoring the importance of prevention of, and education on, the disease.

“For a while there was only one drug, called 5FU, that was available to colon cancer patients,” he said. “Now, there are several.”

Like many new cancer drugs on the market and in the research stage, these new treatments work differently than many of their predecessors, but can still be combined with existing chemotherapies to offer patients the best treatment available.

They have long, complicated names like bevacizumab and cetuximab, and are gradually becoming the new standard for colon cancer care. Bowers calls them ‘rocket science’ drugs.

“They’re not technically chemotherapy,” he explained, noting that the newer drugs work by targeting the cancer causing proteins and other growth factors that stimulate cancer cell production. “Most are being used in conjunction with standard treatments to fight the cancer with a number of different mechanisms; the combination seems to create even higher response rates.”

Those combinations allow for more options when treating a patient with colon cancer, Bowers said, and are also a move toward more targeted cancer treatments that spare healthy cells rather than damaging them, as with chemotherapy.

“Chemotherapy essentially bombs all of the cells in the body,” Bowers explained. “This is another way of stopping cancer cells from growing that is less destructive. “Developments like this make it a really exciting time in colon cancer research, and it definitely keeps your interest up,” he continued. “The advances translate to a higher percentage than ever of people seeing tumors shrink and surviving much longer. It’s a dramatic improvement over the past five years alone.”

The Last Word

But without an early detection, Bowers reiterated that any treatment must be initiated more aggressively and invasively than if a polyp or tumor is found in its beginning stages. In short, Bowers recommends taking the advice of, but leaving the research to, the experts, as they continue to study the clinical trials of newer, safer, more effective drugs and therapies to fight an already pervasive disease.

“There is a lot in the testing stages right now,” Bowers said. “I have the feeling that in the next three to four years we will be doing things very differently.”