Colorectal Cancer

The multistep process of carcinogenesis, which can take many years, provides many opportunities for intervention to inhibit disease progression. Effective chemoprevention agents may reduce the risk of cancer by inhibiting the initiation stage of carcinoma through induction of apoptosis or DNA repair in cells harboring mutations, or they may act to prevent promotion of tumor growth. Similarly, chemoprevention may entail blocking cancer progression to an invasive phenotype.

One of the most important prognostic factors in colorectal cancer is the presence or absence of regional lymph node metastases. In many instances, micrometastatic disease may not be found on routine pathologic analysis using hematoxylin and eosin staining, but may be discovered only with immunohistochemical methods or polymerase chain reaction assay.

The Fourth Investigators’ Workshop sponsored by The University of Texas M. D. Anderson Cancer Center was held on July 25-29, 2001, in Colorado Springs, Colorado.

BOSTON-Excessive sun exposure is a known risk factor for the development of skin cancer, but sun exposure appears to have a protective effect against a variety of other cancers, according to speakers at a symposium on sunlight at the 168th National Meeting of the American Association for the Advancement of Science (AAAS).

A 51-year-old man presents with iron deficiency anemia and occasional blood in his stool. He has no abdominal pain, no change in appetite, no diarrhea or constipation, no melena, and no loss of weight. The patient denies any nausea and vomiting.

Surgery is still the most important treatment for solid tumors, regardless of the age of the patient. In this article, we discuss the physiology of aging as it relates to risk assessment in the elderly surgical oncology patient. A brief review of the role of surgery in the treatment of breast, colorectal, pancreatic, and gastric cancer is provided, because these solid tumors primarily affect elderly patients.

Over 130,000 new cases of colon cancer are diagnosed annually. Approximately 20% to 30% of these are attributable to familial risk, and 3% to 5% belong to a hereditary colorectal cancer predisposition syndrome.

A substantial body of evidence supports the conclusion that chronic inflammation can predispose an individual to cancer, as demonstrated by the association between chronic inflammatory bowel diseases and the increased risk of colon carcinoma. Chronic inflammation is caused by a variety of factors, including bacterial, viral, and parasitic infections, chemical irritants, and nondigestible particles.

A 49-year-old woman presents with increasing constipation. She has noted intermittent bright red blood on the toilet tissue. She denies abdominal pain, anorexia, weight loss, and fever. She has a long history of constipation treated with "natural, herbal remedies." Her medical history is unremarkable. She is taking no other medications. Her surgical history is positive for hysterectomy for fibroids. Her family history is positive for colon cancer in her maternal grandmother.

Colonoscopy was performed on this asymptomatic 72-year-old man with colonic adenomatous polyps.

ROCKVILLE, Maryland-The FDA has approved a tiny ingestible video camera-the Given Diagnostic Imaging System (Given Imaging Ltd)-for use with other endoscopic and radiologic GI tract evaluations, to detect polyps, cancer, or causes of bleeding and anemia in the small intestine.

Effective radiotherapy for patients with cancer should include maximal tumor cell killing with minimal injury to normal tissue. Radiation doses that can be delivered, without causing severe damage to surrounding normal

BMS-247550 is a methyl, semi-synthetic analog of the natural product epothilone B. Provided to the National Cancer Institute (NCI) by Bristol-Myers Squibb, BMS-247550 was chosen for clinical development because it demonstrated

The US Food and Drug Administration (FDA) has approved capecitabine (Xeloda), the first oral chemotherapy for the

Given the well-established role of angiogenesis (or new blood vessel formation) in tumor growth and metastasis, antiangiogenic therapy, a concept first proposed by Dr. Judah Folkman,[1] has become increasingly recognized as a promising

WASHINGTON-Sentinel lymph node (SLN) mapping has been used in gastrointestinal cancers to identify patients with occult micrometastases who might benefit from adjuvant chemotherapy. Because rectal lymph drainage is "less predictable" than colon lymph drainage, the technique had been considered less suitable for rectal than for colon cancers, said Sukamal Saha, MD, of the McLaren Regional Medical Center of Michigan State University, Flint.

Colorectal cancer is the second leading cause of cancer-related death in the United States. An estimated 135,400 new cases and 56,700 deaths from colorectal cancer are expected during 2001. Since the mid-1990s, national guidelines have

At the Chemotherapy Foundation Symposium XVIII in New York City, researchers from the Arkansas Cancer Research Center, Cedars-Sinai Medical Center, M. D. Anderson, and the National Cancer Institute presented updated clinical trial data

The standard surgical treatment of distal, resectable, invasive rectal cancers is an abdominoperineal resection or a low anterior resection. Given the morbidity associated with these standard treatments and the frequent need

Colorectal carcinoma is one of the most common malignancies in the western world, and although fluorouracil (5-FU) has been used in its treatment for almost 40 years, new agents with significant activity have been introduced recently. Irinotecan (CPT-11, Camptosar), a topoisomerase I inhibitor, administered at 300 to 350 mg/m2 every 3 weeks is significantly more active than continuous-infusion 5-FU in patients who have experienced disease progression after conventional therapy with 5-FU. In comparison to best supportive care, irinotecan improves survival and preserves quality of life despite treatment-related toxicity. Moreover, the combination of irinotecan and 5-FU has been explored in a number of different schedules. In previously untreated patients, overall response rates are high. Irinotecan can also be combined with mitomycin (mitomycin-C [Mutamycin]), oxaliplatin, or raltitrexed (Tomudex). Oxaliplatin is a new-generation platinum compound that has demonstrated activity against colorectal carcinoma in preclinical trials. It has been evaluated as a single agent against advanced colorectal carcinoma in the salvage setting and also in combination with 5-FU as initial therapy for metastatic disease (where it shows significant activity). The toxicity profile of oxaliplatin (chiefly characterized by neurotoxicity) differs from that of irinotecan (primarily producing diarrhea) and the potential, therefore, exists for combining these agents or for exploiting their possible synergy with 5-FU. The introduction of these two new active agents of different pharmacologic classes promises to enable significant improvements in the treatment of patients with colorectal carcinoma. [ONCOLOGY 15(4):415-434, 2001]

In the largest prospective study of cigarette smoking and colorectal cancer mortality, researchers from the American Cancer Society report finding strong evidence that cancers of the colon and rectum are, in part, smoking related.

ROCKVILLE, Md-The FDA has approved the marketing of the Optical Biopsy System (SpectraScience, Inc.), a laser-based technique designed to assist physicians in deciding whether certain colon polyps are precancerous and should be removed. The company chose the trademark name Optical Biopsy System after the FDA refused to accept the name "Virtual Biopsy System" for its product.

Ateam of European researchers recently reported that the addition of oxaliplatin to the standard regimen for advanced colorectal cancer of fluorouracil (5-FU) and leucovorin doubled the response to therapy and significantly prolonged progression-free survival, compared to leucovorin and 5-FU alone.

The world’s population is aging. Older age is associated with an increase in the incidence of cancer, especially cancer of the breast, lung, prostate, and colon. The management of older patients with cancer is biased by the

BOSTON-HIV-positive patients often cannot tolerate treatment for anal squamous cell carcinoma and have a worse prognosis than other patients, according to two studies presented at the American Society of Colon and Rectal Surgeons (ASCRS) annual meeting.

Capecitabine (Xeloda) is a new, orally administered, enzyme-activated fluoropyrimidine carbamate designed to generate high levels of fluorouracil (5-FU) in tumor cells. Selective tumor activation of 5´-deoxy-5-fluorouridine,

Capecitabine (Xeloda) is a new, orally administered, enzyme-activated fluoropyrimidine carbamate designed to generate high levels of fluorouracil (5-FU) in tumor cells. Selective tumor activation of 5´-deoxy-5-fluorouridine,

FLINT, Michigan-The debate continues on the use of sentinel lymph node (SLN) mapping in colon cancer. How many nodes need to be analyzed to improve the outcome for this patient group? The current thought is the more nodes harvested, the better the predictive value, and Dr. Thomas LeVoyer made the case that removing more nodes yields a better survival benefit.

PHILADELPHIA-Nearly 45% of all cases of colon cancer have lymph node involvement. Surgical resection is the gold standard of treatment, with adjuvant chemotherapy used in an attempt to improve survival in patients with late-stage disease, but the outlook is often dismal.

NEDLANDS, Australia-If the implications of an Australian study are validated in further prospective studies, microsatellite instability (MSI) could potentially predict those patients with Dukes’ C and possibly Dukes’ B colorectal cancer who will respond best to chemotherapy.