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New method proposed for determining which patients should get treatment for colorectal cancer
May 19, 2008A new study being presented at the American Society of Clinical Oncology meeting in Chicago (Abstract #4020), may change treatment practice in about 25 percent of patients with colon cancer and is the basis for proposed changes to the way colorectal cancers will be staged.
This new study, using National Cancer Institute (NCI) SEER population-based statistic registries from 1992 to 2004, and phase III clinical trial data, shows that outcomes of patients with positive nodes (Stage III) in colorectal cancer interact, to a greater extent than previously thought, with how deeply the cancer penetrates the bowel wall.
Survival outcomes depend on the thickness of the primary cancer within or beyond the bowel wall in addition to whether nodes are positive or negative. A patient with a node positive 'thin' lesion (i.e., confined to the bowel wall) has a stage III cancer with better survival outcomes than a patient with a Stage II node negative 'thick' cancer that penetrates beyond the bowel wall. The current standard of practice for colon cancer patients is that all or most Stage III patients receive chemotherapy after surgical removal of their cancer, but Stage II patients do not routinely receive chemotherapy. In a separate National Cancer Data Base (NCDB) analysis, patients with Stage III colon cancers confined to the bowel wall who did not receive chemotherapy still had better survival than Stage II patients.
Guidelines for adjuvant therapy may need re-examination in future clinical trials as well as more research into the molecular basis for the interplay between a primary cancer's ability to penetrate the bowel wall and to spread to regional nodes.
Also, the survival of patients whose cancers invade beyond the bowel wall to involve adjacent structures or organs is worse than that of patients whose cancers merely penetrate to the surface of the bowel wall (the reverse had been thought to be true).
Mayo Clinic
Guidelines for adjuvant therapy may need re-examination in future clinical trials as well as more research into the molecular basis for the interplay between a primary cancer's ability to penetrate the bowel wall and to spread to regional nodes.
Also, the survival of patients whose cancers invade beyond the bowel wall to involve adjacent structures or organs is worse than that of patients whose cancers merely penetrate to the surface of the bowel wall (the reverse had been thought to be true).
Mayo Clinic
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Bowel cancer indicator should lead to better treatment
STEM cell scientists have developed a more accurate way of identifying aggressive forms of bowel cancer, which should eventually lead to better treatment and survival rates.
Stem cell indicator for bowel cancer should lead to better survival rates
Stem cell scientists have developed a more accurate way of identifying aggressive forms of bowel cancer, which should eventually lead to better treatment and survival rates. Bowel cancer is the third most common cancer in the UK.
Scientists discover major genetic cause of colorectal cancer
About one-third of colorectal cancers are inherited, but the genetic cause of most of these cancers is unknown. The genes linked to colorectal cancer account for less than 5 percent of all cases.
Perceived discrimination affects screening rates
Minority men and women who perceived discrimination from their health care providers were less likely to be screened for colorectal or breast cancer, according to a report in the August issue of Cancer Epidemiology, Biomarkers and Prevention, a journal of the American Association for Cancer Research.
First worldwide analysis of cancer survival finds wide variation between countries
Cancer survival varies widely between countries according to a worldwide study published online today in Lancet Oncology.* More than 100 investigators contributed to the study.
'Smothered' genes combine with mutations to yield poor outcome in cancer patients
Johns Hopkins Kimmel Cancer Center researchers have identified a set of genes in breast and colon cancers with a deadly combination of traditional mutations and "smothered" gene activity that may result in poor outcomes for patients.
Protein thought to promote cancer instead functions as a tumor suppressor, researchers report
A protein previously thought to promote colorectal cancer instead suppresses the growth of human cancer cells in culture, researchers at UT Southwestern Medical Center have found.
Different type of colon cancer vaccine reduces disease spread, Jefferson scientists show
Taking advantage of the fact that the intestines have a separate immune system from the rest of the body, scientists at the Kimmel Cancer Center at Jefferson in Philadelphia have found a way to immunize mice against the development of metastatic disease.
Study evaluates factors associated with racial disparities in colon cancer screening
Blacks and Hispanics appear less likely to undergo colorectal cancer screening than whites because of socioeconomic, health care access and language barriers, according to a report in the June 23 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. However, other factors may contribute to screening disparities experienced by Asians.
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