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Colorectal Cancer - March '07
Non-surgical treatments offer hope to colorectal cancer patients
Rekha Chaudhary, MD
The American Cancer Society estimates there will be more than 112,000 new cases of colon cancer and 40,000 new cases of rectal cancer in the United States in 2007. The two cancers combined, known as colorectal cancer, will cause more than 50,000 deaths. At The University of Toledo Medical Center, physicians are striving to save lives with early diagnosis and innovative treatments.
Five stages of colorectal cancer
Colorectal cancer is divided into five stages:
- Stage 0: Cancer is at the earliest stages and has not grown beyond the inner layer of the colon or rectum.
- Stage I: Cancer has grown through the inner layer of the colon or rectum but has not spread beyond the colon wall or rectal wall.
- Stage II: Cancer has grown through the colon wall or rectal wall but has not spread to nearby lymph nodes.
- Stage III: Cancer has invaded nearby lymph nodes but has not yet affected other areas of the body.
- Stage IV: Cancer has spread to other areas of the body including other organs.
Once diagnosed with colorectal cancer, patients must undergo treatment to recover from the disease. According to Rekha Chaudhary, MD, assistant professor of medicine and oncologist at The University of Toledo Medical Center, patients have several options for treating colorectal cancer depending upon the stage. If a patient is in Stages 0, I, or II surgery and radiation are options that may be offered. “Surgery and radiation treat cancer if it is confined within the colon, so either treatment (depending on the clinical situation) can be effective if the cancer is in just one spot,” says Dr. Chaudhary. “But if there is a risk of the cancer spreading outside the colon, or if it has already spread, you cannot use surgery or radiation because the cancer cells may be floating through the blood stream and may land or already have landed in other organs. The effective treatment option at that point is chemotherapy.”
Chemotherapy and bevacizumab are effective forms of treatment
Chemotherapy is often administered through an intravenous line, although we do have options in the pill form now, and can kill off current cancer cells in the body as well as prevent future growth. “There are two situations where we use chemotherapy,” explains Dr. Chaudhary. “The first is if the colon is removed, and physicians feel the cancer is aggressive and the patient is at high risk for the cancer spreading to other areas of the body. In that case, we use chemotherapy to prevent the cancer cells from going to other organs of the body, like the lungs, liver and bones. Another situation where we use chemotherapy is when the cancer has already spread outside the colon to other organs in the body. Then chemotherapy is used to prevent further growth in those organs.”
The Food and Drug Administration recently approved a new treatment, bevacizumab, for treating colorectal cancer that has spread to other areas of the body. The drug is used in combination with standard chemotherapy, and in clinical trials it added an average of five months to study participants’ survival times.
“It is a brand new drug and it is basically an antibody that we inject intravenously. It blocks the growth of the tumors’ blood vessels,” says Dr. Chaudhary. “Chemotherapy kills the tumor cells, and bevacizumab cuts off the blood supply to the tumor so that any remaining cancer cells have no nutrition supply and eventually die as well. It is like having an army approaching from two different sides to kill the same enemy.
Team approach means better treatment
At the UT Medical Center, physicians work as a team to provide the best care for patients diagnosed with colorectal cancer. Patients are able to receive a second, third, fourth and fifth opinion in a single location.
“We have a multidisciplinary team with radiation oncologists, radiologists, surgeons, oncologists and pathologists and we meet weekly to discuss all tumor cases,” says Dr. Chaudhary. “We have what we call a team-directed approach – everyone reviews each case and gives their expert opinion on the best treatment options.”
For more on the risk factors and symptoms for colorectal cancer, read Dr. Frederick Cason’s article regarding surgical treatment of colorectal cancer. For more about the diagnosis of colorectal cancer, read Dr. Isam Daboul’s article regarding advances in colonoscopy.
To schedule an appointment with Dr. Chaudhary or another UTMC oncologist, please call 877-451-2299.
