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.
Colon 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.
Certain genetic mutations can greatly increase the risk of developing colon cancer. Among the most common are hereditary non-polyposis colon carcinoma (HNPCC) or Lynch Syndrome and the familial adenomatous polyposis syndrome (FAP). However the majority of colorectal cancers occur in people with no known genetic risk factors.
Between 90 and 95 percent of all colon cancers are adenocarcinomas. More rare forms of colon 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.
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 colon 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.
The types of treatments recommended will depend on the stage of your cancer. The three primary colon 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 flourouracil (5-FU) plus leucovorin (FU/LV) and the closely related capecitabine.
The addition of irinotecan and oxaliplatin can often demonstrably improve the effect of 5-FU based therapy and capecitabine. Monoclonal antibodies like Erbitux, Vectibix and Avastin are also often used in combination with chemotherapy.
At Nagourney Cancer Institute, we recommend colon cancer treatment regimens based upon the observed patterns of cell death in your cancer cells following exposure to drugs in our laboratory.
As a colorectal cancer patient, you may be responsive to several different drugs or combinations. Selecting the most effective, least toxic drug regimen may offer an advantage to you as you confront this disease.
I was diagnosed with Stage 4 Colon Cancer in late August 2013. On September 4, 2013, I was scheduled for surgery to remove the large tumor in my lower colon.
Prior to the surgery, my wife and I made an appointment to consult with Dr. Nagourney at Rational Therapeutics (now Nagourney Cancer Institute). Dr. Nagourney performed a comprehensive examination, reviewed all the imaging, tests, and notes that had been compiled since my diagnosis. He recommended that we submit tissue obtained during surgery to Rational Therapeutics for testing in order to find the most suitable colon cancer treatment options for my case.
The functional profile testing performed showed that my cancer cells were responsive to both the FOLFOX and FOLFIRI chemotherapy regimes, and that the use of these agents should be highly effective.
— Jeff Bassman
When I learned I had cancer, I did research. A good friend of mine told me about Rational Therapeutics (now Nagourney Cancer Institute) and Dr. Robert Nagourney in Long Beach, California.
Before I had surgery, I went to see Dr. Nagourney and decided that having my tumor tested to determine which chemotherapy would provide the most effective course of treatment was definitely the way to go . . . So, if I have anything to tell someone who is battling cancer, it is this: Do your homework and take charge of your care and don’t let anyone push you around – stick to your guns! I took charge and I’m doing just great 10 years later.
— Walt Wilson