Radiologists at M.D. Anderson Cancer Center in Texas have found that conformal radiotherapy (CRT) to the largest (dominant) liver metastasis can control cancer progression for several months. 

Reviewing records of 17 patients with colorectal cancer that had spread to the liver and who were treated with conformal radiotherapy, they found median time to progression after treatment were:

• 6.8 months for the tumor that was radiated
• 3.1 months for tumors in the liver outside the field of radiation
• 4.1 months for tumors outside of the liver

Dominant liver tumors had a median size of 10 centimeters, and 71% of patients had evidence of cancer outside the liver.  Surgical resection was impossible.  In addition, patients had already received a median of 2 chemotherapy regimens.

Overall survival time after radiotherapy was 12.6 months.

Most patients were also receiving chemotherapy including celecoxib (Celebrex®) and capecitabine (Xeloda®).

Side effects included diarrhea, nausea, vomiting, fatigue, hand-foot syndrome, and low white cell counts — none of which were severe.

The researchers, who reported their study in the December 2006 issue of the American Journal of Clinical Oncology concluded:

Conformal RT to the dominant liver metastasis as palliative therapy for unresectable colorectal cancer liver metastases has an acceptable toxicity profile and may improve survival. This approach merits further exploration.

In a group of 300 Munich patients who underwent both CT colonography (virtual colonoscopy) and optical colonoscopy on the same day, CT colonography was both sensitive and specific in finding polyps. 

Dividing the adenomas into three groups — small polyps under 5 mm, intermediate 6 mm to 9 mm, and large 10 mm and over–,  the radiologists found sensitivity and specificity of:

• 96% and 100% for large polyps
• 92% and 96.7% for intermediate
• 78.9 and 89.5% for small

Optical colonoscopy missed one large, two intermediate, and eight small polyps for sensitivities of 96%, 95%, and 89.5%.

Dr. Anno Graser, a radiologist at the University of Munich, presented the results at the 2006 meeting of the Radiological Society of North America (RSNA) on November 28. The study is part of the Munich Colorectal Cancer Prevention Trial.

The researchers cautioned that while CT colonography is highly accurate in finding polyps, there is more of a problem in finding flat lesions, a difficulty shared with optical colonoscopy.

Dr. Graser also presented a new 3-dimensional CT technique that provides a panoramic view of the colon and requires only one passage of the scanner from rectum to colon rather than a two-directional one.  The technique decreased the time necessary for the test without sacrificing accuracy

Just before a midnight deadline Congress passed a stopgap funding bill and sent it to President George W. Bush for his signature. The bill passed the House by a 320-70 vote while the Senate backed it by unanimous consent.

Because Congress only passed two of the thirteen appropriations bills by the end of the 2006 Fiscal Year a continuing resolution was required to keep the U.S. government running. That resolution expired at midnight thus the rush to pass a replacement resolution.

Programs of interest to the colon and rectal cancer community are in the Labor, Health and Human Services, and Education appropriations bill. Since this bill did not pass programs are funded at the level in the FY 2006 bill which means level funding continues.

I happened to pass by C-Span and noticed the House was considering House Joint Resolution (H. J. Res.) 102 which is the official name of this latest stopgap bill. I watched as Rep. Jerry Lewis (R-Calif.), House Appropriations Chair, and Rep. David Obey (D-Wis.), House Appropriations Ranking Member, spoke on the House floor about the bill.

From what was said on both sides of the aisle I have to agree with was Reuters said in its report: ”Both Republicans and Democrats in the House complained about having to pass the stopgap spending bill

According to the article Rep. Lewis “put blame ‘squarely…at the feet’ of retiring Senate Majority Leader Bill Frist of Tennessee, saying he had failed to move the spending bills through the Senate.” It also reported that Rep. Obey, the next chair of the House Appropriations Committee, ”called the temporary spending bill ‘a blatant admission of abject failure by the most useless Congress in modern times.’”

My sense is that both sides in the House tried to get all the spending bills passed and to the President before the end of the fiscal year. Rep. Obey said that Congress did not fulfill its responsibility in the process.

I am as upset about this as they are. Delay after delay then a big rush to get things done before close of business. I’d even go so far to say I agree with The Associated Press report which said this Congress “dumped an unfinished budget” on the next Congress.

What next? First off this muddies the waters for the President’s fiscal 2008 budget proposal which will be sent to Congress early next year as this year’s leftovers will delay things next year. To sped things up the remaining bills could be combined into an omnibus bill. Each bill could be reconsidered but it would more than likely be without major changes given the time constraints. It could be something else.

No matter what happens constituents affected by colon and rectal cancer need to keep reminding their Members of Congress to make cancer funding a priority.

Click here to read the Reuters article.