Genome sequencing lab — NIH

A Labor Day salute to the hard-working scientists—doctors, PhDs, lab techs, technology inventors—who have done some  heavy lifting to peer into the tiniest recesses of cells, genes, and molecules to unravel what makes colorectal cancer happen.

In the widest and deepest effort to date, the Cancer Genome Atlas Project has produced some surprises and key clues about colorectal cancer, published recently in the journal Nature.

It was almost “ industrial-strength genetics to try to unpick and take apart the genetic coding,” according to Dr. David Kerr, professor at the University of Oxford and Past President of the European Society for Medical Oncology. 

One of the surprises for colorectal cancer—the third cancer they’ve analyzed—is that “colon and rectal cancer are genetically virtually indistinguishable,” said Kerr. “This puts to rest a mythology …that rectal and colon cancers are somehow different beasts… There is no molecular basis for that whatsoever. They have put that mythology to bed.” Read the rest of this entry »

From 15 to 30% of people who have colorectal surgery will get an surgical-site infection—and those surgical infections (just among colorectal patients) cost an estimated $1 billion a year. The surgical infections cause longer hospital stays; are the most common cause of hospital readmission within 30 days; and require more doctor visits, wound-care supplies, and home care. Not to mention the added difficulties for patients and their families.

A two-year study at Johns Hopkins Hospital, just published in the August 2012 Journal of the American College of Surgeons, describes how a team of front-line providers used their “local wisdom” plus an evidence-based safety system to cut their infection rate in colorectal surgery patients by 33.3 percent in one year. Read the rest of this entry »

Despite better screening for colorectal cancer (CRC), about 1 in 5 newly diagnosed patients will have metastatic CRC that already has spread to distant organs.  Many will have symptoms of fatigue or weight loss, but only a minority will have symptoms (significant bleeding or abdominal pain, or a blocked bowel) caused by the colon tumor itself.

In those people first diagnosed with stage IV CRC, about 80% have metastases that cannot be removed by surgery. There’s been intense debate—but no clear evidence—about whether patients whose colon tumor isn’t causing symptoms should have the colon tumor surgically removed routinely before they start chemotherapy. 

A recent important study provides the first evidence that such patients often do just as well to start systemic chemotherapy immediately without having their colon tumor surgically removed. Read the rest of this entry »

Do cholesterol-lowering drugs help prevent CRC?

You might be able to help answer that question. A national research project needs people who have been treated for early-stage (stage I or II) colorectal cancer in the past year.

There have been tantalizing hints that cholesterol-lowering drugs (statins) might help prevent the growth of precancerous (adenomatous) polyps and/or recurrent colorectal cancer. Millions of Americans already take these statins to protect against heart attacks. We also know that people who have had early-stage colorectal cancer have up to a 50% chance of developing new polyps within 3 years.

Some studies have shown that people who had taken statins had lower rates of colorectal cancer (CRC), but other studies did not. And all of those studies were fairly short-term, looking for heart events rather than slower-developing cancers. So the jury is still out.

In 2010, the first national study was launched designed specifically to see if cholesterol-lowering statins could prevent colorectal cancer. But researchers still need more participants from all over the US, especially those at relatively high risk of developing cancerous polyps. Read the rest of this entry »

Ziv-Aflibercept Approved as 2^nd line treatment for metastatic CRC  

For the first time in more than five years, the FDA has approved a new drug for certain patients who have metastatic colorectal cancer.

The FDA has approved ZALTRAP® (ziv-aflibercept) to be used with FOLFIRI as a “second-line” treatment for patients with stage IV colorectal cancer whose cancer got worse despite an initial oxaliplatin-based treatment (e.g. FOLFOX).  Read the rest of this entry »