John Forsythe, who starred in the television series Dynasty,  has had surgery to treat colon cancer, according to reports from the Associated Press.  Forsythe is 88 and is recovering from surgery in a Los Angeles Hospital.  His cancer was first discovered on September 28.

Hospital spokesperson Harlon Boll told the Associated Press:

“He seems to be in good spirits. They hope to have him home this weekend.”

Nearly 149,000 people will be diagnosed with colon or rectal cancer in the United States this year, and 55,000 will die of the disease.  Colorectal cancer is the second-leading cause of cancer death in the United States.  Men and women are equally affected by it.

Early detection of colorectal cancer before it has spread to organs beyond the colon greatly improves changes of survival.  However, colorectal cancer can actually be prevented if pre-cancerous polyps are discovered and removed during routine screenings. 

Other announcements of Forsythe’s cancer appear in online editions of  People Magazine, MSNBC, and the UK Daily Express.

Between November 2006 and June 2007 the Colon Cancer Alliance will provide one-day seminars designed to provide information and support for people who are affected by colon or rectal cancer in 10 cities across the United States.

The first seminar will be held in San Francisco on November 4, 2006.  Other cities where conferences are planned include Tampa, Denver, Atlanta, Durham, Orlando, Los Angeles, New York, Columbus, Ohio, and Washington, DC.

• Conversations about Colorectal Cancer:  Finding HOPE in Your Community
• November 4, 2006
• John Muir Medical Center
• Walnut Creek Campus
• Walnut Creek, CA (just outside of San Francisco)
• To register:  925-947-4447

The local events are shorter versions of CCA”s annual conference for people with colorectal cancer, their families and caregivers, and colorectal cancer survivors.

Additional information about the conference tour is available from Donna Quinlan, Program Director, (212) 627-7451.

Radiation before surgery to remove rectal cancer reduces the risk that the cancer will return at the surgical site.  It has been standard therapy for rectal cancer in France since 1992.

French researchers wanted to find out if adding chemotherapy to radiation could improve outcomes for rectal cancer that had not spread to distant organs (metastasized).  They randomly assigned 733 rectal cancer patients to receive five weeks of radiation, 5 days each week or to receive the same radiation plus 5FU (fluorouracil) together with leucovorin for 5 days during the first and fifth week.

Surgery to remove the rectal tumor was done 3 to 10 weeks after radiation or chemoradiation was completed, and chemotherapy was planned for all patients after surgery.

When the researchers analyzed the results, they found:

• Chemotherapy added some toxicity to the treatment.  14.6% of patients in the chemoradiation group had severe (grade 3 or 4) toxic side effects during treatment compared to 2.7% of the radiation-only arm.
• There was no difference in being able to preserve the sphincter and avoid colostomy.
• At surgery, all signs of tumor had disappeared for 11.4% of patients who received chemoradiation compared to 3.6% of the radiation-only group.
• After 5 years, 16.5% of the radiation group had suffered a recurrence of their cancer at the site of the surgery compared to 8.1% of those who had chemotherapy in addition to radiation.
• There was no difference in overall survival at five years.

Jean-Pierre Gérard, MD and his colleagues reported their results in the October 1, 2006 Journal of Clinical Oncology.  They concluded,

Preoperative chemoradiotherapy despite a moderate increase in acute toxicity and no impact on overall survival significantly improves local control and is recommended for T3-4, N0-2, M0 adenocarcinoma of the middle and distal rectum

       Gerard et. al. Journal of Clinical Oncology, Vol 24, No 28 (October 1), 2006: pp. 4620-4625 

The Institute for Medical Education and Research (IMER) is holding a free one-day educational conference for advanced practice oncology nurses and oncology registered nurses who are interested in an advanced program focused on colorectal cancer treatment.

Breakthrough data on treatment for colorectal cancer will be presented by leading national experts in colorectal cancer.  Each presentation will be followed by practical case-based discussions on incorporating new information into clinical practice.

• State-of-the-Art Systemic Therapy for Colorectal Cancer
  Friday, November 3, 2006
  8:30 AM – 3:30 PM
  California Ballroom
  Sheraton Los Angeles Downtown Hotel
  Los Angeles, CA
• Register online or call 877-956-9718
• Program includes breakfast and lunch

Conference topics include:

• Chemotherapeutic Options for Metastatic Colorectal Cancer
• Systemic Adjuvant Therapy for Colorectal Cancer
• Angiogenesis Inhibitors for Colorectal Cancer
• EGFR Inhibitors for Colorectal Cancer

More information and continuing education programs about colorectal cancer for oncology nurses is available at the IMER web site.

Surgeons in Germany reviewed records of patients in their institution who had had surgery to remove colorectal cancer that had spread to the lungs to analyze factors that led to successful outcomes.

Overall, there were 153 patients who had lung surgery between 1978 and 2003. 61 with colon cancer and 92 with rectal cancer.  71% had solitary tumors in the lungs, the rest had multiple tumors.  The maximum number of metastatic lung tumors was 8.  Some patients had a second lung surgery.

Two years after surgery, 64% of patients were alive, and 37% were alive at 5 years.  Median survival time was 39 months.  When surgeons were able to remove all signs of cancer in the lungs, 2-year survival was 68%, 5-year survival was 39%, and median survival was 43 months.

The research team found that some factors were not statistically significant in predicting survival after surgery:

• Original stage of the primary colorectal cancer
• CEA (carcinoembryonic antigen) level prior to surgery
• Tumor size
• Previous surgery to remove liver metastases

On the other hand factors that improved chances of survival were:

• Solitary metastases versus multiple mets
• A longer period of disease-free survival between surgery for the primary cancer and resection of lung mets.  Patients whose lung mets were discovered within a year after the primary cancer had a 25% 5-year survival while 66% of those whose mets were discovered after 3 years were alive at 5 years.
•  Surgery to remove larger sections of the lungs than wedge resections.
• No need to replace blood during surgery.

Suleyman Yedibela and colleagues from the University of Erlangen-Nuremberg published their study in an online version of the Annals of Surgical Oncology September 29, 2006.  They wrote:

Pulmonary resection for metastases from colorectal cancer is safe and results in long-term survival in selected patients. Single metastases, anatomical resection, intraoperative blood substitution, and DFI >36 months seem to be the most reliable predictors of survival.