Irinotecan (also called CPT-11 and/or Camptosar) is often used to treat advanced colorectal cancer. But it causes diarrhea in most patients–severe in 30 percent—that often limits the dose a patient can tolerate.

Now researchers at the University of North Carolina at Chapel Hill have found a way to block one specific troublemaking enzyme thought to play a big role in causing the diarrhea.

Irinotecan is complicated: After it has killed tumor cells, the drug is filtered out of the bloodstream by the liver, where it’s changed to an inactive compound and discharged into the intestine to be excreted. But in the intestine, the drug can be reactivated by an enzyme that is made by bacteria that normally live in the gut. The reactivated toxic drug then damages the intestinal lining—leading to severe diarrhea.

Matthew Redinbo, PhD, and his team wanted to block the enzyme that reactivates irinotecan, yet not kill the intestinal bacteria, because it’s vital for digestion, vitamin manufacturing and fighting infections. Sorting through a database of 10,000 chemical compounds, the research team found four chemicals that, at least in a test tube, blocked the enzyme without harming the bacteria. They tested one compound in mice: Those given irinotecan plus the compound had far less severe diarrhea than mice given just irinotecan.

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Infusions of calcium and magnesium can reduce numbness and tingling caused by oxaliplatin without affecting survival, according to a recent study in the Netherlands.  But the infusions didn’t affect treatment success.

Most colorectal cancer patients being treated with oxaliplatin chemotherapy experience some sensory peripheral neuropathy that may vary from mild tingling in their hands and feet to pain and difficulty walking.  Although peripheral neuropathy usually gets better within a few months after treatment ends, it can last years for some patients.

Sometimes patients need to stop oxaliplatin treatments before they get full advantage from them because of this troublesome side effect. Read the rest of this entry »

Traditionally, people getting cancer treatments were told to rest and avoid exertion, to save their strength during treatment. But more experts now say that the best way to get through treatment, and possibly the best way to beat cancer, is to stay as physically active as possible.

The American College of Sports Medicine has revised its national recommendations, saying that cancer patients and survivors should strive for the same goal as everyone–about 150 minutes a week of moderate aerobic exercise, along with resistance training and stretching.

The panel does caution that workout plans must be adapted to each person’s condition and treatment. For example, some cancer treatments make bones more brittle, which will require exercise that place less stress on them. And immunosuppressed patients must avoid exercise in groups of people.

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A commonly used treatment for prostate cancer may increase the risk of colorectal cancer.

Older men with prostate cancer who received treatment that reduced androgen had a 30 to 40 percent higher risk of getting colorectal cancer than men who didn’t have the therapy. The longer they received the treatment, the greater their risk.

Androgen deprivation therapy (ADT) is approved for treatment for men with advanced prostate cancer, but its use is controversial in older men with earlier, low-risk cancer although it is widely used in those men.

The link of ADT to colorectal cancer may help lower-risk men make a decision about therapy for their prostate cancer. Read the rest of this entry »

Too many people avoid colonoscopy.  Too invasive, they say.  Too scary, too risky.

There may be an answer for them in an improved stool test that looks for DNA that is changed in both colorectal cancer and some precancerous polyps.

Of course, if the stool test identifies possible polyps or cancer, a colonoscopy is critical to evaluate the findings and remove polyps.

The test that looks for methylated DNA in human feces, found 85 percent of cancers and 64 percent of large adenomas.  There were few false positives.  Only one in ten follow-up colonoscopies didn’t confirm cancer or adenomas. Read the rest of this entry »