Since many of you know that I was trained in Germany, I have a surprising number of patients asking me if there are better therapies in Germany or in Europe than in the US.
Because of my role in clinical research and laboratory research I am invited to give lectures around the world about the latest in colon cancer research. In the last 12 months, I gave lectures in Japan, China, India, Germany, Spain, Portugal. Israel, Brazil, Argentina, Switzerland, and Greece. It is not easy to travel through so many time zones, but it is very important to understand different cultures and different ways that colon cancer patients are treated in Asia and Europe. The rest of the world is looking at us for what we do in colon cancer research.
We are very blessed in the USA to have access to all these new drugs which is not the case throughout the world. The last three new medications approved in colon cancer were developed in the USA: Erbitux by Imclone, Avastin by Genentech and Vectibix by Amgen. Who would have thought that Erbitux would just have been approved in Japan and is still not approved in Israel.
Overall survival for patients with advanced disease is much shorter in Europe and Japan compared to the USA because they have less access to the latest therapies and treatments are given not only by medical oncologists but also surgeons and gastroenterologists which slows down the implementation of the most effective therapies. However in Europe because surgeons play a bigger role in chemotherapy not necessarily do they give the best chemotherapy but they watch very carefully to see if there is any role for resection of metastases which is the only chance for cure.
In the USA this involvement happens less often, and only centers with multidisciplinary conferences incorporate the expertise of disciplines such as oncology, radiation oncology, colorectal surgery and hepatobiliary surgery. Only with the best therapies and the best expertise in all these areas will we be able to improve outcomes for our patients and hopefully cure more and more patients.
We in the USA should be very thankful for having cutting edge therapies available for our patients with colon cancer. One of the reasons I stayed at the University of Southern California is because comprehensive cancer centers such as USC/Norris are heaven for clinical scientists who can work easily with population scientists and basic scientists, take advantage of cutting edge technologies, and really do bench to bedside research.