In this month we don’t want to only raise awareness about prevention of colon cancer. We should be aware of the significant progress we have made in the last 10 years treating it.
With the introduction of irinotecan, oxaliplatin, bevacizumab, and cetuximab, overall survival has tripled to more than two years; but this does not tell us the whole story. In the past patients with metastatic disease all died from their disease. This is not true any longer.
With more active therapies, we have cured more and more patients, particularly those whose cancer has only spread to the liver. There are increasing reports that this is also true for lesions found in one site in the lung.
With genetic testing we now can identify more active therapies, which now have response rates of 70 percent and higher, leading to more conversion of unresectable to resectable tumors.
I wanted to share with you one story of my patient who was diagnosed with metastatic disease with a liver lesion in 1998. We treated him for years with any new drug which came on the market, which translated into seven different therapies. Because of some success, we resected liver lesions three times and lung lesions twice.
He was even on a Phase I clinical trial prior to his last lung resection. We cleared both his lungs and his liver but never removed his rectal cancer.
Last year we saw on the PET scan that there was a lesion close to the rectum (colonoscopy was clean). We needed two attempts to biopsy it but found rectal cancer, which was the site of the 1998 tumor. We removed it, and we are now treating with chemo.
We kept this patient alive to have access to new medication which again allowed us to make him live longer and allow another surgery with the intent to cure. It is amazing that there are metastases left after our battle against this disease.
He has no evidence of disease after 12 years. Unfortunately this does not happen to all patients but gives us hope that we have developed a lot of new treatments which will help more patients.
There is hope and cure for more and more patients. FIGHT ON.