Aggressive Treatment Leads to Cures for Colon and Rectal Cancers

Colon and rectal cancer that is attached to critical body structures like the wall of the pelvis or important large veins has traditionally been considered not surgically treatable.  Patients have been offered palliative treatments designed to extend life or reduce symptoms, but the goal wasn’t cure.

However, Mayo Clinic surgeons are now working together with teams of surgeons, radiologists, and oncologists to treat normally unresectable colon and rectal cancer with a combination of therapies.  Surgery, both external radiation and radiotherapy done during surgery, and chemotherapy have gone beyond palliative care for this group of patients.  Almost half of the patients treated with the multimodality approach were alive and cancer free five years after treatment began.

Writing in the Annals of Surgery, the doctors titled their article, Unresectable Colorectal Cancer Can Be Cured With Multimodality Therapy.

Mayo doctors treated 146 patients whose colon or rectal cancer was considered unresectable because it was attached to a critical body structure with combinations of surgery, external beam radiotherapy, intraoperative radiation, and chemotherapy.  Five years later 76 patients were alive (52 percent), and 66 were alive with no sign of cancer (43 percent).

No patients died during surgery.  Long term side effects in some patients included peripheral neuropathy, bowel obstruction, or obstruction of urine.

The best results were in younger patients under age 58, patients where there were no cancer cells in the surgical margins, and patients who received chemotherapy after surgery.

Kellie Mathis, M.D., and her colleagues concluded,

Aggressive multimodality therapy for locally unresectable primary colorectal cancer results in excellent local disease control and a 5-year disease-free and overall survival rate of 43% and 52% respectively with no operative mortality and acceptable perioperative morbidities.

SOURCE: Mathis et al., Annals of Surgery, Volume 248, Number 4, October 2008.

Comments

  1. Kate Murphy says

    Rexin-g is now in early clinical trials for breast cancer and for pancreatic cancer, and patients are being sought for those trials. Trials in sarcoma and osteosarcoma are also underway, but are no longer seeking new patients.

    Currently there are no trials for colorectal cancer for rexin-g, and it is not FDA approved for colorectal or any other cancer.

    A clinical trial studying rexin-g for colon cancer that had spread to the liver was planned to start in 2002, but never opened because it did not receive institutional review board (IRB) approval. We do not know further details about this terminated clinical trial.

    For more information about where to find active clinical trials studying rexin-g, use the NCI Clinical Trials Advanced Search and choose rexin-g from the Drug list.

  2. bonnie says

    What research indicates using chemo as a life-long treatment for colon cancer? I cannot find any internet results that reflect this question…..it has been suggested to my brother. No specifics for treatment just would like to know where to look.

  3. Kate Murphy says

    Bonnie,

    It is hard to point you to one place that discusses all the research on chemotherapy for colon cancer.

    For early stage disease (stages II and III) chemo usually lasts about six months.

    For more advanced stage IV disease, chemotherapy is very rarely a treatment that leads to cure of the cancer. It does prolong life, sometimes for several years, and reduces symptoms from the tumor.

    There are several different chemotherapy drugs and combinations of drugs. Usually a patient begins with one combination, takes it until it is no longer working to keep the cancer in check, and then moves on to the next one.

    When the burden of chemotherapy outweighs its advantages, patients can decide to stop treatment.

    It is important, however, to realize that surgery CAN produce long-term remissions, sometimes even cures for stage IV colorectal cancer. So getting a surgeon’s opinion is vitally important.

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