Believe it or not, using 5-FU in the fight against colorectal cancer goes back to the 1950s when the chemo drug was first used for advanced disease.
Today 5-FU remains a mainstay against colon and rectal cancer, but it has been joined by new drugs, targeted biological agents like Avastin, radiation, and greatly improved surgery.
Along with improved treatment, routine colorectal cancer screening has reduced death from colorectal cancer by 40% since 1975.
ASCO has a new interactive graphic that shows progress against cancer, including colorectal cancer.
Highlights of progress against colorectal cancer include:
- 1967: Fecal occult blood testing begins to be used to screen for colorectal cancer. In the next few years flexible sigmoidoscopy and colonoscopy joined FOBT as methods to find early cancer. Endoscopy did more — it removed precancerous polyps (adenomas) and prevented cancer.
- 1982: Surgeons began using total mesorectal excision for rectal cancer, saving many patients from permanent colostomies.
- 1985-1991: Adjuvant chemotherapy begins to be used after surgery for early stage colon cancer, reducing risks that cancer will return from 1 in 2 to 1 in 4 patients.
- 1990s: Genetic tests are developed for inherited familial adenomatous polyposis (FAP) and Lynch syndrome (HNPCC) helping to identify patients and families at high risk for colorectal cancer so that closer surveillance and preventive surgery could reduce deaths.
- 1996: Irinotecan is added to 5-FU to improve survival time for advanced colorectal cancer. Oxaliplatin follows in 2002. FOLFIRI and FOLFOX become standard treatment for advanced colorectal cancer.
- 2004: Avastin (bevacizumab), a biological agent that targets VEGF further improved survival time when added to combination chemotherapy.
- 2004-2008: Erbitux (cetuximab) and Vectibix (panitumumab) target EGFR make a further impact on keeping tumors stable and improving survival time for some patients.
- Radiation and chemotherapy before surgery for rectal cancer shrinks rectal tumors while reducing side effects from chemoradiation and becomes standard treatment for locally advanced rectal cancer.
- 2008: Patients with KRAS mutations in their tumors are found to have no benefit from Erbitux or Vectibix. Testing for the biomarker becomes routine before prescribing these agents.
- 2009: Adding oxaliplatin to 5-FU reduces risk of recurrence after surgery for early stage colon cancer.
With the help of research, we are making progress!
In 1975, half of people diagnosed with colorectal cancer would have died. Today 2 out of 3 are alive.
To view progress against colorectal cancer on
the CancerProgress.Net timeline, highlight Colorectal Cancer and touch the yellow buttons to read details.