I have shared some inspiring stories with you of patients in my practice who I think are examples of how colon cancer therapies have changed. Today when patients walk into my practice with metastases only in liver or lungs, I know that I can cure some of them. The way we look at these patients has completely changed. Read the rest of this entry »

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. Read the rest of this entry »

It is important to stage somebody correctly that you examine a reasonable number of lymph nodes.

Many studies now show that the ideal number is 12 or higher. We know that if you have no lymph nodes involved with cancer out of 12 lymph nodes that you really have stage II disease.  You might wonder when only two nodes are removed and none are involved in cancer if additional lymph nodes could show cancer. Therefore, even when the pathological stage is II, we would classify this tumor as not well-staged and treat it like a stage III cancer. Read the rest of this entry »

Since the last ASCO meeting in June 2008 not only has KRAS made headlines but also microsatellite instability (MSI).

Microsatellite instability has developed into the most important prognostic and predictive marker for patients with stage II colon cancer. Recent studies presented by Dr. Daniel Sargent at ASCO showed that patients with stage II colon cancer who have microsatellite instability did not benefit from 5-FU chemotherapy. Therefore these patients with no risk factors such as clinical obstruction, lymphovascular invasion, poorly differentiated adenocarcinoma, or insufficient lymph node collection should not receive 5-FU. Read the rest of this entry »

Looking into the future, I have no doubt that we will use colon cancer stem cells to find more effective therapies for colon cancer patients and develop novel chemoprevention strategies.

I am collaborating with a basic scientist, Michael Kahn, from the USC Stem Cell Institute. He moved from the Fred Hutchinson Cancer Center to USC to develop novel strategies for cancer stem cells. As many of you know, California will spend over $3 billion over the next 10 years on stem cell research. I have no doubt in my mind that California will be the world leader in a couple of of years in stem cell research and the development of new therapies for a lot of different disorders including cancer. Read the rest of this entry »