Increased awareness of colorectal cancer by the public and by private insurers, government agencies, and medical personnel will result in better use of available screening techniques. Development of preventive drug strategies against colorectal cancer, particularly with drugs that reduce polyp formation or prevent polyp progression to cancer, promises to be a fruitful field of endeavor.
There is ample reason to expect refinement of diagnostic and staging tests for the disease, perfection of surgical and nonsurgical techniques for treatment of large bowel cancer and its complications, and improving chemotherapeutic treatment by means of more effective and less toxic drugs.
A number of molecular markers for colorectal cancer can be measured but it is not yet clear that they have prognostic value or therapeutic implications. Measures of DNA synthesis or cell division are of uncertain value as clinical decision-making tools. Measurement of thymidilate synthase activity in colorectal cancer tissue is one of several markers under investigation as a prognostic indicator.
This could be useful in making decisions regarding the use of adjuvant chemotherapy for certain patients, especially those with stage II or B tumors. Another goal would be to collect a set of markers for cancer risk for an individual who has adenomatous polyps. Presumably, such testing could reflect exposure to colon carcinogens and help define the outlook for an individual. This in turn could narrow the prospective use of screening and diagnostic procedures such as colonoscopy.
Techniques to identify micrometastases in lymph node tissue are in development. These include special stains for cytokeratin, which can identify small clusters or single malignant cells in lymph node tissue. Another method uses a technique known as PCR for detection of CEA in resected lymph nodes. PCR is a technique which permits rapid reproduction of large quantities of short segments of DNA or RNA.
Other techniques include the identification in lymph node tissue of oncogene, or tumor suppressor gene mutations, which occur in the primary tumor. Such techniques may be of use in reclassifying patients whose lesions are stages as II or B by conventional means and in selecting them for potentially life-saving adjuvant chemotherapy. Large clinical trials will be needed to determine if identification of micrometastases by these methods indeed leads to more appropriate treatment and improved progress.
Expression of the enzyme COX-2 by colorectal cancers is highly variable. Greater expressions of COX-2 by tumors are associated with lymph node metastasis, advanced stage of cancer, and poorer long-term outlook for patients. Thus, there could be potential future application of this test as a means of staging and prognostication.
The Symptoms Of Colon Cancer
The risk of colon cancer increases as people age ? 90 percent of colon cancers occur in individuals over 50 years of age.
Colon cancer is also more common in people with a family history of colon cancer, or a personal history of colon polyps or inflammatory bowel disease.
Cigarette smoking and excessive alcohol consumption may also increase the risk of colon cancer. Mutated versions of several genes have been linked to colon cancer.
For example, in their normal form the genes MSH2, MLH1, PMS1, and PMS2 correct tiny errors that occur when cells divide and grow.
Mutated versions of these genes cannot make such repairs, and eventually an accumulation of many such errors interferes with a cell's ability to resist the uncontrolled division and growth that characterize cancer.
Research has linked the consumption of certain foods to colon cancer.The more red meat and animal fat that people eat, the greater their risk of developing colon cancer. Physicians continue to recommend low-fat, high-fiber diets as part of a healthy lifestyle to reduce the risk of high blood pressure, heart disease, and diabetes mellitus. Studies suggest that some drugs may decrease the risk of colon cancer.
For instance, estrogen replacement therapy after menopause and the use of nonsteroidal anti-inflammatory drugs such as ibuprofen appear to reduce the chances of developing this cancer.
Colon cancer usually develops slowly and may not present apparent symptoms in its early stages. Some individuals with undiagnosed colorectal cancer may detect blood in their bowel movements (feces). They may also experience persistent constipation or diarrhea, abdominal pain, or unexplained weight loss.
Two simple tests can detect most colon tumors while they are still in an early, easy-to-treat stage. The first test is the digital rectal examination, during which the physician uses a gloved finger to gently check the smoothness of the rectal lining.
The second test is the fecal occult blood test, in which a small sample of the patient's feces is smeared on a card coated with a chemical called guaiac, which reacts with blood.
The card is analyzed in a laboratory for occult (hidden) blood. A positive result does not necessarily indicate the presence of cancer.
The primary treatment for colon cancer is surgery to remove the tumor. The surgery may be combined with radiation, chemotherapy, or both.
Using a combination of high-dose radiation and chemotherapy prior to surgery now makes it possible to avoid permanent colostomies in many patients who previously would have needed this procedure.
A colostomy is a surgical procedure to create an artificial opening through the abdominal wall to the exterior of the body for elimination of wastes into a plastic bag.
If cancer has spread from the colorectal area to the lymph nodes or liver, surgery or chemotherapy used in combination with three drugs?fluorouracil, leucovorin, and irinotecan?prolongs the lives of some patients.
Both Robert Andrew & Scott Michaels are contributors for EditorialToday. The above articles have been edited for relevancy and timeliness. All write-ups, reviews, tips and guides published by EditorialToday.com and its partners or affiliates are for informational purposes only. They should not be used for any legal or any other type of advice. We do not endorse any author, contributor, writer or article posted by our team.
Robert Andrew has sinced written about articles on various topics from Computers and The Internet, Finances and Fitness. Future study of will refine our understanding of the genetics of the disease. This in turn will lead to earlier identification and treatment of high-ris. Robert Andrew's top article generates over 301000 views. to your Favourites.
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