February 5, 2010, 7:52 AM CT

Barriers to screening for colorectal cancer

Colorectal cancer is the second leading cause of cancer-related deaths in the United States. Despite evidence and guidelines supporting the value of screening for this disease, rates of screening for colorectal cancer are consistently lower than those for other types of cancer, particularly breast and cervical. Although the screening rates in the target population of adults over age 50, have increased from 20-30 percent in 1997 to nearly 55 percent in 2008 the rates are still too low. An NIH state-of-the-science panel was convened this week to identify ways to further increase the use and quality of colorectal cancer screening in the United States.

"We recognize that some may find colorectal cancer screening tests to be unpleasant and time-consuming. However, we also know that recommended screening strategies reduce colorectal cancer deaths," said Dr. Donald Steinwachs, panel chair, and professor and director of the Health Services Research and Development Center at the Johns Hopkins University. "We need to find ways to encourage more people to get these important tests".

The panel found that the most important factors associated with being screened are having insurance coverage and access to a regular health care provider. Their recommendations highlighted the need to remove out-of-pocket costs for screening tests......... Posted by: Sue      Read more         Source

January 26, 2010, 8:46 AM CT

Virtual colonoscopy is effective

Computed tomographic colonography (CTC), also known as virtual colonoscopy, remains effective in screening older patients for colorectal cancer (CRC), produces low referral for colonoscopy rates similar to other screening exams now covered by Medicare, and does not result in unreasonable levels of additional testing resulting from extracolonic findings, as per a research studyreported in the recent issue of Radiology.

CT colonography employs virtual reality technology to produce a three-dimensional visualization that permits a thorough and minimally invasive assessment of the entire colon and rectum. Prior CTC trials have demonstrated excellent performance in average risk individuals. However, concerns remained that such results may not be applicable to older Medicare beneficiaries. Scientists at the University of Wisconsin School of Medicine and Public Health analyzed various CTC performance and program outcome measures for screening individuals aged 65-79.

"These results confirm that CTC is a safe and effective colorectal cancer screening tool for the older individual. There is no significant difference in the way CTC performs in older patients as opposed to younger patients," said David H. Kim, MD, associate professor of radiology, University of Wisconsin School of Medicine and Public Health, and principal investigator of the study......... Posted by: Sue      Read more         Source

December 2, 2009, 8:21 AM CT

CT imaging taken post avastin

Using routine computed tomography (CT) imaging to analyze form and structural changes to colorectal liver metastasis after bevacizumab and chemotherapy may predict overall survival, as per research from The University of Texas M. D. Anderson Cancer Center.

The findings appear in the Dec. 2 issue of JAMA

When combined with chemotherapy, the angiogenesis inhibitor bevacizumab, also known as Avastin, is linked to both improved survival in those with metastatic colorectal cancer and higher rates of pathologic response in patients undergoing surgical resection of colorectal liver metastases. The monoclonal antibody was approved for use in the front line setting of metastatic colorectal cancer in 2004.

However, the treatment presents a unique set of challenges, explains Jean-Nicolas Vauthey, M.D., professor in M. D. Anderson's Department of Surgical Oncology.

"We've known for years that tumor shrinkage is not necessarily a strong indicator of survival in this patient population, and this has been an area of much controversy and study within the cancer community," explained Vauthey, the study's corresponding author. "Some of these tumors are so aggressive and may immediately start to grow when a patient goes off bevacizumab-containing chemotherapy"......... Posted by: Sue      Read more         Source

August 6, 2009, 11:35 PM CT

Starving the colon cancer cells

Researchers at the Johns Hopkins Kimmel Cancer Center have discovered how two cancer-promoting genes enhance a tumor's capacity to grow and survive under conditions where normal cells die. The knowledge, they say, may offer new therapys that starve cancer cells of a key nutrient - sugar. However, the researchers caution that research does not suggest that altering dietary sugar will make any difference in the growth and development of cancer.

"Cancer cells adapt to living within the inner layers of a tumor, a place where circulating nutrients are relatively scarce," says Nickolas Papadopoulos, Ph.D., associate professor at the Johns Hopkins Kimmel Cancer Center. "We wanted to know what makes these cancer cells survive under such conditions".

Working with colorectal cancer cell lines that carry two of the most common cancer genes - KRAS and BRAF - they went on a hunt for genes that were controlled by KRAS and BRAF and allowed cancer cells to be more fit for survival. Nearly half of all patients with colon cancer carry KRAS mutations in their tumors and another five percent of these patients have alterations in BRAF. The findings are published online in the August 6 issue of Science Express.

Their hunt quickly narrowed to one gene, GLUT1, which was consistently turned on at high levels in cells laden with KRAS and BRAF mutations. Proteins made by GLUT1 are located on the cell surface and transport glucose into cells' interiors. With increased expression of the GLUT1 gene, cells make more GLUT1 transporters and ingest more glucose......... Posted by: Sue      Read more         Source

August 5, 2009, 9:59 PM CT

Significant Benefits of F-FDG PET in Evaluating Colorectal Liver Metastases

The Access to Medical Imaging Coalition (AMIC) announced recently that a study published in this month's Journal of Nuclear Medicine demonstrated the tremendous benefits of advanced imaging in the assessment of colorectal liver metastases. Dr. Theo Ruers lead a team of scientists in evaluating the benefits of F-fluorodeoxyglucose (FDG) positron emission tomography (PET) when combined with computed tomography (CT), and its ability to diagnose and stage hepatic growths far more effectively than standard CT alone. The study was presented at the Society of Nuclear Medicine annual meeting in 2008 and received the Siemens Award for Excellence in Practice-Based Research.

"Liver metastases are among the most dangerous threats to patients who have been treated for colorectal cancer, and it is absolutely imperative that at-risk patients have access to the highest quality diagnostic procedures in order to detect and properly stage these malignant growths if they develop," said Tim Trysla, executive director, AMIC. "Effective staging of these growths can lead to improved clinical outcomes, and in a number of cases can prevent unnecessary or ineffective surgeries. AMIC applauds the work of Dr. Ruers and his team, whose research proves the addition of F-FDG PET to standard diagnostic protocols to be extremely useful in accurately identifying the population of individuals most likely to benefit from hepatic surgery and, in turn, drastically reducing the number of wasteful procedures"......... Posted by: Sue      Read more         Source

June 1, 2009, 5:18 AM CT

Surgery for late-stage colon cancer

A newly released study shows that a great majority of patients who present with advanced colorectal cancer that has spread to other organs (stage IV) don't require immediate surgery to remove the primary tumor in the colon. Scientists from Memorial Sloan-Kettering Cancer Center (MSKCC) presented their data today at the American Society of Clinical Oncology Annual Meeting.

"For this population with metastatic disease that cannot be cured by surgery, undergoing colon surgery is not always necessary," said Philip Paty, a surgical oncologist at MSKCC and one of the study's main authors. "If the colon tumor is not causing obstruction, perforation, or bleeding we've found these patients are best treated with chemotherapy. By moving straight to chemotherapy, patients can avoid the risk of surgical complications and can start therapy for all sites of disease without delay".

For this retrospective study, a multidisciplinary team looked at 233 metastatic colorectal cancer cases treated at MSKCC from 2000 to 2006. Their analysis showed that 217 of the 233 patients, or 93 percent, did not have complications that mandatory resection of the primary tumor. Only 16 patients mandatory colon surgery for symptom management.

Previously, in the conventional approach to treating stage IV disease, patients underwent colon surgery immediately following their diagnosis and would typically start chemotherapy therapys three to six weeks later. The rationale for immediate colon resection was to prevent future symptoms and complications from the primary tumor. It was assumed that the majority of colorectal cancers would have little response to chemotherapy......... Posted by: Sue      Read more         Source

June 1, 2009, 5:00 AM CT

Obesity predicts inadequate bowel prep at colonoscopy

Obesity is an independent predictor of inadequate bowel preparation at colonoscopy, and the presence of additional risk factors further increases the likelihood of a poorly cleansed colon, as per a newly released study in Clinical Gastroenterology and Hepatology, the official journal of the American Gastroenterological Association (AGA) Institute.

Obesity has become an epidemic in the present era, both in the U.S. and in other developed nations. Abnormal elevation of body mass index (BMI) is linked to several gastrointestinal diagnoses, including diverticular disease, gastroesophageal reflux disease, colon polyps and colon cancer.

Since the majority of colon cancers arise from adenomatous (benign) colon polyps, proper screening becomes crucial while performing colonoscopy on obese patients. An inadequately cleansed colon can jeopardize the effectiveness of screening or surveillance colonoscopy, exposing these patients at higher risk for colorectal tumors to the dangers of missed lesions and higher cost of repeat colonoscopy.

"The implications of our findings are profound. Since over a quarter of all patients had an inadequate examination, identification of a patient profile with a high risk for poor colon preparation will be helpful in capturing those who would benefit from an initial individualized designer preparation regimen," said Brian Borg, MD, of Washington University in St. Louis, MO and main author of the study. "Our results suggest that the obese patient should at least be subject to more precise instructions and possibly a more rigorous bowel preparation regimen. In addition, as the number of risk factors for an inadequate bowel preparation increase, the need for early repeat colonoscopy escalates"......... Posted by: JoAnn      Read more         Source

April 13, 2009, 12:47 AM CT

How high-fiber diet protects you from colon cancer?

Though a high-fiber diet has long been considered good for you and beneficial in staving off colon cancer, Medical College of Georgia scientists have discovered a reason why: roughage activates a receptor with cancer-killing potential.

Scientists report in the recent issue of Cancer Research that the GPR109A receptor is activated by butyrate, a metabolite produced by fiber-eating bacteria in the colon. The receptor puts a double-whammy on cancer by sending signals that trigger cell death, or apoptosis, and shutting down a protein that causes inflammation, a precursor to cancer.

"We know the receptor is silenced in cancer but it's not like the gene goes away," says Dr. Vadivel Ganapathy, corresponding author and chair of the Department of Biochemistry and Molecular Biology in the MCG School of Medicine.

Cancer shuts down the receptor by chemically modifying its gene through a process called DNA methylation. It's a typical MO for cancer to turn genes off to suit its purpose which is why DNA methylation inhibitors already are under study for a variety of cancers.

But cancer patients likely also need something to ensure the receptor gets activated by butyrate, such as eating more roughage or, more likely, getting mega doses of butyrate or a compound with similar properties, Dr. Ganapathy says......... Posted by: Sue      Read more         Source

February 18, 2009, 6:15 AM CT

Predicting recurrence in colorectal cancer

(PHILADELPHIA) Findings reported in the Journal of the American Medical Association by scientists at Thomas Jefferson University show that the presence of a biomarker in regional lymph nodes is an independent predictor of disease recurrence in patients with colorectal cancer.

Detection of the biomarker, guanylyl cyclase 2C (GUCY2C), indicates the presence of occult metastases in lymph nodes that may not have been identified by current cancer staging methods, as per Scott Waldman, M.D., Ph.D., chairman of the Department of Pharmacology and Experimental Therapeutics at Jefferson Medical College of Thomas Jefferson University.

As per Dr. Waldman, who is also the Samuel M.V. Hamilton Professor of Clinical Pharmacology in the Department of Medicine at Jefferson Medical College, colorectal cancer that has metastasized, or spread, to the regional lymph nodes carries a worse prognosis and a higher risk for recurrence. However, these metastases are often missed, and the cancer is understaged.

"One of the unmet needs in colorectal cancer is an accurate staging method to determine how far the disease has spread," said Dr. Waldman, who is also director of the Gastrointestinal Malignancies Program at the Kimmel Cancer Center at Jefferson. "The current standard method, histopathology, is imperfect since it only involves looking at a very small sample of the regional lymph nodes under a microscope. There is no way to know whether occult metastases are present in the rest of the tissue"......... Posted by: Sue      Read more         Source

February 12, 2009, 6:14 AM CT

Regular exercise to prevent colon cancer

An ambitious newly released study has added considerable weight to the claim that exercise can lower the risk for colon cancer. Scientists at Washington University School of Medicine in St. Louis and Harvard University combined and analyzed several decades worth of data from past studies on how exercise affects colon cancer risk. They observed that people who exercised the most were 24 percent less likely to develop the disease than those who exercised the least.

"What's really compelling is that we see the association between exercise and lower colon cancer risk regardless of how physical activity was measured in the studies," says lead study author Kathleen Y. Wolin, Sc.D., a cancer prevention and control expert with the Siteman Cancer Center at Barnes-Jewish Hospital and Washington University. "That indicates that this is a robust association and gives all the more evidence that physical activity is truly protective against colon cancer".

Colorectal cancer is the third most common type of cancer. Each year more than 100,000 people in the United States are diagnosed with colon cancer and about 40,000 are diagnosed with rectal cancer. The study suggests that if the American population became significantly more physically active, up to 24 percent, or more than 24,000, fewer cases of colon cancer would occur each year......... Posted by: Sue      Read more         Source

February 12, 2009, 5:18 AM CT

New drug to prevent colon cancer in making

Scientists at the Mayo Clinic campus in Florida have observed that a drug now being tested to treat a range of human cancers significantly inhibited colon cancer development in mice. Because the agent appears to have minimal side effects, it may represent an effective chemopreventive therapy in people at high risk for colon cancer, the researchers say.

Their study, reported in the Feb. 15 issue of Cancer Research, observed that use of the agent, enzastaurin, significantly reduced development of malignant colon tumors in treated animals. Furthermore, the tumors that did develop in the mice were of a lower grade, which meant they were less advanced and aggressive than the tumors seen in animals not given the drug. "There is need for an agent that has a proven ability to reduce colon cancer risk, and this study suggests that enzastaurin could be uniquely effective," says the study's senior investigator, Nicole Murray, Ph.D., of the Department of Cancer Biology.

Individuals at high risk for colon cancer often develop numerous premalignant colon polyps, which must be periodically removed during a colonoscopy, Dr. Murray says.

The laboratories of Dr. Murray, and her collaborator and co-author, Alan Fields, Ph.D., chair of the Department of Cancer Biology, focus on characterizing the genes involved in different stages of colon carcinogenesis. They have zeroed in on the protein kinase C (PKC) family of enzymes as major players in cancer development and progression, but it has taken them years to understand the different roles of each type of PKC molecule or "isozyme."........ Posted by: Sue      Read more         Source

February 3, 2009, 6:23 AM CT

Inflammation colon cancer link

(New York, February 2, 2009) -- While chronic inflammation is widely thought to bea predisposing factor for colon cancer, the exact mechanisms linking these conditions have remained elusive. Researchers at the Melbourne Branch of the international Ludwig Institute for Cancer Research (LICR) and the Technical University Munich have jointly discovered a new piece of this puzzle by demonstrating how the Stat3 protein links inflammation to tumor development, a discovery that may well lead to the identification of new therapeutic targets for colon cancer.

Aberrant activation of the intracellular signaling protein, Stat3, has been linked to inflammation and several cancers, including those of the gastrointestinal tract. The results published on-line today in the journal Cancer Cell provide the first direct evidence confirming the role for Stat3 in inflammation-associated tumorigenesis. Using an inflammation-associated cancer model in genetically manipulated mice, the team identified a relationship between epithelial cell Stat3 activity and colonic tumor incidence, as well as tumor growth. They also determined that stimulation of Stat3 by the cytokines IL-6 and IL-11, chemicals produced by inflammatory and other tumor-associated cells, promotes both cell survival and growth of tumor cells......... Posted by: Sue      Read more         Source

January 30, 2009, 6:18 AM CT

Fluorouracil-based Therapy May Cure Colon Cancer

Adjuvant fluorouracil-based chemotherapy can lead to significant disease-free survival in colon cancer patients and may do even better in some, scientists report in an advance on-line issue of the Journal of Clinical Oncology.

As lead investigator Dr. Daniel Sargent told Reuters Health, "The primary clinical implications of this research are that adjuvant fluorouracil-based therapy actually cures colon cancer patients -- as opposed to simply delaying a recurrence -- and that most relapses occur in the first 2 years after surgery".

Dr. Sargent of the Mayo Clinic, Rochester, Minnesota, and his colleagues analyzed data from 18 trials involving more than 20,800 patients with stage II or III colon cancer. The scientists observed a significant benefit of adjuvant chemotherapy over 8 years of follow-up.

Significant disease-free survival benefit was seen in the first 2 years. However, after this point there were no significant differences from untreated controls.

Nevertheless, the recurrence rates were less than 1.5% per year after 5 years, and 0.5% per year after 8 years. "The risk of recurrence in patients treated with adjuvant chemotherapy never exceeds that of control patients, signifying that adjuvant chemotherapy cures some patients," the researchers explain......... Posted by: Sue      Read more

January 8, 2009, 10:11 PM CT

Hormone therapy and colorectal cancer

The combination of estrogen plus progestin, which women stopped taking in droves following the news that it may increase their risk of breast cancer, may decrease their risk of colorectal cancer, as per a report reported in the recent issue of Cancer Epidemiology, Biomarkers and Prevention, a journal of the American Association for Cancer Research.

"In comparison to women who had never taken these hormones, the use of estrogen plus progestin was linked to a reduced risk of colorectal cancer," said Jill R. Johnson, M.P.H., a doctoral student at the University of Minnesota School of Public Health.

The largest risk reduction, approximately 45 percent, was seen among women who had completed use of estrogen plus progestin five or more years previously.

Johnson and her colleagues extracted data from 56,733 postmenopausal women who participated in the Breast Cancer Detection Demonstration Project follow-up study. Hormone treatment use and other risk factors were ascertained through telephone interviews and mailed questionnaires between 1979 and 1998. During an average 15 years of follow-up, Johnson and his colleagues identified 960 new cases of colorectal cancer in this population.

Any use of estrogen treatment was linked to a 17 percent reduced risk in colorectal cancer. Among those who used estrogen, the largest reductions were seen among those who were current users (25 percent reduced risk) and users of ten or more years duration (26 percent reduced risk)......... Posted by: Sue      Read more         Source

December 22, 2008, 5:27 AM CT

Predicting metastasis from colon cancer

Cancer Scientists at the Max Delbrck Center for Molecular Medicine (MDC) Berlin-Buch and the Charit Universitts Medizin Berlin (Gera number of) have identified a gene which enables them to predict for the first time with high probability if colon cancer is going to metastasize. Assistant Professor Dr. Ulrike Stein, Professor Peter M. Schlag, and Professor Walter Birchmeier were able to demonstrate that the gene MACC1 (Metastasis-Associated in Colon Cancer 1) not only promotes tumor growth but also the development of metastasis.When MACC1 gene activity is low, the life expectancy of colon cancer patients is longer compared to patients with high MACC1 levels. (Nature Medicine, doi: 10.1038/nm.1889)*.

As per the National Institutes of Health in Bethesda, Maryland, USA, more than 108,000 people developed colon cancer in the US in 2008. Despite surgery, chemo- and radiotherapy, only 50 percent of patients can be cured because 20 percent of the patients have already developed metastasis by the time their colon cancer is diagnosed. In addition, one-third of patients whose therapy of the original colon cancer was successful will, nevertheless, go on to develop metastasis.

The MDC and Charit scientists are convinced that the identification of the MACC1 gene will aid medical doctors in identifying those patients as early as possible who are at high risk of developing life-threatening metastasis in the liver and the lungs. As a result, more intensive therapy and follow-up care could be offered to high risk patients......... Posted by: Sue      Read more         Source

December 16, 2008, 9:44 PM CT

A qualified endoscopist for your colonoscopy

A study released recently in the Annals of Internal Medicine observed that colonoscopy is linked to lower death rates from colorectal cancer, however, the procedure missed lesions more often on the right side of the colon versus the left side. The study highlights the importance of seeking a qualified gastrointestinal endoscopist to perform a thorough colonoscopy and that patients must take the bowel prep as directed by their doctor allowing for a clear view of the colon to detect lesions. The American Society for Gastrointestinal Endoscopy (ASGE), representing the specialists in colorectal cancer screening, recommends that patients seek out an expertly-trained gastrointestinal endoscopist to perform a colonoscopy and to ask questions about their qualifications before the procedure.

"Colonoscopy is the gold standard for colorectal cancer screening for its ability to detect and remove polyps before they turn into cancer. Colonoscopy's effectiveness is evidenced in the recent decline in the incidence and death rates from colorectal cancer announced last month by leading cancer organizations," said John L. Petrini, MD, FASGE, president of the American Society for Gastrointestinal Endoscopy. "While colonoscopy is not a perfect test, this study should not deter anyone from undergoing a colonoscopy for colorectal cancer screening. Approximately 70 percent of the colonoscopies performed in this study were not done by gastroenterologists. Studies have shown that missed lesion rates are higher for internists and family practice physicians doing colonoscopy. We urge patients to log on to www.asge.org to find a qualified, expertly-trained gastrointestinal endoscopist to perform their colonoscopy and to ask questions about their qualifications"......... Posted by: Sue      Read more         Source

December 16, 2008, 9:29 PM CT

Smoking and colorectal cancer

An analysis of prior studies indicates that smoking is significantly linked to an increased risk for colorectal cancer and death, as per an article in the December 17 issue of JAMA

Eventhough tobacco was responsible for approximately 5.4 million deaths in 2005, there are still an estimated 1.3 billion smokers in the world. While many cancers are attributable to smoking, the link between cigarette smoking and colorectal cancer (CRC) has been inconsistent among studies. "Because smoking can potentially be controlled by individual and population-related measures, detecting a link between CRC and smoking could help reduce the burden of the world's third most common tumor, which currently causes more than 500,000 annual deaths worldwide. In the United States alone, an estimate of approximately 50,000 deaths from CRC would have occurred in 2008," the authors write.

Edoardo Botteri, M.Sc., of the European Institute of Oncology, Milan, Italy, and his colleagues conducted a meta-analysis to review and summarize published data examining the link between smoking and CRC incidence and death.

The scientists identified 106 findings based on observation, and the meta-analysis was based on a total of nearly 40,000 new cases of CRC. For the analysis on incidence, smoking was linked to an 18 percent increased risk of CRC. The scientists also found a statistically significant dose-relationship with an increasing number of pack-years (number of packs of cigarettes smoked/day, multiplied by years of consumption) and cigarettes per day. However, the association was statistically significant only after 30 years of smoking......... Posted by: Sue      Read more         Source

December 15, 2008, 5:17 AM CT

Racial gap growing in colorectal cancer

A new report from the American Cancer Society says despite unprecedented progress in reducing incidence and death rates from colorectal cancer, the gap between blacks and whites continues to grow. The latest data show death rates are about 45 percent higher in African American men and women than in whites. The data come from Colorectal Cancer Facts & Figures 2008-2010, the second edition of a report first issued in 2005.

Colorectal cancer is the third most usually diagnosed cancer and the third leading cause of cancer death in both men and women in the United States. The American Cancer Society estimates that in 2008, about 148,810 people will be diagnosed with colorectal cancer and about 49,960 people will die of the disease. The great majority of these cancers and deaths could be prevented by applying existing knowledge about cancer prevention and by increasing access to and use of established screening tests.

Eventhough incidence and mortality rates continue to decrease in both blacks and whites, rates remain higher and declines have been slower among blacks. Differences in incidence and mortality between blacks and whites have actually grown in the three years since the prior edition of the report was published. For example, in the prior report, the incidence rate in white men was 63.1 (per 100,000) in comparison to 72.9 in black men, an absolute difference of 9.8; in the current report, the difference between the incidence rate in white men (58.9 per 100,000) and black men (71.2 per 100,000) increased to 12.3......... Posted by: Sue      Read more         Source

November 27, 2008, 5:21 AM CT

Encouraged by drop in colorectal cancer deaths

The American Society for Gastrointestinal Endoscopy (ASGE) heralds the recent news of a decline in U.S. cancer deaths and incidence rates, with colorectal cancer among the top three cancers with significant declines. ASGE, representing the specialists in colorectal cancer screening, is excited by the report showing that colorectal cancer deaths among men and women dropped 4.3 percent per year between 2002 and 2005. The incidence rate for colorectal cancer (the rate at which new cancers are diagnosed) dropped 2.8 percent per year among men and dropped 2.2 percent per year among women between 1998 and 2005.

The study, issued annually since 1998 by the American Cancer Society, the National Cancer Institute, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries, showed for the first time a simultaneous decline in both cancer death rates and incidence rates in men and women. Incidence rates for all cancers combined (15 most usually diagnosed) decreased 0.8 percent per year from 1999 through 2005 for both sexes combined; rates decreased 1.8 percent per year from 2001 through 2005 for men and 0.6 percent per year from 1998 through 2005 for women. The decline in both incidence and death rates for all cancers combined is due in large part to declines in the three most common cancers among men (lung, colon/rectum, and prostate) and the two most common cancers among women (breast and colon/rectum), combined with a leveling off of lung cancer death rates among women......... Posted by: Sue      Read more         Source

November 24, 2008, 9:46 PM CT

Genomic signature of colon cancer may individualize treatment

Scientists in the Duke Institute for Genome Sciences & Policy have developed a model for predicting risk of recurrence in early stage patients with colon cancer, and have used the model to also predict sensitivity to chemotherapy and targeted treatment regimens.

"These findings have important implications for individualizing treatment," said Katherine Garman, M.D., a gastroenterology fellow at Duke and lead investigator on the study. "By examining gene expression in early-stage colon cancer tumors, we have found certain patterns that seem to put some patients at higher risk for recurrence. By identifying these patients up front, we may be able to treat them in a targeted and proactive manner to prevent this recurrence and help them live longer and healthier lives".

The findings are due to appear in the online edition of the Proceedings of the National Academy of Sciences, between November 24 and November 26, 2008. The study was funded by the Emilene Brown Cancer Research Fund and the National Institutes of Health.

The scientists studied gene expression data from 52 samples of early stage colon cancer tumors, looking for patterns. Then they correlated the gene expression patterns with patient progress reports to track the recurrence of cancer. The predictive power of the correlations was subsequently tested in two independent data sets from 55 and 73 tumors, respectively......... Posted by: Sue      Read more         Source

November 21, 2008, 5:46 AM CT

Screening for colorectal cancer detects unrecognized disease

Screening for colorectal cancer detects four out of ten cancers and should be carefully designed to be more effective, as per a research studypublished recently on bmj.com.

About one in 20 people in the UK develop bowel cancer during their lifetime. It is the third most common cancer in the UK and the second leading cause of cancer deaths in Europe and the US.

Prior screening trials have show that faecal occult blood testing can reduce the risk of dying by about 16%. More than 50 countries have introduced screening programmes, but their effectiveness in a public health setting is not clear.

Dr Nea Malila and his colleagues from the Finnish Cancer Registry examined whether Finland's national colorectal cancer screening programme could detect unrecognised disease. They studied 106 000 people aged 60󈞬 to test how sensitive screening was in identifying unrecognised disease at three levelsthe faecal occult blood test (test to detect small traces of blood in faeces that may indicate disease at an early stage), screening episode, and the national screening programme.

A national screening programme for colorectal cancer began in Finland in 2004 as a public health policy in 22 volunteer municipalities and grew to 161 municipalities by 2006......... Posted by: Sue      Read more         Source