Steps you can take NOW to prevent or defeat this highly treatable cancer
Colon (or colorectal) cancer is the second leading cause of cancer-related deaths among both men and women in the United States...
...Yet when diagnosed and treated in the early stages, it is among the most curable of all cancers.
Consider this: The five-year survival rate for people whose colon or rectal cancer is discovered and treated in its earliest stage is 93 percent.
In many cases, regular screening reveals precancerous growths that can be removed, thereby preventing cancer from developing in the first place. In fact, it is estimated that 80 to 90 percent of all colorectal cancers could be prevented if everyone were screened and polyps identified and removed!
The challenge: What can you do right now to protect yourself against colorectal cancer, or, if you've already been diagnosed, to ensure a positive outcome?
To answer this question, we turned to Ross. C. Donehower, M.D., Director of the Division of Medical Oncology at the Johns Hopkins University School of Medicine. Dr. Donehower is at the forefront of research in gastrointestinal malignancies and new anticancer therapies. Dr. Donehower shares his expertise and extensive hands-on experience treating patients with colorectal cancer and those at high risk for it in our new guide: Colon Cancer: Prevention, Early Detection and Treatment .
If you have been diagnosed with colon or rectal cancer - or you think you may be at risk - it's critically important to learn everything you can now, so you can partner with your doctor effectively, ask the right questions and understand the answers. That's why we have made Colon Cancer: Prevention, Early Detection and Treatment available to you instantly as a digital PDF download.
Just click the order button below and in a few moments your guide will be delivered to your email address. It's that simple.
Knowledge is Key
When It Comes To Preventing and Defeating Colon Cancer
What will you learn in this comprehensive resource? Colon Cancer: Prevention, Early Detection and Treatment explains the way colorectal cancer develops, how it can be detected early and how you can reduce your risk. It describes new developments in colon cancer screening, diagnosis, treatment and research. And it explains the ways in which people who have already been treated for colon cancer can lower their risk of having a recurrence.
In the early chapters, we explain the risk factors for colorectal cancer and look in-depth at the importance of family history. If you have a familial history of colon cancer, you may want to consider genetic testing to determine your risk. Is it a good idea? What about privacy concerns? What about the cost?
In Colon Cancer, we discuss the risks and benefits of genetic testing and counseling as well as the roles of diet, lifestyle and ethnicity on colon cancer risk.
You'll read about hereditary nonpolyposis colorectal cancer (HNPCC, also known as Lynch syndrome) and familial adenomatous polyposis (FAP), the most common genetic causes of colon or rectal cancer. Other genetic conditions that increase your risk are also explained, including MUTYH-associated polyposis (MAP), Peutz-Jeghers syndrome (PJS) and juvenile polyposis syndrome (JPS).
The "Ick" Factor: Colon Cancer Screening
Fewer than HALF of Americans over the age of 50 have ever had any kind of colon-cancer screening test. If you've been putting off screening because of the "ick" factor, you'll want to read our chapter on Screening and Prevention, which explains your many screening choices:
Take-home fecal occult blood test (FOBT)
FIT - an alternative to the standard FOBT
Stool DNA test - the latest option
Flexible sigmoidoscopy - the five-year test
Colonoscopy - the gold standard
Double-contrast barium enema
Virtual colonoscopy - the new noninvasive option
Computed tomography - spiral CT scans, PET, MRI and ultrasound
What else can you do to prevent colon cancer? While the only known way to prevent it is to have regular colonoscopies to detect and remove precancerous polyps, researchers are looking at various medications, minerals and nutrients that may be protective.
We discuss the progress - and pitfalls - of many of the more promising options and offer bottom-line advice:
Asprin
HRT
Omega 3s
Statins
Vitamin B6
Vitamin D
For Patients Diagnosed with Colorectal Cancer:
Your Options for Treatment
If your polyp biopsy results come back positive for colon cancer, it's time to make treatment decisions, and these decisions often involve surgery. Dr. Donehower addresses many of the questions that may be on your mind as you weigh your treatment options:
What type of cancer do I have - colon or rectal?
Where is it located? Is it in more than one place?
Are the lymph glands involved? Has the cancer spread outside the colon?
What stage is the cancer?
Am I a candidate for minimally invasive therapy or do I need abdominal surgery for my colon cancer?
What's transanal edoscopic microsurgery (TEM)? What's fulguration?
What will happen during abdominal surgery for colorectal cancer?
What about recovery - how long will I be in the hospital and what complications can I expect?
Will I need adjuvant therapy after surgery - radiation, chemotherapy or both?
What drugs are used for chemotherapy?
How serious are the side effects from chemotherapy drugs?
New treatments for advanced colon cancer are emerging all the time, and can often offer hope of a longer life and better quality of life. In Colon Cancer you'll learn about:
State-of-the-art chemotherapy for treating advanced, recurrent, and metastatic colorectal cancer: "targeted" antibody therapies like Avastin, Erbitux and vertibix... transarterial chemoembolization (TACE)... hepatic artery infusion (HAI).
Radiation therapy is used most often for inoperable tumors or for tumors that have not responded to chemotherapy. Choices include: brachytherapy, intensity-modulated radiationt therapy (IMRT), intraoperative radiation therapy (IORT), TheraSphere and cyberknife.
Weighing the benefits of participating in a clinical trial. A clinical trial may give you access to promising new or experimental therapies that are not available otherwise.
Palliative and hospice care
Emotional issues surrounding colon cancer and its treatments
Direct to You From Johns Hopkins - America's #1 Hospital
Colon Cancer: Prevention, Early Detection and Treatment is designed to give you unprecedented access to the expertise of the hospital consistently ranked #1 of America's Best Hospitals by U.S. News & World Report -in annual rankings for more than 4,800 American hospitals.
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Wednesday, March 30, 2011
Signs and Symptoms of Colon Cancer
When something goes wrong with the digestive system, it usually makes itself known pretty quickly, through pain or discomfort. Common problems are upset stomach, constipation, and diarrhea, which are usually not serious and don’t last long.
Unfortunately, colon or rectal cancer may generate few or no symptoms in the early stages. Colon cancer grows slowly, does not usually interfere with function in early stages, and can remain undetected for some time. This is bad news; by the time symptoms are noticeable, colon cancer may be advanced.
Many symptoms of colon cancer that do show up could be related to other digestive issues. If they are related to colon cancer, the disease could be advanced beyond early stages. Therefore, signs or symptoms of digestive problems that last more than a few weeks should be discussed with your doctor.
Possible symptoms of colon cancer include:
* a change from usual bowel habits and appearance, such as constipation, diarrhea, or extremely narrow stools, that lasts for 10 days or more
* bright red blood in the stools or black, tarry stools, which can be a sign of rectal or intestinal bleeding
* pain or tenderness in the lower abdomen that doesn’t go away
* bloating, cramps, or gas pains
* a feeling that the rectum isn’t completely empty after bowel movements
* loss of appetite and weight
* anemia, which can be a sign of blood loss from intestinal bleeding
* vomiting
* persistent fatigue, paleness, and heart palpitations, which can be signs of anemia
* inability to pass stools at all for more than a week. This can signal an intestinal blockage, which is an emergency situation.
Posted from John's Hopkins University
Unfortunately, colon or rectal cancer may generate few or no symptoms in the early stages. Colon cancer grows slowly, does not usually interfere with function in early stages, and can remain undetected for some time. This is bad news; by the time symptoms are noticeable, colon cancer may be advanced.
Many symptoms of colon cancer that do show up could be related to other digestive issues. If they are related to colon cancer, the disease could be advanced beyond early stages. Therefore, signs or symptoms of digestive problems that last more than a few weeks should be discussed with your doctor.
Possible symptoms of colon cancer include:
* a change from usual bowel habits and appearance, such as constipation, diarrhea, or extremely narrow stools, that lasts for 10 days or more
* bright red blood in the stools or black, tarry stools, which can be a sign of rectal or intestinal bleeding
* pain or tenderness in the lower abdomen that doesn’t go away
* bloating, cramps, or gas pains
* a feeling that the rectum isn’t completely empty after bowel movements
* loss of appetite and weight
* anemia, which can be a sign of blood loss from intestinal bleeding
* vomiting
* persistent fatigue, paleness, and heart palpitations, which can be signs of anemia
* inability to pass stools at all for more than a week. This can signal an intestinal blockage, which is an emergency situation.
Posted from John's Hopkins University
Wednesday, March 9, 2011
Can dietary fiber help prevent colorectal cancer ?
The issue of whether dietary fiber can help prevent colorectal cancer has always been unclear, as studies have reached inconsistent results. Now a study from the Journal of the National Cancer Institute (Volume 102, page 614) suggests that the type of dietary assessment tools used in these studies might be to blame.
Researchers in the United Kingdom compared data from 579 people who developed colorectal cancer and 1,996 people who did not develop colorectal cancer. Some of the participants kept four-or seven-day food diaries in which they recorded what they ate, and others filled out a food frequency questionnaire detailing their usual diet.
In the food diary group, people who consumed 24 g of dietary fiber per day had a 30% lower risk of colorectal cancer than those who ate 10 g per day. This association remained even after the researchers adjusted for other risk factors such as age, physical activity, alcohol intake, and red meat consumption. However, the same analysis performed on the food frequency questionnaires did not find the same association.
Take-away message. Since food diaries are thought to be more accurate than food frequency questionnaires, this study supports the idea that higher dietary fiber intake can reduce colorectal cancer risk. Other studies using different parameters and assessment tools, such as food frequency questionnaires, may have reached inaccurate or inconclusive results.
Researchers in the United Kingdom compared data from 579 people who developed colorectal cancer and 1,996 people who did not develop colorectal cancer. Some of the participants kept four-or seven-day food diaries in which they recorded what they ate, and others filled out a food frequency questionnaire detailing their usual diet.
In the food diary group, people who consumed 24 g of dietary fiber per day had a 30% lower risk of colorectal cancer than those who ate 10 g per day. This association remained even after the researchers adjusted for other risk factors such as age, physical activity, alcohol intake, and red meat consumption. However, the same analysis performed on the food frequency questionnaires did not find the same association.
Take-away message. Since food diaries are thought to be more accurate than food frequency questionnaires, this study supports the idea that higher dietary fiber intake can reduce colorectal cancer risk. Other studies using different parameters and assessment tools, such as food frequency questionnaires, may have reached inaccurate or inconclusive results.
Friday, January 28, 2011
FICE -- A New Imaging Tool
FICE -- A New Imaging Tool
Colonoscopy is considered the gold standard for finding and removing – and possibly preventing – colorectal cancer. It can detect up to 95% of colon cancers and can be used to remove precancerous polyps before they develop into cancer. Today researchers are working to make colonoscopy an even better screening tool. One new imaging system in development is the Fuji Intelligent Chromo Endoscopy (FICE).
As with narrow-band imaging, FICE also narrows the bandwidth of conventional white-light colonoscopy to improve visualization, but it creates this effect electronically. Using special software, FICE takes the image transmitted from the white-light colonoscope and creates a "virtual" image at predetermined wavelengths.
The virtual image shows minute details in the polyp and the colon lining that can't be seen using standard colonoscopy. As with narrow-band imaging, the doctor can, with the push of a button, alternate between the white-light-generated image and the virtual one.
FICE is beneficial in the same way as narrow-band imaging. Research shows that it likely doesn't improve polyp detection, compared with white-light colonoscopy, but it does help differentiate cancerous and precancerous polyps from benign polyps. What's more, it may do it even better than narrow-band imaging. In a 2009 study in Gastrointestinal Endoscopy, the overall accuracy of FICE in identifying cancerous and noncancerous polyps during colonoscopy was 98%.
While the FICE device is commercially available, it is a newer technology than narrow-band imaging and its benefits in accurately identifying benign versus cancerous polyps require confirmation in larger studies.
From John Hopkins University
Colonoscopy is considered the gold standard for finding and removing – and possibly preventing – colorectal cancer. It can detect up to 95% of colon cancers and can be used to remove precancerous polyps before they develop into cancer. Today researchers are working to make colonoscopy an even better screening tool. One new imaging system in development is the Fuji Intelligent Chromo Endoscopy (FICE).
As with narrow-band imaging, FICE also narrows the bandwidth of conventional white-light colonoscopy to improve visualization, but it creates this effect electronically. Using special software, FICE takes the image transmitted from the white-light colonoscope and creates a "virtual" image at predetermined wavelengths.
The virtual image shows minute details in the polyp and the colon lining that can't be seen using standard colonoscopy. As with narrow-band imaging, the doctor can, with the push of a button, alternate between the white-light-generated image and the virtual one.
FICE is beneficial in the same way as narrow-band imaging. Research shows that it likely doesn't improve polyp detection, compared with white-light colonoscopy, but it does help differentiate cancerous and precancerous polyps from benign polyps. What's more, it may do it even better than narrow-band imaging. In a 2009 study in Gastrointestinal Endoscopy, the overall accuracy of FICE in identifying cancerous and noncancerous polyps during colonoscopy was 98%.
While the FICE device is commercially available, it is a newer technology than narrow-band imaging and its benefits in accurately identifying benign versus cancerous polyps require confirmation in larger studies.
From John Hopkins University
Wednesday, January 5, 2011
Narrow Band Colonoscopy
Mixed Results on Narrow-Band Imaging
A standard colonoscope uses a regular white light to illuminate the colon. Narrow-band imaging uses an optical filter to produce blue light, which provides more contrast between the polyp and the colon lining. At the push of a button, a colonoscope with narrow-band imaging capabilities can switch between white light and blue light. Blue light has a narrower wavelength, which is why the device is called "narrow-band" imaging.
Researchers hypothesized that narrow-band imaging would improve a doctor's ability to find polyps. But clinical trials have shown mixed results, with one randomized study reporting improved polyp detection and three others showing it was no better than standard white-light colonoscopy. Based on these results, narrow-band imaging will likely not be used to improve detection of polyps.
Where narrow-band imaging appears most promising, however, is in differentiating benign polyps from those that are cancerous or precancerous. Today, the standard of practice is to remove all polyps and send them to the pathology lab for analysis. But about a third of these polyps end up being benign and thus were removed unnecessarily, putting the patient at risk -- albeit a small risk -- for bleeding complications.
Narrow-band imaging can visualize differences in surface and blood vessel patterns that can help determine whether or not a polyp is cancerous. So far, six well-designed studies have investigated whether narrow-band imaging can be used accurately to differentiate polyp types during colonoscopy. These studies found that using narrow-band imaging, doctors could accurately identify suspicious and benign polyps about 80 to 90% of the time.
Although a narrow-band imaging colonoscope called Exera is commercially available, more research and refinement of this technology are necessary to bring the accuracy rate closer to 100%. If this level of accuracy is reached, doctors could begin diagnosing polyps during colonoscopy, removing only those that are life-threatening and leaving benign ones in place.
A standard colonoscope uses a regular white light to illuminate the colon. Narrow-band imaging uses an optical filter to produce blue light, which provides more contrast between the polyp and the colon lining. At the push of a button, a colonoscope with narrow-band imaging capabilities can switch between white light and blue light. Blue light has a narrower wavelength, which is why the device is called "narrow-band" imaging.
Researchers hypothesized that narrow-band imaging would improve a doctor's ability to find polyps. But clinical trials have shown mixed results, with one randomized study reporting improved polyp detection and three others showing it was no better than standard white-light colonoscopy. Based on these results, narrow-band imaging will likely not be used to improve detection of polyps.
Where narrow-band imaging appears most promising, however, is in differentiating benign polyps from those that are cancerous or precancerous. Today, the standard of practice is to remove all polyps and send them to the pathology lab for analysis. But about a third of these polyps end up being benign and thus were removed unnecessarily, putting the patient at risk -- albeit a small risk -- for bleeding complications.
Narrow-band imaging can visualize differences in surface and blood vessel patterns that can help determine whether or not a polyp is cancerous. So far, six well-designed studies have investigated whether narrow-band imaging can be used accurately to differentiate polyp types during colonoscopy. These studies found that using narrow-band imaging, doctors could accurately identify suspicious and benign polyps about 80 to 90% of the time.
Although a narrow-band imaging colonoscope called Exera is commercially available, more research and refinement of this technology are necessary to bring the accuracy rate closer to 100%. If this level of accuracy is reached, doctors could begin diagnosing polyps during colonoscopy, removing only those that are life-threatening and leaving benign ones in place.
Wednesday, December 15, 2010
Preventive Immunotherapy for Colorectal Cancer
In the Pipeline: Preventive Immunotherapy
for Colorectal Cancer
Your immune system serves as the front line in your body's defense against illness. Its job is to detect foreign intruders, like bacteria or viruses, and to then manufacture the antibodies necessary to destroy them. And it does this quite well -- except when the intruder is cancer.
The problem is that cancer cells are like double agents. They start off as normal, healthy cells, but when they become cancer cells, they act like foreign invaders. And even though they are doing things cells are not supposed to do, your immune system continues to perceive them as the normal cells they used to be.
But what if it were possible to teach your immune system that cancer cells are just like any other foreign invader that needs to be sought out and destroyed? That's the question cancer researchers have been pursuing. And they are now getting closer to finding the answer.
Preventive Immunotherapy
Most likely, you've received a number of preventive vaccines over your lifetime. And they've been incredibly effective at controlling diseases like measles and chickenpox and at virtually eradicating others such as smallpox and polio. All of these vaccines were designed to do the same thing: introduce your immune system to a virus so that it would know how to fight off the virus if it ever encountered it again.
The same strategy has been effective in fighting off some virus-related cancers: The hepatitis B vaccine, which helps prevent infection with the hepatitis B virus, reduces the risk of liver cancer, and Gardasil, the vaccine against human papillomavirus, reduces the risk of cervical cancer. But will a vaccine for colorectal cancer prevention be next in line?
That is the hope of a group of researchers at the University of Pittsburgh. They are currently conducting a phase II trial of a vaccine, called MUC1 poly-ICLC, in people at high risk for developing colorectal cancer.
MUC1 is a cell protein that is produced in large amounts by precancerous polyps and colorectal cancer tumors. The vaccine teaches the immune system that the MUC1 protein is a foreign invader and that it needs to destroy any cells that are harboring it. Poly-ICLC is a drug used to boost the body's response to vaccination.
The researchers hope that by getting the immune system to go after these cells, the vaccine will be able to prevent polyps from turning into colorectal cancers and to keep the polyps from recurring. Interest in MUC1 for colorectal cancer stems, in part, from research showing that people with pancreatic cancer or breast cancer who naturally produce antibodies against the MUC1 vaccine live longer than those who don't produce them.
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Wednesday, August 11, 2010
Personalized Colon Cancer Therapy
What if there was a test that could determine the best treatment regimens for your specific tumor? How about a test that could tell you how likely you are to have a cancer recurrence? A decade ago, doctors could only dream of such tests. But in the not-too-distant future, they will probably be the mainstay of cancer care.
These developments reflect changes in the way scientists think about cancer. Initially, researchers believed that cancer was just one disease and that all cancers could be treated in virtually the same way. Now we know that's not the case. Not only does colorectal cancer differ from, say, breast or pancreatic cancer, but the latest research demonstrates that all colorectal cancers are not the same disease biologically, either.
This, in turn, is changing the way we think about colorectal cancer care. The more we learn about the different types of tumors, the clearer it becomes that not all tumors will respond in the same way to treatment regimens. Instead, the treatment must be tailored to the tumor's specific characteristics. Your doctor might refer to this new era of cancer care as personalized medicine; others call it individualized therapy, tailored treatment, or genome-based medicine. Each term refers to the same process: using genetic information obtained from your tumor to assess which treatment plan is best for you.
Biological Markers --
To move fully into this era of personalized medicine, scientists must first identify the biological markers -- measurable characteristics, like a protein level or the presence or absence of a certain gene or gene mutation -- that can tell us about your tumor's personality. These markers fall into two broad categories: predictive and prognostic.
Predictive biomarkers provide information about which chemotherapy regimens or biological agents might be effective against your tumor and which might not be effective at all.
Prognostic biomarkers assess how likely it is that your tumor is aggressive and, in turn, how likely it is to spread or recur. If you have an aggressive tumor, you may need more or different types of treatment than if your tumor is one that can be cured successfully by surgery alone. Prognostic markers could also be used in conjunction with predictive markers to determine the type of chemotherapy you need.
KRAS: The First Predictive Biomarker -- The National Comprehensive Cancer Network's treatment guidelines now recommend that if you are diagnosed with metastatic colorectal cancer and are a candidate for anti-epidermal growth factor receptor (EGFR) therapy, your tumor tissue should be tested for a predictive biomarker called KRAS, or K-ras. KRAS is a gene that helps tumors grow by sending signals to the cell nucleus through the EGFR on the cell's surface.
MACC1:
A Possible Prognostic Biomarker? A German research group recently reported that it had identified a gene, called metastasis-associated in colon cancer 1 (MACC1), that promotes rapid tumor growth and encourages cancer to spread to additional organs throughout the body. Early studies suggest that if your tumor has high levels of MACC1 you are at a much greater risk for developing metastatic cancer and should consider more aggressive treatment and closer monitoring than someone whose tumor has low levels of MACC1. Larger studies will need to be done to confirm these findings. However, if the results are reproduced, we might see a day when treatment decisions are influenced by a tumor's MACC1 level.
Posted in Colon Cancer on August 11, 2010
These developments reflect changes in the way scientists think about cancer. Initially, researchers believed that cancer was just one disease and that all cancers could be treated in virtually the same way. Now we know that's not the case. Not only does colorectal cancer differ from, say, breast or pancreatic cancer, but the latest research demonstrates that all colorectal cancers are not the same disease biologically, either.
This, in turn, is changing the way we think about colorectal cancer care. The more we learn about the different types of tumors, the clearer it becomes that not all tumors will respond in the same way to treatment regimens. Instead, the treatment must be tailored to the tumor's specific characteristics. Your doctor might refer to this new era of cancer care as personalized medicine; others call it individualized therapy, tailored treatment, or genome-based medicine. Each term refers to the same process: using genetic information obtained from your tumor to assess which treatment plan is best for you.
Biological Markers --
To move fully into this era of personalized medicine, scientists must first identify the biological markers -- measurable characteristics, like a protein level or the presence or absence of a certain gene or gene mutation -- that can tell us about your tumor's personality. These markers fall into two broad categories: predictive and prognostic.
Predictive biomarkers provide information about which chemotherapy regimens or biological agents might be effective against your tumor and which might not be effective at all.
Prognostic biomarkers assess how likely it is that your tumor is aggressive and, in turn, how likely it is to spread or recur. If you have an aggressive tumor, you may need more or different types of treatment than if your tumor is one that can be cured successfully by surgery alone. Prognostic markers could also be used in conjunction with predictive markers to determine the type of chemotherapy you need.
KRAS: The First Predictive Biomarker -- The National Comprehensive Cancer Network's treatment guidelines now recommend that if you are diagnosed with metastatic colorectal cancer and are a candidate for anti-epidermal growth factor receptor (EGFR) therapy, your tumor tissue should be tested for a predictive biomarker called KRAS, or K-ras. KRAS is a gene that helps tumors grow by sending signals to the cell nucleus through the EGFR on the cell's surface.
MACC1:
A Possible Prognostic Biomarker? A German research group recently reported that it had identified a gene, called metastasis-associated in colon cancer 1 (MACC1), that promotes rapid tumor growth and encourages cancer to spread to additional organs throughout the body. Early studies suggest that if your tumor has high levels of MACC1 you are at a much greater risk for developing metastatic cancer and should consider more aggressive treatment and closer monitoring than someone whose tumor has low levels of MACC1. Larger studies will need to be done to confirm these findings. However, if the results are reproduced, we might see a day when treatment decisions are influenced by a tumor's MACC1 level.
Posted in Colon Cancer on August 11, 2010
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