The chances of survival will increase
Science is making great strides in colon cancer research. Thus, the chances of survival are increasing. How far are the doctors?
Prof. dr. dr. Ernst Kuipers is head of the department of stomach, intestinal and liver diseases and of the department of internal medicine at the Erasmus Medical Center in Rotterdam. He is also chairman of the Dutch Association of Gastrointestinal Liver Doctors and a member of the Health Council.
Screening prevents deaths
Prof. dr. dr. Ernst Kuipers: “It will not be that time yet, but people will certainly hear a lot about it: the national population screening to colorectal cancer to be introduced in 2013. That is necessary, because colon cancer is na breast cancer the most common cancer in women. In men, colorectal cancer ranks third (after prostate cancer and lung cancer).
“The introduction of the population screening will be phased. In the first year, only people who are 65 or 75 years old at that time will be invited. The rest will follow in the following years. From 2018, all Dutch people aged 55 to 75 will be invited every two years. invited for a screening year.They have to fill a special stick with faeces and send it to a laboratory. That stick looks for microscopic traces of blood in the stool which could be a sign of colon cancer.”
Colonoscopy
“Research shows that there may be something wrong with 8 percent of the participants. They are invited for a colonoscopy, also called colonoscopy called, in the hospital, a bowel examination with a flexible tube (scope) that is inserted through the anus. If abnormal polyps or an incipient form of cancer are discovered (the case in half of the people examined), they can usually be removed immediately during the colonoscopy. In some cases, follow-up treatment is required.”
Benefit for the patient: “At the moment, 5000 Dutch people die from bowel cancer every year. The expectation is that, if the population screening goes well, we will prevent 2500 deaths every year.”
Less burdensome bowel examination
“Before a colonoscopy, patients have to drink four liters of special liquid to clean the intestines. That is a nasty stuff; every sip is a task. We do our best to make that experience less unpleasant. For example, some hospitals are already using a new one. type of liquid, of which you only need to take two liters.In the future, medicines may make the liquid work more effectively and so you need even less of it.
Another thing is that the pressure of the scope in the intestines is painful. That is why the examination is usually done under a light anesthetic (a sedation). A scope is now being developed that unrolls itself in the gut instead of you having to guide it through it as a doctor.”
Benefit for the patient: “Less unpleasant experiences during a bowel examination. With new scope techniques we may be able to use local anesthesia in the future.”
Combination therapy works better
“In recent years, doctors have been given much more options for treating people with metastatic colorectal cancer. A good example is the group of patients who have metastases in the lymph nodes, but not yet in other places in the body. We recently learned that part of They respond positively to a combination of two types of chemotherapy, increasing the chance that they will still be alive after five years from 50-60 percent to 70-80 percent.”
“By using combinations of chemotherapy and targeted drugs, the life expectancy of people with incurable colorectal cancer has been extended by one and a half to two years. Another new development is that we now irradiate people with cancer in the rectum and give chemotherapy before their surgery. the chance of success. It is being investigated whether this also applies to other forms of colon cancer.”
Benefit for the patient: “Better prospects for people with metastatic colorectal cancer. If developments continue at this pace, I hope that colorectal cancer will become a controllable, chronic disease within ten years.”
Customization with local therapy
“We have more treatment options for colorectal cancer patients with metastases, for example HIPEC (Hyperthermic Intraperitoneal Chemotherapy). This is a treatment in which all visible tumors are first removed by surgery and then the abdomen is rinsed with three liters of heated chemotherapy fluid for an hour and a half. to work better in specific cases than ‘normal’ chemotherapy via the bloodstream. Moreover, the local application means that the patient suffers much less from side effects. It is an example of the customization that we offer to more and more patients.”
Benefit for the patient: “Five years after HIPEC treatment, 40 percent of colorectal cancer patients who had metastases in the abdominal cavity are still alive. That is four times as many as with regular treatment.”
“Join the screening soon”
Prof. dr. Dr. Ernst Kuipers: “I am already looking ahead and give advice for 2013. If you receive a call for the bowel cancer screening program in that year, please respond to it. By having yourself screened every two years, you will reduce the chance of dying “In the meantime, it makes no sense to do a self-test that you can order online. The results are by no means always reliable and, moreover, difficult to interpret for a layman.”
Sources):
- Plus Magazine
