Colorectal cancer is the third most commonly diagnosed cancer in the United States for men and women.
But in recent years, new advancements in early detection and treatment of colorectal cancer (also called colon cancer) show a promising future for patients and their families.
Experts provide an overview of what you can look forward to in the field of colorectal cancer treatment.
The death rate of colorectal cancer has been dropping for decades, according to the American Cancer Society. In addition to new and improved colon cancer treatments, early detection is a big reason for this.
Late stage metastatic colon cancer, or cancer that’s spread to other parts of the body, is much harder to treat.
People with a diagnosis of stage 4 cancer have a 5-year relative survival rate of about 14 percent, meaning that 14 out of 100 people who have stage 4 colon cancer are still alive after 5 years.
In comparison, those with stage 1 cancer have a 5-year relative survival rate of about 90 percent.
There are a number of tests available today that can help detect early signs of colon cancer or even a predisposition to developing it.
Routine screenings are key in detecting early stage colon cancer. The types of screening tests are:
Generally, it’s recommended that you start screening for colon cancer at 50 years old, if you have a 15-year CRC risk of less than 3%. To find out your risk, you can use this risk calculator recommended by the
But if you have a family history of colon cancer or other signs that indicate a higher risk for it, your doctor may recommend more frequent screenings starting from a younger age.
Colon cancer screenings are important because they allow doctors to look inside your colon to see how things are doing.
The American College of Physicians recommends fecal occult blood testing every 2 years, a colonoscopy every 10 years, or a sigmoidoscopy every 10 years plus FIT every 2 years.
If after taking a FIT test or a sigmoidoscopy, you test positive for cancer, your doctor will perform a colonoscopy to confirm your diagnosis.
During a colonoscopy, if your doctor sees polyps, or abnormal growths, inside your colon, they can remove them and closely monitor you to make sure any polyps you have aren’t cancerous.
If the tissue is already cancerous, there’s a higher chance of stopping cancer growth before it becomes metastatic.
About 5 to 10 percent of colon cancer cases are a result of a genetic mutation passed down from parents to children.
DNA testing is available that can help doctors learn whether you have a higher risk for developing colon cancer.
This testing involves taking a sample of tissue from your blood or a polyp, or from a tumor if you’ve already received a colon cancer diagnosis.
Surgical techniques have continued to evolve for colon cancer treatments in the last couple of decades, as surgeons have developed new methods and learned more about what to remove.
Recent advancements in minimally invasive surgery to remove polyps or cancerous tissue mean patients experience less pain and a shorter recovery period, while surgeons enjoy more precision.
Laparoscopic surgery is an example: Your surgeon makes a few small incisions in your abdomen through which they insert a little camera and surgical instruments.
Today, robotic surgery is even being used for colorectal cancer surgery. It involves use of robotic arms to perform the surgery. This new technique is still being studied for its efficacy.
“Many patients now go home in 1 or 2 days, compared to 5 to 10 days 20 years ago [with minimally invasive surgery],” says Dr. Conor Delaney, chairman of the Digestive Disease and Surgery Institute at Cleveland Clinic.
“There are no drawbacks, but this minimally invasive surgery requires an expert surgeon and a well-trained surgical team,” he says.
In recent years, targeted therapy has been used together with or instead of chemotherapy.
Unlike chemo drugs, which destroy both cancerous tissue and healthy surrounding tissue, targeted therapy drugs only treat cancer cells.
Additionally, they’re usually reserved for people with advanced colon cancer.
Researchers are still studying the benefits of targeted therapy drugs, as they don’t work well for everyone. They can also be very expensive and cause their own set of side effects.
Your cancer team should speak with you about the potential benefits and drawbacks of using targeted therapy drugs. Those commonly used today include:
- bevacizumab (Avastin)
- cetuximab (Erbitux)
- panitumumab (Vectibix)
- ramucirumab (Cyramza)
- regorafenib (Stivarga)
- ziv-aflibercept (Zaltrap)
Perhaps the most recent innovation in colon cancer treatment involves immunotherapy, which uses your body’s immune system to fight cancer.
For example, a colon cancer vaccine to boost immune system response to cancer is being developed. But most immunotherapies for colon cancer are still in clinical trials.
And as for what’s next in colon cancer treatment, Dr. Michael Kane, medical director of Community Oncology for Atlantic Health System and founder of Atlantic Medical Oncology, says there’s much more work to do, but the future looks promising.
“The sequencing of the human genome has begun to yield great promise in earlier diagnosis and more targeted treatment of many types of malignancies, including colon cancer,” Kane says.
According to Kane, there’s also potential in using germline genetic testing to increase the number of earlier diagnoses and thereby improve cure rates.
This type of testing is done on noncancerous cells to see whether someone has a gene mutation that can increase their risk for developing cancer or other diseases.
In addition, Kane says advancements in treatment approaches are helping maximize the results of treatment and minimize side effects.
“Next-generation sequencing of colon and rectal tumors promise the ability to match an individual patient with a specific ‘cocktail’ of treatment that can lead to improved efficacy and minimize unwanted toxicities,” Kane says.
Kane emphasizes that we need to encourage the development of more complementary medicine trials to expand treatment approaches.