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Stage II: Treated by surgical resection, plus adjuvant chemotherapyin cases eligible by the Oncotype DX Colon Cancer (Gene) Assay,plus other criteria.Stage III: Cancers with positive metastatic lymph nodes areusually treated with adjuvant chemotherapy regimens, including 6months of FOLFOX-6 or CAPEOX, in the out-patient setting.Stage IV: (Including cancers metastatic to the liver, lung andlymph nodes) Is treated with multiple chemotherapy protocols,plus either Avastin or Zaltrap (monoclonal antibodies which inhibitvascular endothelial growth factor, known as VEGF ) or cetuximab(noted above).Patients with a significant response to metastatic disease, (>50percent tumor shrinkage from chemotherapy) can often becomecandidates for surgical resection of small residual tumors by ourliver oncologic surgeon or for Radio-Frequency Ablation (RFA),specifically, high energy thermal treatment. Some patients whoachieve a complete remission status can often enjoy long-term survivaland even cure.Stage II and III rectal cancers are treated more often withneoadjuvant (pre-surgical) combined chemo-therapy, plus radiationtherapy which offers a distinct therapeutic advantage. High cure ratesare expected after surgery and additional chemotherapy.Metastatic or advanced colorectal cancer patients that do notachieve a complete remission with treatment can frequently bestabilized (in a palliative mode) for two to three or more yearswhile enjoying good quality of life and minimal side effects fromchemotherapy.The St. Anthony’s Colorectal Cancer Care Team, including boardcertifiedoncologic specialists is currently available for “PersonalizedCare Prescriptions” (“PCRx“ ) plans with an opportunity for superioroutcomes and survivals.St. Anthony’s Colorectal Cancer Care is proud of its team and itsachievements and is seeking early stage and advanced colorectal cancerpatients for first and second treatment opinions.R. William Morris, M.D., M.B.A.Medical Director, Oncology Services314-849-60668
Treatment of colorectal cancerColon Cancer: Preventable • Treatable • BeatableColorectal cancer is the third most common cancer and the secondmost common cancer killer in the United States, which, in 2012,is an estimated 143,000 new colorectal cancers and 52,000 deaths.The risk of developing colorectal cancer increases with age. All menand women age 50 and older are at risk of developing colorectalcancer, and should be screened. Those with a personal history ofinflammatory bowel disease or family history of colorectal cancer orpolyps should be screened before age 50.At St. Anthony’s Medical Center, rectal cancers are treated with ateam approach which includes the colon and rectal surgeon, medicaloncologist and radiation therapist. Radiation therapy is used in mostrectal cancer cases, and in the few instances of colon cancer when it isnot possible, or safe, to surgically remove all of the cancer. Surgeonsworking with the radiation therapists utilize different techniques toallow for the delivery of the maximum appropriate dose of radiationtherapy while minimizing the adverse effects to the surroundingtissues.Current screening methods include one or more of the following:fecal occult blood testing, flexible sigmoidoscopy, double contrastbarium enema and the gold standard - colonoscopy. Colorectal cancerscreening costs, including colonoscopies, are covered by Medicare andnearly all commercial health plans.Colorectal cancer can be cured in up to 90 percent of patientswhen discovered in its early stages. Approximately 40,000 lives ayear could be saved through widespread adoption of colon cancerscreening and early treatment in men and women.Symptoms from colorectal cancer may include any or all of thefollowing: bleeding per rectum, dark black stools, change in stoolcaliber, tenesmus, lower abdominal pain, recent change in bowelhabits towards diarrhea or constipation, and unintentional weightloss. However, most patients identified to have colorectal cancer haveno symptoms. This is why screening is so important.Ten percent of all colorectal cancers are identified in patientsyounger than age 50; therefore, when these patients do present withthe symptoms associated with colorectal cancer, they should beinvestigated thoroughly.Colorectal cancer, like most cancers, is staged at four differentlevels. Each stage carries different treatment recommendations andprognoses. Although staged the same, treatment recommendationsfor colon cancer and rectal cancer are different.Stage I colorectal cancers are those where the cancer penetratesonly a portion of the bowel wall. Colon resection is the main stay,without any additional therapy, and yields a five-year survival rate of74- 93 percent. Stage II colorectal cancers invade through most, ifnot all, of the bowel wall or directly invade an adjacent organ. Colonresection provides a significant cure rate with five-year survivalDavid Schuval, M.D.9
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