Understanding Colorectal Cancer: Diagnosis and Treatment Options Colorectal cancer, including cancers of the colon and rectum, is one of the leading causes of cancer-related deaths worldwide. However, thanks to advances in screening, diagnosis and treatment options, the prognosis for colorectal cancer patients has improved significantly. In this article, we will examine the diagnosis and treatment options for colorectal cancer. Colorectal Cancer Diagnosis Early diagnosis is crucial for the successful treatment of colorectal cancer. Screening plays a crucial role in detecting colorectal cancer in its early stages, even before symptoms appear. Common screening methods include the following: Colonoscopy: This is considered the gold standard for colorectal cancer screening. It involves a thorough examination of the entire colon and rectum using a flexible tube with a camera. Polyps (abnormal growths) can be detected and removed during a colonoscopy, potentially preventing the development of cancer. Faecal occult blood test (FOBT): This test checks for blood in the stool that may indicate the presence of colorectal cancer. It is a simple, non-invasive test that can be done at home or in a health care provider’s office. Flexible sigmoidoscopy: This is a procedure similar to a colonoscopy, but only examines the lower part of the colon and rectum. CT colonography (virtual colonoscopy): This is a non-invasive imaging test that uses CT scans to create detailed images of the colon and rectum. If any abnormal findings are detected during the scan, further diagnostic tests such as biopsy, MRI or PET scans may be performed to confirm the presence of colorectal cancer and determine the stage of the disease. Treatment Options for Colorectal Cancer The treatment plan for colorectal cancer depends on several factors, including the stage and location of the tumour, the patient’s general health and age, and the presence of other medical conditions. The main treatment options for colorectal cancer are: Surgery: Surgery is the most common treatment for colorectal cancer and may involve removal of the tumour and nearby lymph nodes. The type of surgery performed depends on the stage and location of the tumour. For early-stage colorectal cancer, minimally invasive techniques such as laparoscopic or robotic-assisted surgery may be used, offering faster recovery and less post-operative pain. Radiation therapy: Radiation therapy uses high-energy beams to kill cancer cells or shrink tumours. It can be used before surgery to shrink tumours, after surgery to kill remaining cancer cells, or to relieve symptoms in advanced cases. Chemotherapy: Chemotherapy uses drugs to kill cancer cells or stop their growth. It may be used before or after surgery or, in advanced cases, to control the spread of cancer. Chemotherapy can be given by mouth or intravenously. Targeted therapy: Targeted therapy uses drugs that specifically target cancer cells or specific proteins in cancer cells. These drugs can be used in combination with chemotherapy or as a stand-alone treatment for advanced colorectal cancer. Immunotherapy: Immunotherapy uses drugs that help the body’s immune system fight cancer. It can be used in advanced colorectal cancer cases with specific genetic mutations. Palliative care: Palliative care focuses on providing relief from symptoms and improving quality of life for patients with advanced colorectal cancer. It may include pain management, nutritional support and psychological support. Clinical trials, which are research studies that test new treatments, may also be an option for some colorectal cancer patients, especially those with advanced or recurrent disease. n addition to medical treatments, lifestyle changes such as healthy eating, regular exercise, avoiding tobacco and excessive alcohol consumption can also play a role in the overall management of colorectal cancer. Advances in Colorectal Cancer Treatment: A Multidisciplinary Approach Colorectal cancer, including cancers of the colon and rectum, is one of the leading causes of cancer-related deaths worldwide. However, significant advances have been made in the treatment of colorectal cancer in recent years, resulting in better outcomes for patients. A multidisciplinary approach combining surgery, radiation therapy, chemotherapy, targeted therapies and immunotherapies has emerged as the standard of care, offering patients a range of treatment options tailored to their specific condition and stage of disease. Surgery remains an important component of colorectal cancer treatment for the removal of the tumour and surrounding lymph nodes. Minimally invasive techniques, such as laparoscopic and robotic-assisted surgery, have become increasingly popular due to their benefits, such as less blood loss, shorter hospitalisation and faster recovery times compared to open surgery. In some cases, minimally invasive techniques can even be used for complex surgeries such as rectal cancer surgery, offering patients a less invasive option. Radiation therapy, which uses high-energy beams to kill cancer cells or stop their growth, is often used in combination with surgery or chemotherapy for colorectal cancer treatment. Advances in radiation techniques such as intensity-modulated radiation therapy (IMRT) and stereotactic body radiation therapy (SBRT) allow more precise targeting of the tumour while minimising damage to surrounding healthy tissue. Chemotherapy remains the cornerstone of colorectal cancer treatment both before and after surgery and can be administered orally or intravenously. Traditional chemotherapy drugs such as fluorouracil (5-FU), leucovorin and oxaliplatin are often used in combination to maximise their effectiveness. In addition, newer chemotherapy regimens, such as FOLFOX and FOLFIRI, have shown better results in certain patient populations. Targeted therapies have revolutionised the treatment of colorectal cancer, particularly by targeting genetic mutations or proteins that are overexpressed in cancer cells. For example, monoclonal antibodies such as bevacizumab, cetuximab and panitumumab target vascular endothelial growth factor (VEGF) or epidermal growth factor receptor (EGFR), respectively, and have shown efficacy in advanced colorectal cancer. Other targeted therapies, such as regorafenib and TAS-102, are approved for the treatment of metastatic colorectal cancer where other treatments have failed. Immunotherapies such as immune checkpoint inhibitors have also emerged as a promising treatment option for colorectal cancer. Pembrolizumab and nivolumab, which target the programmed death-1 (PD-1) protein, have been approved for certain patients with advanced colorectal cancer with specific genetic mutations, such as microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) tumours. These immunotherapies work by unleashing the body’s immune system to recognise and attack cancer cells, offering a new approach to treating colorectal cancer.
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