Treatment

Treatment of Colorectal cancer can include surgery, radiation therapy, chemotherapy, and other targeted therapies, or a combination of these. Doctors who treat cancer choose treatments based on the state of the disease, and the particular condition of the individual. 

Surgery	Surgery is the removal of the tumour and surrounding tissue during an operation.
Radiation Therapy	Radiation therapy is the use of high-energy X-rays to kill cancer cells and is commonly used for treating rectal cancer.

 

Chemotherapy:

• The use of drugs to kill cancer cells, usually by stopping the cancer cell's ability to grow and divide.
• For many years, 5-flouroucacil (5FU) plus leucovorin [IFL] was the only effective treatment regime. It had a median overall survival of 12 months. There have been recent advances to this program. The treatment, known as FOLFOX (5-FU with leucovorin and oxaliplatin), has helped increase average overall survival, and is now among a variety of chemotherapy options one offer.
• These treatments – surgery, radiation therapy, and chemotherapy - are often tried in combination with targeted therapies, as discussed below. 

Targeted Therapies: 

Targeted therapy is an approach that targets the cancer's specific proteins, genes, or the tissue environment that enable the cancer to survive. 

Epidermal Growth Factor Receptor Inhibitors:

• This treatment can help to shrink and stabilize the growth of colorectal cancer by disturbing the process by which tumours develop. 
• The two drugs available for this treatment - Cetuximab and Panitumumab - do not work as well for tumours that have specific gene mutation (changes) within a gene called KRAS. Therefore, for many people, this treatment is not a suitable option. 

Anti-angiogenesis therapy: 

This treatment focuses on stopping angiogenesis, which is the process of making new blood vessels.

• Because a tumour needs the nutrients delivered from blood vessels to grow, the goal is to effectively starve the tumour.

Bevacizumab (Avastin) – an antibody therapy - was introduced in 2004, and, when combined with chemotherapy, has led to an increased overall survival for patients with metastatic (advanced) Colorectal Cancer. It has become a standard first-line treatment option.

• However, the response to this treatment is heterogeneous, meaning that not everyone benefits. It can also have negative side effects, as discussed in section three - What will AngioPredict do?