Surgical and Chemotherapy Options for Treating Advanced CRC

Basic understanding on Colorectal Cancer

If you want to learn basic anatomy and gather understanding on CRC and the different options, below sites have helpful information –

Introduction and review of anatomy of colon cancer

You may also visit

Selected Animations of Colorectal Cancer (CRC)

Above site has great animations and offers succinctly information on current Treatment Strategies –

Surgery
Radiation
Chemotherapy
Targeted Therapy

For Understanding the different molecular laboratory test required for colorectal cancer, you may click here.

Chemotherapy and Targeted Therapy Options (please click hyperlink)

Different options are given and you may want to discuss these with your Oncologists

TREATMENT FOR STAGE IV, METASTATIC CANCER OR RECURRENT CRC

Site helps us understand that it is a worthwhile effort to manage this, never a futile effort.

Your metastatic tumors are limited enough to be removed surgically (resectable) and might be curable
Your tumors are not resectable now, but with adjuvant treatment might become resectable and converted to a curable situation
Your cancer is widespread and unlikely to become resectable and should be treated palliatively with the goal of extending your quality of life for as long as possible

I also saw other interesting content worth reading on this same site –

QUESTIONS TO ASK IF YOU HAVE STAGE IV OR RECURRENT CRC
EXAMPLES OF TREATMENT OPTIONS COMBINED TO TREAT METASTATIC DISEASE OVER TIME
CHEMOTHERAPY COMBINATIONS
TARGETED THERAPIES

Chemo drugs for treating CRC

Current Options for Third-Line Treatment of Metastatic Colorectal Cancer

Surgical Options – Colorectal Cancer: Treatment Options

Approved by the Cancer.Net Editorial Board, 06/2016

You may want to consider chemo options per your case. Another Interesting Site that indicates Chemo Options per Stage –

Stage I – No adjuvant treatment is recommended for stage I colon cancer.
Stage II & III – Adjuvant therapy is recommended for stage III and high-risk stage II colon cancer patients.
Stage IV – Treatment for stage IV colon cancer is generally palliative. There are many new cytotoxic chemotherapy and targeted agents available for treating metastatic colon cancer, such as 5-FU, oxaliplatin, irinotecan, cetuximab, and bevacizumab.

What is the cancer cells have seeded to peritoneum (abdominal cavity)?

Options for treating CRC that has spread to peritoneum are –

Old Traditional method such as
Newer Option such as

However, before we chose the options, we have to measure the baseline with scores. Socres are counted using two scales, Peritoneal Cancer Index (PCI ) and Peritoneal Surface Disease Severity Score (PSDSS). The scales compute information from three distinct parameters –

Patient’s symptoms
Location and
CRC tumor burden (Size)

Older Methods – removal of the omentum, systemic and/or palliative chemotherapy, and palliative surgery.
Newer Regimen – cytoreductive surgery (CRS), hyperthermic intraperitoneal chemotherapy (HIPEC), and intraperitoneal chemotherapy.

Survival benefit –

Note: Older systemic chemotherapy regimens such as 5-flurouracil (5FU) and leucovorin offer a limited survival benefit of approximately 7 months, whereas, if Oxiplatin or irinotecan are added, survival can be extended to approximately 2 years.

Newer Regimens such as CRS and HIPEC have survival benefit of approximately 63 months with a 5-year survival near 50%. To say it simply, 50% patients will survive beyond 5 years.

The scales help in understanding the 5 years survival more objectively –

PCI 10 or less – 50% 5-year survival
PCI of 11 to 20 – 20% 5-year survival
PCI more than 20 – 0% 5-year survival

For Information on Gene Expression Profiling, you may visit following site –

Disclaimer:

The information available is for information purpose only. These are not recommendations. You are advised to consult your oncologist to get the recommendations for managing CRC patients. The above site has all relevant references hyperlinked to the subtopics. The author holds no responsibility for any information mentioned herein.