Colon

Colorectal Cancer is the combined term for two types of cancer, colon cancer and rectal cancer (the last several inches of the colon), and is often referred to as colon cancer. Colon cancer develops in the tissues of the large intestine, the lower part of your digestive system. Most cases of colon cancer originate as small clusters of cells called polyps which become malignant over time. In later stages of the disease, cancerous cells may penetrate the colon wall and spread (metastasize) to nearby lymph nodes or surrounding organs.

Polyps may be small and produce few, if any, symptoms. For this reason, doctors recommend regular screening tests to help prevent colon cancer by identifying polyps before they become colon cancer.

Stage 0:
Very early cancer on the innermost layer of the intestine.
Treatment of stage 0 may include the following types of surgery:

• Local excision or simple polypectomy
• Resection /anastomosis (performed when the tumor is too large to remove by local excision)

Stage I:
Cancer is present in the inner layer of the colon.
Treatment of stage I is commonly resection/anastomosis

Stage II:
Cancer has spread through the wall of the colon.
Treatment of stage II colon cancer may include the following:

• Resection/anastomosis
• Chemotherapy and/or radiation therapy
• Targeted therapies: angiogenesis inhibitors, which act by blocking tumor blood vessel formation, and monoclonal antibodies, which target proteins on the surface of cancer cells to kill or block their growth

Stage III:
Cancer has spread to the lymph nodes.
Treatment of stage III colon cancer may include the following:

• Resection/anastomosis with chemotherapy
• Chemotherapy, radiation therapy

Stage IV:
Cancer has spread to other organs outside the colon.
Treatment of stage IV and recurrent colon cancer may include the following:

• Resection/anastomosis
• Radiation therapy and/or chemotherapy
• Clinical trials of chemotherapy, or biologic therapy after surgery
• Targeted biologic therapies

Special treatments of cancer that has spread to or recurred in the liver may include the following:

• Chemotherapy followed by resection
• Radiofrequency ablation or cryosurgery
• Clinical trials of hepatic chemoembolization with radiation therapy
• Targeted biologic therapies

(Approved chemotherapy treatment agents for colon cancer include irinotecan, Oxaliplatin, Capecitabine, and 5-fluorouracil, and monoclonal antibodies, including Cetuximab (Erbitux), Panitumumab (Vectibix), Bevacizumab (Avastin), and Regorafenib may be used alone or in combination with chemotherapy agents.)

Common Treatment Programs include:

Capox or Xelox:
Capecitabine (Xeloda) plus Oxaliplatin (Eloxatin)

Folfox
5-FU, Irinotecan (Camptosar) and Leaucovorin

Folfiri
5-FU, Irinotecan (Camptosar) and Leucovorin

These regimens may be also combined with targeted therapies such as Bevacizumab (Avastin®), Cetuximab (Erbitux®), ziv-aflibercept (Zaltrap®)

National Cancer Institute Colon Cancer clinical trials
http://www.cancer.gov/clinicaltrials/featured/types/colon-cancer
http://www.cancer.gov/clinicaltrials/results/type/colorectal

Colon Cancer Alliance Clinical Trial matching Service
http://www.emergingmed.com/partners/CCA/

US National Institutes of Health
http://clinicaltrials.gov/ct/search?term=colorectal+cancer

Cancer Research Institute
http://www.cancerresearch.org/home
http://www.cancerresearch.org/cancer-immunotherapy/impacting-all-cancers/colorectal-cancer
http://www.cancerresearch.org/cancer-immunotherapy/clinical-trial-finder

Center for Information and Study on Clinical Research Participation (CISCRP). CISCRP offers an online clinical trials search engine at SearchClinicalTrials.org. In addition, they provide a toll-free number where patients can receive help locating a clinical trial.
www.SearchClinicalTrials.org

Centerwatch This site helps people connect with clinical trials by offering a list of institutional review board (IRB)-approved clinical trials.
www.centerwatch.com

ClinicalTrials.gov This database of publicly and privately supported clinical trials is maintained by the National Library of Medicine at the NIH.
www.clinicaltrials.gov

Coalition of Cancer Cooperative Groups This organization provides resources and information in order for patients to search for clinical trials.
www.cancertrialshelp.org

WHO International Clinical Trials Registry Platform Search Portal The World Health Organization (WHO) coordinates health matters within the United Nations. This database allows people to search clinical trial registration information from many countries’ registries.
http://www.who.int/ictrp/en/

For support, including counseling, financial assistance, and community programs, as well as podcasts and publications about Colorectal Cancer:

CancerCare Website
http://www.cancercare.org/diagnosis/colorectal_cancer

National Cancer Institute Educational Pages
http://www.cancer.gov/cancertopics/pdq/treatment/colon/Patient/page6
http://www.cancer.gov/cancertopics/pdq/treatment/colon/Patient/page2

Colon Cancer Information from Live Strong
http://www.livestrong.com/colon-

ASCO Colorectal Cancer Info
cancer/http://www.cancer.net/sites/cancer.net/files/asco_answers_colorectal.pdf

Two types of bacteria commonly found in the gut work together to fuel the growth of colon tumors, according to a new study published in the journal Science.
February 1, 2018
https://www.nytimes.com/2018/02/01/health/colon-cancer-bacteria.html

Colorectal cancer: New, less toxic drug target uncovered
October, 2017
https://www.medicalnewstoday.com/articles/319779.php

Efficacy And Safety of Bevacizumab in metastatic colorectal cancer: pooled analysis from seven randomized controlled trials
The Oncologist
September, 2013
Bevacizumab Efficacy and Safety in mCRC: Pooled Analysis

For Advanced colorectal cancer: Promising response to new combination therapy of vermurafenib, cetuximab and irinotecan.by patients with metastatic colon cancer
http://www.medicalnewstoday.com/releases/277611.php

First line therapy approved for Stage IV Colon Cancer
June 16, 2014
http://fightcolorectalcancer.org/first-line-treatment-approved-for-stage-iv-colorectal-cancer/

ASCO 2014: Chemo with either Avastin or Erbitux are equally effective against colorectal cancer (KRAS wild type)
http://breakthroughs.cityofhope.org/asco-2014-colorectal-cancer-erbitux-avastin

Colon Cancer Alliance Top Four 2014 ASCO Findings
http://www.ccalliance.org/
http://ccalliance.org/blog/asco-annual-meeting/

Colon Cancer Drug Pricing
March, 2014
http://ccalliance.org/blog/340b-drug-pricing-program-what-you-need-to-know

Colon Cancer Alliance (Patient Advocacy Group) Monthly Patient Webnars from Fight Colorectal Cancer
http://www.ccalliance.org/

Colon Cancer Buddy Program (peer-to-peer support for newly diagnosed colorectal patients)
https://ccalliance.org/volunteer/buddy_program.html

Fight Colon Cancer
http://fightcolorectalcancer.org/

Daily Strength (Online Support Group)
http://www.dailystrength.org/c/Colon-Cancer/support-group

Colorectal Cancer Network (not for profit foundation that offers information about colorectal cancer symptoms, treatment, and support for patients)
http://www.colorectal-cancer.net

Susie’s Colon Cancer Foundation
http://www.coloncancerfoundation.org

Cancer Care: free counseling, support groups, education, financial assistance, online, telephone and in person support groups led by oncology social workers
http://www.cancercare.org/diagnosis/colorectal_cancer

Fighting Chance- free counseling service for cancer patients and caregivers
http://fightingchance.org/resourceGuide.shtml