Colon Cancer Chemotherapy

" Hi welcome to our webcast by doctor David Marks chemotherapy is commonly used to treat cancer. But only a few chemo drugs are effective in treating colon cancer. This may be changing though because a number of new agents have shown promising results. Here today to talk about these new drugs are two experts. First is Dr. John McDonald he's an oncologist at saint Vincent's comprehensive cancer center in New York City welcome glad you're doing. And next to him as doctor Michael Lieberman is a colorectal surgeon at the Weill Cornell medical college thanks for being here and you can win this chemotherapy used in --"

" basically two to. Parts of the disease in Houston I want is let's call adjuvant therapy which what you're trying to do is to prevent a recurrence. After a surgeon has -- section of the Cohen. And that's really preventive chemotherapy and hearing -- as they say you're taking so many as a high risk for recurrence and by giving chemotherapy typically for six months to decrease it. And the other area now this revolving quite quickly as -- chemotherapy in patients who already have metastatic disease. And these patients what you're trying to do is to reduce the metastatic disease carrying them make them live longer decrease symptoms due to the cancer. And more recently we've become very pursues we have newer agents that are more effective. He and reducing the disease to the point where it might be surgically -- sector -- surgeon maybe it would take cancer out of liver and render the patient for -- does is. So is there any guideline as to what stage of disease that the person has to -- in to have -- Yeah if if you look at what's generally accepted an attachment therapy. Everybody agrees that stage three disease and that means that -- every second when the pathologist looks at that. The lymph nodes showed some evidence of metastatic disease. There's no question that those patients benefit. From the use of chemotherapy. After reception it decreases the likelihood they're gonna recur and improves overall survival. And then the other group for patients with what is called stage four disease which dismissed out of position again. You're treating them to reduce the disease reduce the symptoms and potentially with some patience with a fraction of those patients to eventually be able to surgically recycle Waziristan. And from a surgeon's perspective."

" What role does chemotherapy play from your management. Intern to the -- surgical management. -- patients with colorectal cancer. Very useful techniques to. To make some tumors. More amenable -- section particularly in the rectum and utilized. Both the combination of chemotherapy and radiation therapy -- prior to surgery. And then we would follow up with perception. There's been some association -- salvaging surgery by utilizing this technique. For rectal cancers and also downsizing this community that tumor making more amenable to a complete -- section. When it's in the rectum. Took me a person a greater chance of the overseer ergo -- search and have functional improvement pride in being able to preserve a stinker. And give us a negative margin so we've used that as as a useful technique for rectal cancer. We've also seen utility in utilizing chemotherapy following liver section for metastatic disease. From colorectal cancer. And there's been some nice work that is demonstrated an advantage to getting chemotherapy delivered through continuous pump. Placed in the operating room at the time of -- section. So there are some very entrenched interest in modalities. Where were interacting as a team. Both of surgery and radiation oncologist ending medical oncologist and taking care patients with the stuff."

" This disease. What -- agents being used the main agent is an agent called five if you which has really been around for over thirty years we know how to use it differently now. -- also now being used in combination with some newer drugs in the last ten years we've had. Several newer drugs which are really effective. One is called campus are the other name as a Reno TK and the third interest drug CPT eleven. But the combination of five if you. With this drug cash almost double the response rate seen improves survival so that's been real real. Leap forward as it were another drug is called box -- platinum watches and experimental. In investigational treatment but this is really quite valuable. And it's gonna be very useful and another even some oral chemotherapy agents one called the load another quote you have -- which -- the effect which are effective and colon cancer. Are there anything. Any other. Agents that are coming down the road that maybe even better than what we have well I I think one of the things that's been intriguing about colorectal cancer is. We understand more about the molecular genetics and this wouldn't see in almost any other human malignancy. And so what we've been able to do is -- and able to target the differences the molecular differences between normal cells and colon cancer cells. And we're beginning to look at that ad agency said the fact that for example. Agents that inhibit the F -- mold growth factor receptor there's. Monoclonal antibody called C two to five which is of interest. There are molecule small -- a small molecules that inhibit the way to separate human growth factor interacts with the colon cancer. There agents that that inhibit the ability of the colon cancer. To develop new vascular clarity new blood vessels. These are called anti angiogenesis strategies and a number of agents out there and in clinical development which are real importance and I will will be. Clinically available to many oncologists and then combined modality surgical oncology. Clinical oncology radiation oncology teams in the near future participation find out about clinical trials that are ongoing right now if they wanna get involved and well one of the ways this is the look at cancer centers that can't -- that cancer centers in the United States. Participate in many national clinical trials and all the commissioners also have their own menu of local clinical trials. Certainly the National Cancer Institute. Has some has web sites and has information about the PD can database for example. Which will allow people and -- know what clinical trials are out there and I think the other messages that have. Clinical trials are frequently the best treatment for any cancer. Because you're an opportunity to be involved on the cutting edge of what's what's out there spoken component on the good news. Thank you both for being here thank you for joining our webcast I'm doctor David Marks device."