Bowel cancer: New treatments, improved prognosis
New medicines show promise, but more research is needed
Treatment before surgery for bowel cancer
Traditionally, chemotherapy and radiotherapy have been used after surgery. This approach is called adjuvant therapy. The goal is to kill any cancer cells that might have survived the operation.
However, doctors are also using an approach called neoadjuvant therapy - treatment before surgery. The advantage is that the treatment can make the tumour smaller and easier to remove surgically. Neo-adjuvant chemotherapy is mainly used to treat cancers affecting the rectum. This may make it possible to avoid having a permanent colostomy. Sometimes chemotherapy is given in combination with radiotherapy.
"There's growing acceptance that using chemotherapy and radiation before surgery is more convenient and gives better results," Hoff says. "It's a trend that's gaining momentum around the world, but especially in the US."
Keeping treatment advances in perspective
While these advances in treatment are a cause for enthusiasm, none of them is the magic bullet that researchers hoped to discover.
Survival rates have improved for people with bowel cancer. While the progress may still look frustratingly slow for those with metastatic disease, we are still moving forwards. The progress may not be dramatic, but some of the most important advances may come in the details - small adjustments with different dosages, treatment regimens and combinations of medicines. Hopefully, with time and research, all of these smaller steps may add up to something big.