Conclusion

22 Conclusion



Susan L. Gearhart, Nita Ahuja


Since 1984, death rates from colorectal cancer have decreased in both men and women, with an accelerated rate of decline after 1998. This reduction is attributed not only to the introduction of screening but also to newer systemic therapies and improvement in surgical techniques, such as the ones described in this volume.1,2


Over the past decade, considerable investigational work has resulted in the addition of new chemotherapeutic agents and more innovative combination strategies for the treatment of colorectal cancer. Furthermore, the ability to sequence the entire genome of individual patients allows for the translation of genomic knowledge into the clinical arena. For the first time, limited clinical data are being replaced by “personalized” target therapies. This information, coupled with newer surgical techniques such as total mesorectal excision (TME), transanal excision, sphincter-sparing surgery, and laparoscopic and robotic surgery, has resulted in significantly better quality of life for patients with colorectal cancer.


Although much has been accomplished in the prevention and treatment of colorectal cancer, the job is by no means complete. In the United States, despite the efforts of several organizations including the American Cancer Society, only about 50% of individuals 50 years or older have been screened for colorectal cancers. Identification of new hereditary forms of colorectal cancer and of better screening methods for hereditary colorectal cancer has been slow. Little improvement has been made in risk reduction for the general U.S. population. Medications to prevent polyp formation have shown minimal benefit. Finally, despite the advances detailed in this volume, the incidence of colorectal cancer is increasing worldwide.


Further improvements in outcomes from colorectal cancer will depend on increasing colorectal cancer screening, on the use of minimally invasive surgical techniques, and on translating the vast knowledge from the genomic revolution into the clinical arena. The emerging modalities described in this volume, such as expression profiling, vaccine therapies, and the use of DNA-based markers for early detection, will become increasingly important. Clearly, effective management of colorectal cancer requires a multidisciplinary approach.


We hope this volume will inspire health care practitioners to follow research advances closely and to adopt the most current practices for early diagnosis and multimodal treatment. With the techniques now at our disposal, we can aim not merely to raise survival rates but also to improve each patient’s overall quality of life.



References



1 Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2009. CA Cancer J Clin. 2009;59:225-249.


2 Edwards BK, Ward E, Kohler BA, et al. Annual report to the nation on the status of cancer, 1975–2006, featuring colorectal cancer trends and impact of interventions (risk factors, screening, and treatment) to reduce future rates. Cancer. 2010;116:544-573.

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Hereditary Colorectal Cancer and Polyp Syndromes Preoperative Evaluation Stool and Blood Sampling for Early Detection of Colorectal Cancer Systemic Therapy for Colon Cancer Genetic Profiling in Colorectal Cancer Coping with Colorectal Cancer

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May 8, 2017 | Posted by in ONCOLOGY | Comments Off on Conclusion

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