Colorectal Cancer WebClips

There is no way that an oncologist can survive without the internet these days, not with the furious rate of developments in the field. Patients who mine the Web for info are best served by peer-reviewed sites (see links) for their own safety. Journal articles, commentaries, summaries etc need method & data evaluation, coupled with some insight into basic & clinical science. Discuss them with your physician.

COLORECTAL CANCER

• Screening: Radiographic "virtual" colonoscopy (actually, colonography) is not quite ready to replace optical colonoscopy for colorectal cancer screening. The most common complaint is that you can't biopsy suspicious lesions with the new procedure. Hmm… the GI guys are especially wary, while the x-ray people seem to be ardent fans. A cost comparison for the Philippines should be interesting. In any case, virtual colonography will have to do if the patient absolutely refuses standard endoscopy, is medically unfit for sedation etc, has a partial colon obstruction that a scope can't squeeze through… *Rex DK, Lieberman D. ACG Colorectal cancer prevention action plan: Update on CT-colonography. American Journal of Gastroenterology. 2006;101:1410-1413.

• Resectable Disease: A study in this month's JCO reports that physical activity may be an independent factor in reducing colorectal cancer's recurrence & death rates after definitive treatment. As the accompanying editorial says, "It's time to get moving!" *Meyerhardt JA, Heseltine D, Niedzwiecki D, et al: The impact of physical activity on cancer recurrence and survival in patients with stage III colon cancer: Findings from CALGB 89803. J Clin Oncol 24:3535-3541, 2006  

• Advanced/Stage IV: Chemotherapy-based cancer treatment leading to the disappearance of liver metastases on a CT scan/MRI/PET does not mean cure in the great majority of cases. Surgery must still be considered in this setting, where possible. *Benoist S, Brouquet A, Penna C, et al: Complete response of colorectal liver metastases after chemotherapy: Does it mean cure? Journal of Clinical Oncology 24: 3939-3945, 2006