The management of patients with these disease subtypes has also evolved over the years, in line with advances in medical technology and the release of new drugs. The introduction of 5FU, the first chemotherapy drug in the 1960s, extended the median survival rate of patients with metastatic colorectal cancer from six to 12 months. The introduction in the late 1990s of more effective drugs such as oxaliplatin and irinotecan improved the median survival rate to 16 - 18 months; and this century, the use of antibodies, such as cetuximab, panitumumab and bevacizumab to target growth pathways (Epidermal Growth Factor Receptor, Vascular Endothelial Growth Factor) and the Tyrosine Kinase Inhibitor (TKI) regorafenib has further extended the median survival to close to 30 months. As a result, these days patients with incurable bowel cancer live five times longer than they did 30 years ago - longer than many patients with heart or kidney failure. Thanks to the greater understanding of the disease, and improvements in treatments, many colorectal cancers previously considered to be incurable in approximately 30% of patients, are now treated with the intention of long term survival. This success can be attributed to the use of systemic chemotherapeutic agents, as well as advances in organ specific treatments. These include Stereotactic Internal Radiation Therapy (SIRT), Intra Hepatic Artery chemotherapy, and radiofrequency ablation, which give the treating specialist improved local control over the diseased areas, while protecting healthy areas, thus reducing morbidity and the risk of earlier mortality. The introduction of immunotherapy drugs to control cancer growth by using the immune system to attack cancer cells is also very exciting. It is anticipated this group of drugs will continue to increase the progression-free survival and overall survival of patients with metastatic colorectal cancer. There is no doubt, we are living in times of rapid growth in the understanding of colorectal cancer at the most intimate level, the logical evolutionary process is the development of more effective and less toxic therapeutic options. By understanding the differences between the disease subtypes, and how they differ in terms of their responsiveness to cancer therapies, medical oncologists hope to be able to develop personalised treatment therapies patients with this common cancer. I feel very excited to be practicing as medical oncologist in these amazing days of great discoveries. pm Gene ral Hea lth 24 Pindara Magazine 2015
Pindara Private Hospital Magazine - Issue Five
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