Treatments of colon cancer
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Treatments of Colon Cancer
Standard Treatments: Chemotherapy, Radiotherapy, and Surgery
The standard treatment for colon cancer typically involves a combination of surgery, chemotherapy, and radiotherapy. Surgery is often the first line of treatment, especially for localized tumors, and aims to remove the cancerous area. Chemotherapy and radiotherapy are used to eliminate any remaining cancer cells and reduce the risk of recurrence .
Adjuvant Chemotherapy: Fluorouracil, Leucovorin, and Oxaliplatin
Adjuvant chemotherapy, which is administered after surgical resection, is crucial for improving survival rates in colon cancer patients. The combination of fluorouracil and leucovorin (FL) has been a standard regimen. Adding oxaliplatin to this combination (FOLFOX) has shown to significantly improve disease-free survival rates in patients with stage II and III colon cancer. The addition of oxaliplatin reduces the recurrence rate and increases the three-year disease-free survival rate from 72.9% to 78.2%.
Personalized Adjuvant Treatment
With the advent of precision medicine, personalized adjuvant treatment strategies are becoming more prevalent. Factors such as gender, age, tumor stage, molecular profile, and patient preferences are considered to tailor treatment plans. Molecular profiling, including the assessment of KRAS/NRAS/BRAF mutations and microsatellite instability status, helps in selecting the most effective systemic therapies . This personalized approach aims to optimize treatment efficacy while minimizing adverse effects.
Systemic Therapy: Chemotherapy, Targeted Therapy, and Immunotherapy
Systemic therapy for colon cancer has expanded beyond traditional chemotherapy. Targeted therapies and immunotherapies are now integral parts of treatment regimens, especially for metastatic colorectal cancer (mCRC). Biomarkers such as KRAS/NRAS/BRAF mutations and microsatellite instability status guide the use of these therapies. For instance, checkpoint inhibitors are recommended for mCRC with deficient mismatch repair/microsatellite instability-high status .
Alternative and Complementary Treatments: Medicinal Plants and Nano-Herb Medicine
In addition to conventional treatments, alternative approaches using medicinal plants have gained attention. Plants like grape, soybean, green tea, garlic, olive, and pomegranate have shown efficacy against colon cancer through various mechanisms, including induction of apoptosis and reduction of DNA oxidation. Furthermore, innovative treatments like nano-herb medicine combined with photodynamic therapy (PDT) have demonstrated promising results in activating immune responses and inhibiting tumor growth without significant side effects.
Comparison of Western and Asian Guidelines
There are notable differences between Western and Asian guidelines for managing colon cancer. Asian guidelines emphasize endoscopic techniques for early-stage cancer and advocate for extended lymphadenectomy in certain cases, while Western guidelines are more conservative in this approach. Additionally, only US guidelines include recommendations for neoadjuvant chemotherapy and radiotherapy. These variations reflect different treatment philosophies and highlight the need for further research to standardize care.
Conclusion
The treatment of colon cancer involves a multifaceted approach, including surgery, chemotherapy, radiotherapy, and emerging personalized and alternative therapies. Advances in molecular profiling and systemic therapies have significantly improved patient outcomes. However, ongoing research and clinical trials are essential to refine these treatments and address the variations in guidelines across different regions.
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