Cancer Treatment

Rectal cancer

4 min read
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Rectal Cancer Trials

Rectal Cancer

Rectal cancer is a type of cancer that affects the rectum, the lower part of the large intestine. It is one of the most common types of cancer worldwide, with thousands of new cases diagnosed each year. The exact cause of rectal cancer is unknown, but it is believed to be related to both genetic and environmental factors.

Epidemiology

Epidemiological studies have shown that certain risk factors can contribute to the development of rectal cancer. These include older age, a family history of colorectal cancer, a personal history of colorectal polyps or inflammatory bowel disease, and a diet high in red or processed meats and low in fruits and vegetables.

Early detection plays a crucial role in improving the prognosis of rectal cancer. Regular screening tests such as colonoscopy or sigmoidoscopy can help identify precancerous polyps or early stage tumors, enabling timely treatment.

Diagnosis

Diagnosing rectal cancer involves several steps. If symptoms such as changes in bowel habits, blood in the stool, or abdominal pain are present, a healthcare provider may recommend further tests including a physical examination, blood tests, imaging scans (such as CT or MRI scans), or a biopsy to confirm the diagnosis.

Pathological examination of tumor samples obtained through biopsy provides valuable information about the stage and characteristics of the cancer, guiding treatment decisions.

Treatment

The treatment of rectal cancer varies depending on the stage of the disease. It often involves a combination of surgery, radiation therapy, and chemotherapy.

  • Surgery: Surgery is the primary treatment for localized rectal cancer. It aims to remove the tumor and nearby lymph nodes. In some cases, a temporary or permanent colostomy may be necessary.
  • Radiation Therapy: Radiation therapy uses high-energy X-rays or other types of radiation to kill cancer cells or shrink tumors. It is commonly used before surgery to reduce the size of the tumor or after surgery to destroy any remaining cancer cells.
  • Chemotherapy: Chemotherapy involves the use of drugs to kill cancer cells throughout the body. It can be administered either before surgery (neoadjuvant) to shrink the tumor or after surgery (adjuvant) to destroy any remaining cancer cells and reduce the risk of recurrence.

Current Drugs for Rectal Cancer

There are several important drugs currently used in the treatment of rectal cancer:

  • 1. Fluorouracil (5-FU): This chemotherapy drug is often combined with other drugs and radiation therapy to treat rectal cancer.
  • 2. Oxaliplatin: Another chemotherapy drug commonly used in combination with 5-FU to treat advanced rectal cancer.
  • 3. Capecitabine: This oral chemotherapy drug is an alternative to 5-FU for both pre- and post-surgery treatment of rectal cancer.
  • 4. Bevacizumab: It is a targeted therapy that works by inhibiting the growth of blood vessels in the tumor, thereby restricting its blood supply.
  • 5. Cetuximab: This targeted therapy specifically targets a protein called epidermal growth factor receptor (EGFR), which is often overexpressed in rectal cancer cells.

Promising Future Drugs in Clinical Trials

There are several exciting clinical trials underway for rectal cancer, exploring new treatment options. Some of the promising drugs in late-stage clinical trials include:

  • 1. Pembrolizumab: This immunotherapy drug works by activating the immune system to recognize and destroy cancer cells. It has shown promising results in other types of cancer and is now being evaluated in rectal cancer clinical trials.
  • 2. Trifluridine/tipiracil (TAS-102): This combination drug has demonstrated efficacy against colorectal cancer, including rectal cancer, in clinical trials. It is currently being studied further to assess its potential in treating advanced or metastatic rectal cancer.
  • 3. Napabucasin: This investigational drug targets cancer stem cells, which are believed to be responsible for tumor growth and resistance to treatment. Clinical trials are underway to determine its effectiveness in rectal cancer.
  • 4. Nivolumab: Similar to pembrolizumab, this immunotherapy drug helps activate the immune system to fight cancer cells. Trials are ongoing to evaluate its efficacy in rectal cancer.
  • 5. Regorafenib: This targeted therapy inhibits multiple signaling pathways involved in cancer cell growth. It has shown promise in clinical trials for advanced colorectal cancer, including rectal cancer.

In conclusion, rectal cancer is a significant health concern with various risk factors and diagnostic procedures. The treatment options for rectal cancer include surgery, radiation therapy, and chemotherapy. Currently, several drugs such as fluorouracil, oxaliplatin, capecitabine, bevacizumab, and cetuximab are commonly used in the management of rectal cancer. Excitingly, there are promising drugs like pembrolizumab, trifluridine/tipiracil, napabucasin, nivolumab, and regorafenib that are being investigated in late-stage rectal cancer clinical trials. Continued research and development in the field of rectal cancer hold great potential for improving patient outcomes and advancing the treatment landscape.