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At least 145 records · Page 8Linked to original sources
PubMed2006

Probiotics, prebiotics and synbiotics: a role in chemoprevention for colorectal cancer?

Colorectal cancer (CRC) is the third most common form of cancer. Current treatments including chemotherapy, radiotherapy and surgery are all associated with a high risk of complications and are not always successful, highlighting the need to develop new treatment strategies. The ingestion of probiotics, prebiotics or combinations of both (synbiotics) represents a novel new therapeutic option. Probiotics and prebiotics act to alter the intestinal microflora by increasing concentrations of beneficial bacteria such as lactobacillus and bifidobacteria, and reducing the levels of pathogenic micro-organisms. This strategy has the potential to inhibit the development and progression of neoplasia via mechanisms including; decreased intestinal inflammation, enhanced immune function and anti-tumorigenic activity, binding to potential food carcinogens including toxins found in meat products, and a reduction in bacterial enzymes which hydrolyse precarcinogenic compounds, such as beta-glucuronidase. There is substantial experimental evidence to suggest that probiotics and prebiotics may be beneficial in the prevention and treatment of colon cancer, however to date there have been few conclusive human trials. Probiotics and prebiotics have the potential to impact significantly on the development, progression and treatment of colorectal cancer and may have a valuable role in cancer prevention.

Anticarcinogenic Agents↗
PubMed2002

Resection of pulmonary metastases from colorectal cancer.

Colorectal cancer is one of the most prevalent malignancies in the United States. It has a well-recognized tendency to metastasize to the lungs, and under certain circumstances, these metastases are resectable. Data accumulated over the last 40 years support a survival benefit from resection of these lesions and have given a better understanding of the indications that should be adhered to in performing metastasectomy for colorectal cancer.

Colorectal Neoplasms↗
PubMed2001

Oophorectomy in primary colorectal cancer.

Colorectal cancer is a common cancer affecting women which may metastasize to the ovaries. We present five cases of ovarian metastases requiring surgery and review the debate regarding oophorectomy at the primary resection for colorectal cancer. Although prophylactic oophorectomy has not been proven to affect survival, further surgery for symptomatic ovarian metastases may be avoided and the increased risk of developing primary ovarian cancer is abolished.

Adult↗
PubMed2004

Chemoprevention of colorectal cancer.

Colorectal cancer is a disease with a high mortality rate and it has been increasing in prevalence worldwide. Chemoprevention, as well as primary and secondary prevention, for colorectal cancer have attracted much attention. Many chemopreventive trials have been performed, and several agents, including nonsteroidal antiinflammatory drugs, such as aspirin and sulindac, cyclooxygenase-2 selective inhibitors, such as celecoxib, vitamin D, folate, and calcium, have been shown to have some effect. In these chemopreventive trials, the targeted lesions used for evaluation were mainly polyps. However, the chemopreventive effects of some agents on polyps may require several years to evaluate. Further, larger polyps may not be susceptible to chemopreventive agents. Aberrant crypt foci (ACF) are tiny lesions at the earliest stage of colorectal carcinogenesis, which consist of large, thick crypts identified by dense, methylene blue staining. We succeeded in identifying human ACF in situ using magnifying endoscopy and found that the number of ACF, particularly dysplastic ACF, increased significantly from normal subjects to adenoma patients and then to cancer patients. We also found that the number, size, and dysplastic features of ACF are significantly correlated with the number of adenomas in adenoma patients. Thus, it was surmised that ACF are precursor lesions of the adenoma-carcinoma sequence in humans and that ACF may be the most appropriate lesions as targets for chemoprevention. We have shown that the number of ACF was significantly reduced in patients treated with sulindac. We are currently proceeding with a randomized, double-blind, chemopreventive trial targeting ACF.

Animals↗
PubMed1986

[Chemotherapy of advanced and recurrent colorectal cancer].

Colorectal cancer is one of the most resistant tumors to chemotherapy. The efficacy of many kinds of anti-tumor drugs to the patients with colorectal cancer had been investigated, however most of the drugs was not effective or showed low response rates. As a few effective anti-tumor drug, 5-FU and its derivatives, nitrosoureas and mitomycin C were indicated. Response rates of combinations of these drugs were 20-30%. Methotrexate-5-FU with leucovorin therapy at proper administration intervals showed relatively high response rate to the patients. Effects of intra-arterial infusion of the drugs which often performed to the liver metastases were not so well as expected. Developments of new anti-tumor agents were essential.

Angiotensin II↗
PubMed2001

APC, signal transduction and genetic instability in colorectal cancer.

Colorectal cancer arises through a gradual series of histological changes, each of which is accompanied by a specific genetic alteration. In general, an intestinal cell needs to comply with two essential requirements to develop into a cancer: it must acquire selective advantage to allow for the initial clonal expansion, and genetic instability to allow for multiple hits in other genes that are responsible for tumour progression and malignant transformation. Inactivation of APC--the gene responsible for most cases of colorectal cancer--might fulfil both requirements.

Animals↗
PubMed2004

Progress in the development of novel treatments for colorectal cancer.

Colorectal cancer remains one of the major causes of cancer death worldwide, but the past few years have witnessed the development of a number of new, effective treatment options, which have led to considerable improvement in the survival rate for patients suffering from this common cancer. The advent of agents such as capecitabine (Xeloda), irinotecan (Camptosar), and oxaliplatin (Eloxatin), and newer molecular targeted agents such as cetuximab (Erbitux) and bevacizumab (Avastin) brought innovation to the treatment of colorectal cancer. Oncologists are no longer restricted to using fluorouracil and its variations as the only active treatment, and the number of patients who are able to live longer continues to increase. Patients presenting with stage III cancer can expect a greater chance for cure, and those presenting with metastatic disease can expect a median survival approaching 2 years.

Antibodies, Monoclonal↗
PubMed2002

Adjuvant treatment of colorectal cancer.

Colorectal cancer is a leading cause of morbidity and mortality, with approximately 300,000 new cases and 200,000 related deaths in Europe and the USA each year. Adjuvant treatment of colorectal cancer is now widely accepted and can reduce mortality with approximately 10%. This can be considered as one of the major achievements in oncology from the past decade. Current results will be discussed and strategies for the future will be outlined, including on-going or planned large-scale trials with new drugs and approaches.

Chemotherapy, Adjuvant↗
PubMed2005

Chemoprevention of colorectal cancer.

Colorectal cancer is the 3rd most common form of cancer and the 2nd leading cause of death among all cancer diseases in Europe. The risk of developing colon cancer in the lifetime is about 7% and is gradually increasing with age. Mutation of protooncogenes, tumor-suppresor genes (particularly APC 1 and 2, k-RAS, P53 e.i.) and DNA repair genes (hMSH-2 and -6, hMLH-1, MMR) is leading to unrestricted cell division. Most colorectal cancers should be preventable by an increased surveillance, improved lifestyle, dietary protective agents, and probably, by a targeted chemoprevention. A re-evaluation of the colon cancer chemoprevention in the light of the recent results of clinical data is presented (Ref. 12).

Anticarcinogenic Agents↗
PubMed2005

Prevention and therapy of colorectal cancer.

Colorectal cancer is expected to affect more than 146,000 and kill more than 57,000 Americans in 2004. Increased understanding of carcinogenesis is transforming clinical approaches to all stages of this disease. During the last 5 years, four new drugs have been approved for colorectal cancer treatment, and substantial progress has been made in identifying and developing agents that prevent or delay carcinogenesis. These advances substantiate target-driven approaches to cancer prevention and treatment, and provide fruitful opportunities for future investigations.

Cell Transformation, Neoplastic↗
PubMed2000

Protein degradation in the large intestine: relevance to colorectal cancer.

Colorectal cancer is the second most common form of cancer death in Western countries. Diet has been implicated in the aetiology of this disease. Epidemiological evidence suggests that diets high in meat and fat and low in fermentable carbohydrate increase colorectal cancer risk. One mechanism that could explain the association with meat is increased colonic protein metabolism due to increased protein intake from high meat diets. Products of colonic protein degradation and metabolism include ammonia, phenols, indoles and amines which have been shown to exert toxic effects in vitro and in animal models. These compounds are present in faecal samples suggesting that they may exert gut mucosal effects. Human studies have shown that colonic protein metabolism via the gut microflora is responsive to dietary protein as faecal ammonia and urinary phenolic compound concentrations increase in response to increased intake of protein rich foods. Other toxic metabolites from dietary protein precursors such as N-nitroso compounds and sulphides are also formed. Recent work has shown that diets high in meat, fat and low in fibre increase human faecal water genotoxicity. It is likely that metabolites from colonic protein metabolism contribute to this increase in genotoxicity during high meat intakes.

Adult↗
PubMed2003

Colorectal cancer.

Colorectal cancer (CRC) is one of the leading causes of mortality and accounts for approximately 200000 deaths per year in Europe and the USA. Chemotherapy and radiotherapy have established roles in the treatment of colorectal cancer and can contribute to cure rate, prolongation of survival, reduction of local rates of recurrence and enhanced quality of life in patients with advanced disease. However, over the past few years there have been major advances in our understanding of the molecular basis of this tumour and its progression from adenoma to carcinoma that hold potential for translation into novel strategies for the treatment of CRC. Furthermore, newer agents directed against different intracellular targets have also been shown to be efficacious in CRC treatment. Such improvements should continue to lead to increased cure rates in early disease and better overall survival in advanced cases. The aim of this review is to provide an overview of the pathogenesis of CRC and to present the evidence base for chemotherapy and some of the novel strategies that are currently being evaluated in phase I and II trials.

Antineoplastic Agents↗
PubMed2006

Modern challenges in colorectal cancer.

Colorectal cancer is a major problem worldwide and in the United Kingdom it is responsible for some 20,000 deaths per annum. Mortality from the disease is gradually decreasing in developed countries but, in the United Kingdom at least, its incidence is on the increase. In this article the major current challenges in colorectal cancer will be dealt with under the following headings: aetiology and prevention, early detection, diagnosis, surgery, adjuvant therapy and management of advanced disease.

Colorectal Neoplasms↗
PubMedDate not supplied

Improved imaging and the clinician: the role of positron emission tomography in the management of colorectal cancer.

Colorectal cancer is the second most common cause of cancer death in the United States and Western Europe. Positron emission tomography (PET) has been shown to be a valuable tool for the evaluation of malignancies of the breast, lung, and gastrointestinal tract. Potential areas of utility in patients with colorectal cancer include early detection, improved staging at the time of initial diagnosis, the detection and staging of recurrent disease, and early determination of treatment response. Despite continued advancement in the technical aspects of PET, the true measure of its worth is how well it assists the clinician in the care of the patient. To best use the information provided by PET, the nuclear medicine physician and oncologist must both understand the treatment choices available for patients at various stages in the disease.

Colorectal Neoplasms↗
PubMed2001

Conventional cytotoxic and novel therapeutic concepts in colorectal cancer.

Colorectal cancer (CRC) is a major cause of death, particularly in the Western world, leading to 400,000 deaths each year. Of the patients, 30% have advanced disease at presentation, either locally or at distant sites and chemotherapy in this setting has an established role in improving survival and palliating symptoms. In addition, approximately 50% of those patients initially believed to be cured by surgery, subsequently relapse and die of their disease. Adjuvant chemotherapy administered for six months after surgery for Dukes C colon cancer improves absolute survival by 5-10%. However, the role of adjuvant chemotherapy in Dukes B colon or Dukes B/C rectal tumours is still controversial and is only recommended within the scope of a randomised clinical trial. Cytotoxic drug development for colorectal cancer has traditionally followed the established pathway of Phase I, Phase II and then Phase III trials in advanced disease, with subsequent translation into the adjuvant setting. For the purpose of this review current conventional chemotherapy for advanced CRC is described, followed by an explanation of newer developments that are predicated upon our increasing understanding of the molecular processes underpinning malignant transformation, invasion and metastasis. Paradigm shifts in trial design necessitated by a mechanistic approach to drug development are also discussed.

Antineoplastic Agents↗
PubMed2001

Current surgical management of colorectal cancer.

Colorectal cancer is the leading cause of death from gastrointestinal malignancies in the United States. Recent emphasis on screening of high-risk and no-risk individuals in addition to careful postoperative surveillance has decreased the incidence and improved the quality of life of survivors. Although multimodality approaches to treating colorectal cancer are favored, surgical resection continues to be the mainstay for a cure. This article reviews current surgical approaches and advances based on evidence for best practice.

Adult↗
PubMed2004

Genetics of colorectal cancer.

Colorectal cancer (CRC) is the second leading cause of cancer-related mortality in the United States. As such, it assumes a significant role in both health policy decision-making and scientific research. CRC has been a model for investigating the molecular genetics of cancer development and progression; this is in part due to the easily detectable, sequential transition of cells from normal colonic epithelium to adenoma and then to adenocarcinoma. In addition, familial syndromes that predispose to CRC, such as familial adenomatous polyposis (FAP) and hereditary nonpolyposis colorectal cancer (HNPCC), have significantly contributed to our understanding of the genetic mechanisms underlying CRC formation. It is now well recognized that hereditary CRC syndromes are due to germline mutations of genes that function as tumor suppressors or, less frequently, oncogenes. Accumulation of subsequent mutations in other genes with related functions results in the stepwise progression to carcinoma. It is important to note that somatic changes in similar genes are involved in the formation of sporadic CRC. The identification of these important CRC-related genes may help facilitate the early diagnosis, prevention, and treatment of CRC. This article reviews the various familial CRC syndromes along with their genetic etiology, as well as discusses the principle of genetic testing for these conditions.

Colorectal Neoplasms↗
PubMed2005

[Advantage of immunochemical fecal occult blood test in screening for colorectal cancer].

Colorectal cancer screening is a high public health priority in all industrialized countries. However, the low sensitivity of the common guaiac screening test (Haemoccult II) makes practitioners and public health deciders reluctant to set up national screening program. In recent years, immunochemical tests based on the use of a specific antibody have been found to be more sensitive than the Haemoccult II test. However, for screening purposes, any gain in sensitivity is of interest only if specificity and positive predictive value are satisfactory. As instance, rehydration of the Haemoccult II test prior to lecture can increase sensitivity, but the associated decrease in specificity and positivity predictive value and the high positivity rate render its value in mass screening debatable. Moreover, extra costs, if existing, must be acceptable for the society. Until recently, immunochemical tests costs made it unaffordable in our societies. The arrival of automated reading is likely to remove this obstacle. Moreover it offers the opportunity of positivity cut-off choice. A recent study was conducted in Cotentin (France) to assess the performance of an immunochemical test with an automated reading technique (Magstream 1000) for different haemoglobin content cut-off points. As previous American, Japanese, Chinese and Italian studies, this study suggests that the use of immunochemical tests could lead a substantial gain, in screening sensitivity. Moreover by choosing a higher haemoglobin content as cut-off point (50 ng/ml instead of usual cut-off at 20 ng/ml), a gain in sensitivity can be obtained with a satisfactory specificity (97%) and positivity rate (3%). Considering the increasing number of publications, the use of an immunochemical test with an automated reading technique could improve the prospects for mass-screening for colorectal cancer, since it offers a promising alternative to guaiac tests.

Colorectal Neoplasms↗