Effectiveness of Regional Chemotherapy on Colon Cancer

Video Transcript

"Chemotherapy is used in two settings in colon cancer. First, for patients who don't have metastatic disease, and then patients who have metastatic disease. For the patients who don't have metastatic disease, it should be offered and commonly is offered at least with stage three disease, and some patients with stage two disease who have higher risk. Again, stage three disease patients, no spread outside the colon, but there are lymph nodes that are involved near the colon with the cancer. Stage two, no lymph nodes are involved, no spread to outside organs, but a little deeper through the bowel wall. In those patients, we use chemotherapy for about six months to try to reduce the risk of reoccurring. There have been large, randomized trials, particularly for stage three patients, where it's shown that it decrease the recurrence rate and improves overall survival. For patients with metastatic disease, there have been a lot of advances in the treatment in terms of chemotherapy, particularly over the past 10 years. Before 1998, there was a single drug FDA-approved, 5 Fluorouracil, for the treatment of colorectal cancer. Now there are seven drugs in five different drug categories that are useful in the treatment of colorectal cancer. Back before 1998, the median survival of metastatic colorectal cancer was about a year. Now, with the use of multiple other agents that are helpful against the disease, the median survival is great than two years. So there have definitely been advances, though there's clearly a long way to go in treating patients even with metastatic disease, where there's use of chemotherapy both to palliate symptoms, prolong life, and also to maintain good quality of life while people are getting treatment."