Colorectal cancer: what role does tumor localization play?

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The tumor location allows to improve the efficiency of the treatments.

The Cancer It is one of the issues that most concern society due to the high incidence it has and that, despite the fact that mortality is decreasing, the figure is still high. “There are approximately 220,000 new cases a year of cancer. Of these, approximately 100,000 will die, that is, We are around 50 or 55 percent of people who will be able to be cured of a disease like cancer“, Explains Eduardo Díaz-Rubio, head of the Oncology Service of the San Carlos Clinical Hospital, in Madrid.

Within these figures is the colorectal cancer, the most incident in Spain ahead of other more known (As the breast cancer, for example), because it can manifest itself in both men and women. “The positive fact is that although it is the cancer with the highest incidence, approximately 60 percent of patients get cured,” says Díaz-Rubio.

One of the aspects that favors that the figures of cure increase is the evolution that has taken place and that is taking place in the treatments. “In the initial stages of the disease, with surgery and adding an adjuvant treatment of chemotherapy for six months the cure of the disease is achieved and also without leaving any sequelae in such a way that the quality of life that these patients have is very good, “says the expert, who points out that the situation changes for those in which there is metastasis and the cancer has spread to other areas of the body.

Evolution of treatments

Does that mean that the situation for patients with metastatic colon cancer is irreversible? Díaz-Rubio clarifies that this is not the case and that there is a wide variety of options to treat the disease when it is at an advanced stage, beginning with the traditional treatment, chemotherapy, to which biological drugs are added and immunotherapy for some subgroup of patients. .

However, what is marking a turning point are the latest advances that have occurred today, which have allowed identifying specificities and genetic alterations of each tumor, which is known as precision medicine: a personalized option in which we try to individualize the treatment in each of the cases, according to the specialist.

In this new scheme there is a new alternative of hope: tumor localization.The tumor location has really been a surprise. Until a year ago we had not realized that the tumors are different depending on where they are located, in the right or left colon “, -apostilla Díaz-Rubio and continues-, “In patients who have a location in the left colon have a better prognosis and respond better to many treatments that we have now available.”

The expert insists that the important thing is not only the location, but also to know which is the genetic alteration that comes with it, in this way the alternatives for each patient can be improved. “Those that have been located on the left side seem to respond better to drugs anti-EFGR drugs against a particular gene that is the EFGR gene. On the other hand, on the right side, in which they have a worse prognosis, they respond better to antiangiogenic drugs “.

The expert concludes that not always having an advanced disease determines that the only possible treatment is chemotherapy. “There are more options, the important thing is to integrate absolutely everything.”

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