by Jennifer Abney
Published: Mon, September 08, 2008 - 4:10 am CST
Colorectal cancer is the third most common type of cancer diagnosed in American men and women and the second leading cause of death. This year, the American Cancer Society estimates 148,810 new cases will be diagnosed in the U.S. About 49,960 people will die of the disease. An important risk factor for colorectal cancer is the formation of polyps, tiny growths that project from the wall of the colon or rectum. Researchers estimate about 30 to 40 percent of Americans over 50 have one or more. Most are benign. However, one type of polyp, called an adenoma, has the potential to turn into a cancer. The transition to cancer is usually a slow process, taking 10 to 15 years. Thus, doctors recommend regular screening and removal of polyps to greatly reduce the chance of developing colorectal cancer. Screening should begin at 50 for those without any risk factors for the cancer. Those with a family history or other risk factors may need to start screening at a younger age.
Targeting Polyps
Even if a polyp is removed, it can come back or others can grow elsewhere along the colon/rectum. Researchers recently studied the use of a drug combo, using difluoromethylornithine (DFMO) and sulindac, on recurrence rates of colorectal polyps. DFMO prevents the formation of cancer cells. Sulindac is an anti-inflammatory drug. Scientists theorized the drugs would compliment each other and prevent the formation of polyps.
The study enrolled 375 patients with a history of at least one colorectal adenoma (the type of polyp most likely to become cancer). For three years, half of them received the combo drugs and half received a placebo. Overall, the risk of adenoma recurrence was reduced by 70 percent among those who received the drug combo (12.3 percent recurrence in the combo group vs. 41.1 percent in the placebo group). The benefit was even better for participants who originally had one large polyp or multiple polyps, with a recurrence reduction of 90 to 95 percent.
Eugene Gerner, Ph.D. is Research Director and Director of the Gastrointestinal Cancer Program at Arizona Cancer Center. He says the treatment combo may benefit other patients as well. A small percentage of colorectal cancers develop from flat lesions in the lining of the colon/rectum. These flat cancers aren’t always detected during routine screening. But the drug combo may also prevent their formation. The treatment may also be helpful for patients who are genetically at higher risk for colorectal cancer.
Gerner says DFMO can lead to minor hearing loss in a minority of patients. But there is now a blood test to screen patients and determine who may be at risk for this side effect. In the future, the researchers want to determine if patients with these high-risk polyps may be able to increase the time between screenings if they take the drug combo.
For general information on colorectal cancer:
American Cancer Society, http://www.cancer.org
National Cancer Institute, http://www.cancer.gov
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