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In addition to chemotherapy for stage four colon cancer, recently, there has been some research that has shown the effectiveness of immune therapy in a subset of patients with colon cancer who have a certain mutation. So if these mutations are found in the tumor cells, based on studies that are done after surgery or biopsy, we know that those patients can actually benefit from chemotherapy for their stage four colon cancer, which is a very exciting new development and a great new option for these patients who will not have had this option in the past and often would have had no option after a recurring from their treatment or becoming resistant to the chemotherapy.
In addition to chemotherapy for stage four colon cancer, recently, there has been some research that has shown the effectiveness of immune therapy in a subset of patients with colon cancer who have a certain mutation. So if these mutations are found in the tumor cells, based on studies that are done after surgery or biopsy, we know that those patients can actually benefit from chemotherapy for their stage four colon cancer, which is a very exciting new development and a great new option for these patients who will not have had this option in the past and often would have had no option after a recurring from their treatment or becoming resistant to the chemotherapy.
The treatment for rectal cancer is a little bit different than for patients with colon cancer. Depending on the stage of the patient's rectal cancer, we often offer combined chemo radiation prior to undergoing surgery. Studies have shown that the neoadjuvant or pre-surgery chemo radiation can help to reduce the risk of local recurrence for such patients. Once you have completed chemo radiation, the patients then undergo surgery afterwards and after recovering from surgery, they receive further systemic chemotherapy for several months.
Regarding prevention of colon cancer, studies have shown that patients who are physically active or exercise regularly have a lower risk of developing colon cancer. In addition, we do believe that diet also has a role in preventing colon cancer, specifically with low fat and low animal protein diet with more fruits and vegetables and a high fiber diet can also be protective. Lastly, an aspirin a day can also help protect against the developing colon cancer, in addition to supplements of calcium and vitamin D on a daily basis can also be protective.
Once the patient has completed treatment with surgery, chemotherapy, and possibly radiation therapy, there are other ways to help prevent a recurrence of the colon cancer. Multiple studies actually have shown that physical activity or exercise both during treatment and after treatment can be helpful. During chemotherapy, if patients are physically active, it helps them to respond better to treatment and after completion of treatment, if they continue to be physically active, it also helps to help prevent recurrence of their cancer. With regard to diet, we also feel and know actually that the low fat and low protein or animal protein diet can also be protective. This needs to be proven in future studies. In addition, an aspirin a day, as well as daily supplements of calcium and vitamin D can also be protective. Patients also need to follow up with a gastroenterologist in order to undergo colonoscopies in the future, as recommended periodically to help detect any recurrence of colon cancer.
The best option for screening for colon cancer is a colonoscopy, which is done by a gastroenterologist. This is highly recommended for everyone over the age of 50, and if you have a family history, you should do it earlier. Other options include CT colonography, which is a CT scan of the colon. It is a little bit less invasive and if there's a suspicious lesion that is found on CT colonography, those people still have to undergo a regular colonoscopy for biopsying of the suspicious lesion. I have some patients who absolutely refuse to do any colonoscopy. For those patients, I recommend to do a stool occult blood tests that will detect any microscopic evidence of bleeding in the stool as well as a Cologuard test, which is a newer test that looks for any evidence of DNA from any underlying potential tumors in the colon.
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