Saturday, August 04, 2007

An Unwanted Journey: Day 0616 - HRT, Chemo, and Survival

There are few days that pass without news of research promising hope for colorectal cancer patients. Yesterday witnessed two announcements worth noting.


The first might be considered obvious. Adjuvant chemotherapy for Stage II colorectal cancer patients improves survival rates; in other words, if you've been diagnosed with Stage II colorectal cancer and presumably already been treated surgically, the risk of local disease recurrence is lessened by post-surgical chemotherapy, probably following a typical regime of FOLFOX or FOLFIRI.

What is surprising, at least from my own experience with Stage III rectal cancer, is that 5-fluorouracil-based adjuvant chemotherapy isn't standard practice following surgery for Stage II colorectal cancer. An Australian 10-year study between 1993 and 2003 demonstrated a definite survival benefit of adjuvant chemotherapy.

My own experiences with adjuvant chemotherapy were not pleasant, although I was able to continue working some of the time during treatment. Towards the end of my cycle, my sick days grew in number significantly, making performance of my job responsibilities increasingly difficult.

But studies like this are comforting. Despite the treatment-induced illness, it's good to know that adjuvant chemotherapy has solid statistical evidence to warrant the side effects even if one has no evidence of disease following surgery.


The second interesting piece of news is even more suggestive of changing perspectives on the nature of colorectal cancer. Work by researchers at the Kimmel Cancer Center at Jefferson in Philadelphia suggests that colorectal cancer is not so much a genetic disease as an endocrine disease with a hormone solution.

The research indicates that the growth of intestinal tumors is regulated both by size and number by GCC, guanylyl cyclase C, a protein receptor on the epithelial cells of the gastorintestinal tract. Almost all colorectal cancer patients are afflicted by both carcinogenic agents and mutations in the APC gene regulated by the GCC protein.

I know, your eyes are now glazing over. But the point and the promise of this research is that hormone replacement therapy (specifically guanylin and uroguanylin) looks like it can be applied to both prevent and treat colorectal cancer.


As they say at the Lance Armstrong Foundation, knowledge is power. I'm not saying that you have to read every research article published today. I'm not saying that you need to become an expert on leading-edge hormone replacement therapies. But if, like me, there are days when survival seems harder than it should be, remember the LAF Manifesto, become more knowledgeable, and inspire yourself. Here's a start - watch this video, an excellent counterpoint to the video referenced in my previous blog Never the Same.

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