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Dr. Muzammil Shaikh

March is colorectal cancer awareness month. Colorectal cancer is the cancer that arises from the colon or rectum. It is the 3rd most common cancer in the world, occurring in more than 1,700,000 people. In India, the incidences of this deadly disease are rising due to the western form of lifestyle. Therefore, it is important spread awareness about colorectal cancer.

Around 25% of colorectal cancer patients are diagnosed with stage-IV or metastatic colorectal cancer (mCRC). This is emotionally disturbing for the patients due to fear of short-term survival, treatments, and effects on the family.

In the last two decades, the survival rates in stage IV/mCRC have almost doubled due to evolutions in treatment.

In Stage IV/ mCRC, the cancer spreads from the large intestine to other parts of the body, such as liver and lung. Cancer in this stage can be treated with chemotherapy, targeted therapy, immunotherapy, surgery or a combination of all.

The selection of targeted therapy is important, and it depends on the mutation status of the tumour cells.

According to guidelines, RAS testing is important in this stage to predict which treatment can offer maximum benefit to the patient based on the mutation status of the tumour. Anti-EGFRs (cetuximab) and anti-VEGFs (Bevacizumab) are two mainstay targeted therapy drugs in mCRC, based on mutation status.

In recent years, immunotherapy drugs have also shown benefit in a certain set of patients. Thus, development in personalized treatment methods, based on tumor markers, are much welcome.

As always, prevention is better than cure. The measures include maintaining a normal body weight, exercising regularly, avoiding alcohol, limiting intake of red and processed meats, including more vegetables, fruits, and fibrous foods in the diet, and avoiding smoking.

Also, talk to your doctor about colorectal cancer. And, remember, it’s never too late to fight this deadly disease.

This article has been written by Dr. Muzammil Shaikh, Consultant Medical Oncologist, PD Hinduja National Hospital & Medical Research Centre, Mumbai.