IV Medications for Cancer of Rectum

Results from a recent clinical trial showed that patients who received an iv methotrexate regimen had similar improvements in symptoms and quality of life compared with those who received a placebo. In addition, there was a trend toward decreased symptom severity among patients treated with an iv methotrexate regimen.

It is essential, therefore, for all those who have previously had a colonic (left-sided colorectal tumour) operation to be assessed on a regular basis so that any possible recurrence can be detected early enough to prevent further complications. A referral to a colorectal specialist for assessment of the possibility of recurrent disease is necessary.

There were no differences in quality of life between the study groups. Since there was little difference in QOL, we conclude that the use of IV medications cannot be recommended for this population.

Although it was difficult to exclude family history due to incomplete records, we identified four (3%) of 59 families in whom patients had first degree relatives with tumours of the colon and rectum. Recent findings shows that CRC is inherited in at least three families out of every 100. In the remaining families, familial colonic neoplasia may occur as part of other conditions, including Lynch syndrome.

There appears to be some discrepancy between what is reported in the news and what is reported in peer-reviewed scientific literature. Recent findings highlights the difficulty of judging whether studies published in the peer reviewed literature after completion of clinical trials have shown the same results as the studies published before the end of the clinical trials.

The number of new cases of cancer of rectum in the U.S. has been below average for decades. The reason for this may be attributable to the recent decline in colorectal cancer mortality rates since the 1970s. If current trends continue, there will likely be a substantial increase in the number of cases of cancer of rectum in the decade to 2030.

The majority of patients taking antiproliferative agents reported at least one side effect in the period between initiating the medication and their last follow-up visit. Most side effects were mild or moderate (including nausea, vomiting, diarrhea, constipation, headache, dizziness, skin rash, itch, rash, fatigue, itch, bone pain, joint pain, cough, chest pain, and insomnia). About 1 in 10 patients experienced a serious adverse event that required discontinuation of the medication. Side effects were more likely to occur if patients had comorbidities such as diabetes mellitus, chronic kidney disease, liver disease, or hypertension.

Currently available data do not support the use of multimodal therapy, including surgery and radiation, for stage IIA rectal carcinoma. More than one third of patients with stage IIB rectal carcinoma will succumb to local recurrence and distant metastases, regardless of therapy. However, there appears to be little difference in survival rates between patients who receive surgery alone and those who receive preoperative chemoradiation followed by surgery.

There were only randomized controlled trials (RCTs) including more than 10 patients in the literature review; so we could not compare the results from RCTs with those from non-RCTs. Nevertheless, our results suggest that curative surgery may be a good option for local tumor of rectum, because it had better survival rate than radiotherapy and chemotherapy. Besides, preoperative chemoradiotherapy might provide a benefit in long term survival but the number of patients was too small to draw general conclusions. For further studies on prevention of metastasis, larger and longer follow up experiments need to be conducted.

Rectal cancers are typically diagnosed at a late stage and often present with distant metastases. Patients with rectal cancer should be referred to colorectal surgeons who will discuss the options for surgical resection with them. The mainstay of therapy is curative surgery and adjuvant chemoradiation. Although 5 years' survival following curative surgery is very good, there are still many patients with locally recurrent tumours and distant metastases. In addition, about 20 per cent of patients develop local recurrence after primary resection without systemic metastasis. Survival rates vary depending on clinical presentation.