Treatment of colon cancer is a matter of debate among the scientific community. To date, both the researcher and the treating physician have several options for colon cancer treatment. Such options include a surgical excision of the tumor mass, radio-ablation therapy, systemic treatment such as chemotherapy, and targeted therapy or immunotherapy. Different combinations involving these treatment options have been attempted, weighing benefits against possible side effects and risks involved. However, generally, the treating physician in consultation with the patient, takes a decision on treatment protocols.

Advanced stage of colon cancer like stage III and IV generally requires a surgical excision of the tumor mass in conjunction with long-term chemotherapy, to reduce the recurrence rate. Mostly, such chemotherapy regimens are for six months or more. Although long-term chemotherapy following surgical excision has its benefits, there are also certain side effects. The longer the period of treatment, the more are the side effects that may arise. The scientific community, for long, has been in search of a more effective short-term chemotherapy regimen, so that the side effects are minimized, and therapy benefits maximized.

A recent study pooled data from 6 different studies conducted in North America, Europe, and Asia, to determine whether a 3-month chemotherapy regimen is as effective as a 6-month chemotherapy regimen. Results of the study indicated that a short course (3-month) chemotherapy regimen was equally effective as a long course (6-month) therapy in preventing recurrence of colon cancer (74.6% as against 75.5%). In patients with minimal risk of cancer recurrence, the difference was even smaller (only about 0.2%).

On the other hand, there was a significant difference in the occurrence of side effects. Nerve damage, which is a major side effect of chemotherapy, was observed to be three times more in patients who underwent 6-month chemotherapy regimen in comparison to those who underwent 3-month chemotherapy regimens. Other side effects, such as hair loss and diarrhea, were found in patients of both the 3-month and 6-month treatment course; but, these were transient. It was evident that the lesser the treatment duration, the lesser will be the incidence of side effects, the number of doctor appointments, the number of blood draws, time away from work and social interaction. Eventually, shorter chemotherapy will lead to an increase in the patient’s quality of life.

The study conducted was huge, involving more than 12,800 patients from around 12 countries. So, the results can be generalizable. It is also reported to be a unique study that helps explore options for the betterment of cancer patients. Based on the positive results obtained from the study, ASCO expert Dr. Braxter said that “this is an extremely important work that will affect the lives of many of my patients hopefully tomorrow, and will allow us to provide a more personalized approach to our patients with colon cancer.”

Written by Krishna Tangella, MD

References:

1. Global Study Sets New Risk-Based Standard to Personalize Chemotherapy for Colon Cancer After Surgery [Internet]. ASCO. 2017 [cited 2017 Jun 10]. Available from: https://www.asco.org/about-asco/press-center/news-releases/global-study-sets-new-risk-based-standard-personalize
   
2. Treating Colorectal Cancer [Internet]. [cited 2017 Jun 10]. Available from: https://www.cancer.org/cancer/colon-rectal-cancer/treating.html