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Leukemia Living with Leukemia

FDA Approves New Cancer Fighting Drug


Author:

William Bulman, MD

Columbia Presbyterian Medical Center

Medically Reviewed On: May 07, 2001

The US Food and Drug Administration has approved the first oral treatment for colorectal cancer that has spread to other parts of the body.

The drug is called Xeloda (capecitabine), and reacts with an enzyme in the body that converts the drug into 5-fluororurocil, or 5-FU, a therapy standard in the treatment of colorectal cancer. The treatments are less disruptive, as patients can take their two daily doses at home, whereas standard chemotherapy treatment is delivered intravenously at an outpatient center.

Colon cancer, the most common type of colorectal cancer, is the third most common cancer in the US. For approximately 20 percent of its victims, the cancer has already spread by the time of diagnosis. 50 percent of all patients with colorectal cancer will develop a metastasis, and die from the disease.

But perhaps the darkest statistic about colon cancer is this: fewer than one third of the people who should be screened for colon cancer ever get the simple tests that can identify the cancer in its early, curable stages.

Taking the plunge
It often takes a great deal of discussion to get people to feel comfortable with what can be perceived as embarrassing or uncomfortable tests. Now and then patients will say things like, "I'm better off not knowing," or, "Why go looking for trouble?"

What these patients do not realize is that colon cancer is one of the deadliest diseases in our country today, but if caught early, it is 90 percent curable.

The following are brief descriptions of some of the most common screening techniques we use today.

Digital rectal exam
The digital rectal exam looks for colon cancer in two ways. First, it involves the insertion of a lubricated, gloved finger into the rectum. A full 10 to 15 percent of tumors can be identified this way. Second, testing the stool for traces of blood at the time of the exam identifies people who should have additional testing to rule out a colon cancer.

Fecal occult blood testing
The most common screening test for colon cancer is the fecal occult blood test, or FOBT. It's easy to do, relatively inexpensive, and can be done at home by collecting small samples of stool on a test card. These samples are tested in a laboratory or at a doctor's office for traces of blood in the stool. For those people who show traces of blood, a colonoscopy is recommended, so that doctors can look for polyps or potentially cancerous tumors.

Several very large clinical studies have compared groups of healthy people over the age of fifty who used FOBT (with follow-up colonoscopy for positive tests) for colon cancer screening, to groups who received no screening. Over time, mortality from colon cancer in the screened groups was lower by a full third.

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