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Initial Treatments for Newly Diagnosed Colorectal Cancer

Insights From:Tanios Bekaii-Saab, MD, Ohio State University-James Cancer Hospital; Cathy Eng, MD, FACP, MD Anderson Cancer Center; John L. Marshall, MD, Georgetown University Medical Center
Published: Wednesday, Sep 16, 2015


There are many considerations when deciding on a treatment plan for patients with colorectal cancer (CRC), says Cathy Eng, MD. Knowledge of the disease stage is imperative, as there are limited therapies that are available in the early disease stages, which differ from those used in the metastatic setting. Molecular marker analyses are often utilized more in metastatic disease, where two biologic agents are typically given in combination with chemotherapy, based upon the results of a RAS mutation analysis.

There are advantages and disadvantages associated with all CRC treatments, making patient education critical, says Eng. When explaining the intravenous options to patients, it is helpful to also describe the factors affecting the drug’s administration and the potential impact on the patient’s quality of life. For example, an implantable catheter is inserted underneath the skin and does not limit the patient too much with regards to what he or she can do while at home, explains Eng, although patients must return to the hospital for catheter removal.

It is important to offer the patient choices, states John L. Marshall, MD. One approach is to describe the pump that would be used for a particular chemotherapy treatment, noting all of the factors associated with its use. Some patients are more comfortable with the pump, while others will prefer an oral regimen.
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There are many considerations when deciding on a treatment plan for patients with colorectal cancer (CRC), says Cathy Eng, MD. Knowledge of the disease stage is imperative, as there are limited therapies that are available in the early disease stages, which differ from those used in the metastatic setting. Molecular marker analyses are often utilized more in metastatic disease, where two biologic agents are typically given in combination with chemotherapy, based upon the results of a RAS mutation analysis.

There are advantages and disadvantages associated with all CRC treatments, making patient education critical, says Eng. When explaining the intravenous options to patients, it is helpful to also describe the factors affecting the drug’s administration and the potential impact on the patient’s quality of life. For example, an implantable catheter is inserted underneath the skin and does not limit the patient too much with regards to what he or she can do while at home, explains Eng, although patients must return to the hospital for catheter removal.

It is important to offer the patient choices, states John L. Marshall, MD. One approach is to describe the pump that would be used for a particular chemotherapy treatment, noting all of the factors associated with its use. Some patients are more comfortable with the pump, while others will prefer an oral regimen.
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