Colorectal Cancer - Into the Future

Excerpted from
What Your Doctor May Not Tell You About Colorectal Cancer: New Tests, New Treatments, New Hope
By Mark Bennett Pochapin, M.D.

If you or someone close to you has ever had cancer, or if you have lost a loved one to it, then you know its despair only too well. So I'm sure that you do not wish to see any more lives lost or hurt by this killer disease. Nor do I.

With the huge strides being made in colorectal cancer research just in the last several years, our wish may become more than a dream. Currently, there are more than 400 anticancer drugs in development, many of them designed to fight colorectal cancer-a number up substantially from the roughly 120 test drugs ten years ago. The new gene-based stool tests I mentioned earlier demonstrate just how far we have come in using DNA-specific mutations to detect cancer and polyps. It is hard to believe that DNA was discovered only fifty years ago! And virtual colonoscopies in the future may allow for a less invasive screening test, if the prep can ever be performed "digitally." Meanwhile other medical researchers, including myself, are looking into agents that block the activity of cancer- triggering enzymes-agents that are the closest thing medicine has to prevention in a pill.

Everyone working to fight colorectal cancer knows that there is far more to be done, but the efforts now on the horizon are very promising and encouraging. I don't think there has ever been a more exciting time of discovery in the world of cancer than now.

I know you are thinking: If so much progress has been made against cancer, then why can't we cure it?

This is the most common question that I get asked by patients and by anyone who knows I am a doctor interested in cancer. The answer is this: We can, sometimes. If we can't cure the cancer, at least we can treat it as a chronic disease in the same way we treat other chronic, noncancerous illnesses such as diabetes. I have many patients who have survived multiple cancers. In fact, I have one patient who has had six different malignant cancers; she lives a full life.

Unfortunately, advanced cancer is rarely cured. Yet this is the state in which doctors all too often find patients when first diagnosed with cancer. I know this well. My mother was diagnosed with advanced ovarian cancer three years ago. After six cycles of chemotherapy, she was in a complete remission, and it lasted for a year. Not a single cancer cell could be found. But somewhere in her body, a cancer cell was lurking. Her cancer recurred, this time more resistant to chemotherapy. My mother had been just a few cancer cells away from a complete cure.

Imagine how frustrating it has been for me, as the author of this cancer book, to watch my mother's cancer continue to grow, knowing that ovarian cancer can be "cured" if detected early.

Early is the magic word. For ovarian cancer, however, there are no reliable screening techniques, even for early detection. For colorectal cancer, there are.

We know how to beat colorectal cancer through screening-period. But to get everybody to comply with screening means that we have to change the entire way we think about this disease. We practically have to adopt an infectious disease mind-set. What exactly do I mean by that? To cure or eradicate infectious diseases, we vaccinate against the illness. So how do we "vaccinate" against colorectal cancer? Answer: Remove the polyps via a colonoscopy. That is about as close to a vaccination as I know. We would never dream of not vaccinating a child against polio-so why do we not "vaccinate" ourselves from the number two cause of cancer death?

Knowing that we can prevent a cancer, however, isn't much of a comfort to people who are dealing with it, and dying from it. While I sat at her bedside in the hospital producing these words on my laptop, my mother asked me, "Honey, why can't we get rid of my cancer?"

Telling her that we can cure some ovarian cancer is neither helpful nor reassuring. You see, from the patients perspective, despite every scientific discovery, he or she still has cancer. In this situation, we can provide hope, a hand to hold, and comfort, even in the end stages of the disease. As for my mother, I hope that one of the new agents out there may be able to help her. If not, I know that she can be treated to maintain her comfort. But I always hope that she will get better.

If you have cancer, every day is a day of hope. Protect your family by telling them about your illness and encouraging them to discuss prevention with their doctors. If you are fortunate enough to be blessed with good health, treat it as a treasured but fragile possession. Care for it, enjoy it, and certainly do not take it for granted. But, most importantly, don't wait for illness to strike to ask, Why me? but prevent it by asking, Why not me? Remember: The best person to ensure your good health is not your doctor, but you. That is one piece of lifesaving advice that your doctor may not have told you.