Colorectal Cancer

Background

Clinical Trials SquareColorectal cancer refers to cancers of the large intestine and rectum which usually begin as benign polyps that become cancerous over time. The exact cause of colorectal cancer is not known, but risk factors include age, family history, obesity, lack of exercise, diets high in red and processed meats, and heavy alcohol use. Individuals with a history of ulcerative colitis or Crohn’s disease are also at higher risk for colorectal cancer.

Colorectal cancer accounts for more than 142,000 new cases and 50,000 deaths annually. About 90% of all colorectal cancers occur in individuals older than 50 years.

Current Treatment

Early stage cancers that are confined to the polyp can often be treated with colonoscopy or endoscopic mucosal resection. If the cancer has spread along or into the colonic wall, surgery can be performed to remove the polyps and explore the adjacent lymph nodes. A partial colectomy (removal of cancerous portion of the colon) can be performed in cases where the cancer has invaded the colonic wall. 

Chemotherapy can shrink tumors before surgery or to mitigate the symptoms and spread of the cancer after surgery. It is often used in combination with radiation therapy. Targeted drug therapy can also be used in colorectal cancer.

Focused Ultrasound Therapy

Focused ultrasound could treat colorectal cancer by heating and destroying the tumor. Research efforts have been addressing several challenges, such as the thin colonic wall, air in the colon, and movements related to peristalsis (normal contractions and relaxations of the colon). However, there has been progress made on these issues, and there have been successful pre-clinical and volunteer studies. Clinical trials on humans with rectal cancer have been initiated.

Clinical Trials

A clinical trial is underway in Canada for the treatment of recurrent rectal carcinoma. This trial is only open to Canadian Citizens.

  • To inquire about participating in the study, please contact William Chu (416-480-6100 ext 7086 or )

A clinical trial is underway in London, England looking at end stage rectal carcinoma that may be primary or recurrent. Patients must have exhausted all other treatments.

  • To inquire about the study, please contact Paul D Abel (+44208 383 2268 or ) or Leonardo Monzon (+447932043627 or )

Notable Papers

Chu W, Staruch RM, Pichardo S, Tillander M, Köhler MO, Huang Y, Ylihautala M, McGuffin M, Czarnota G, Hynynen K. Magnetic Resonance-Guided High-Intensity Focused Ultrasound Hyperthermia for Recurrent Rectal Cancer: MR Thermometry Evaluation and Preclinical Validation. Int J Radiat Oncol Biol Phys. 2016 Jul 15;95(4):1259-67. doi: 10.1016/j.ijrobp.2016.03.019. Epub 2016 Mar 24.

PLOS ONE Staff. Correction: First clinical experience of intra-operative high intensity focused ultrasound in patients with colorectal liver metastases: a phase I-IIa study. PLoS One. 2015 Mar 30;10(3):e0123751. doi: 10.1371/journal.pone.0123751. eCollection 2015.

Dupré A, Melodelima D, Pérol D, Chen Y, Vincenot J, Chapelon JY, Rivoire M. First clinical experience of intra-operative high intensity focused ultrasound in patients with colorectal liver metastases: a phase I-IIa study. PLoS One. 2015 Feb 26;10(2):e0118212. doi: 10.1371/journal.pone.0118212. eCollection 2015. Erratum in: PLoS One. 2015;10(3):e0123751.

Mouratidis PX, Rivens I, Ter Haar G. A study of thermal dose-induced autophagy, apoptosis and necroptosis in colon cancer cells. Int J Hyperthermia. 2015;31(5):476-88. doi: 10.3109/02656736.2015.1029995.

Zhang X, Yang G, Zhang Y, Huang P, Qiu J, Sun Y, Shen Z, Liao X, Xia H, Shao S, Wang D. An experimental research into endostatin microbubble combined with focused ultrasound for anti-tumor angiogenesis in colon cancer. Gastroenterol Rep (Oxf). 2014 Feb;2(1):44-53

Sazgarnia A, Shanei A, Taheri AR, Meibodi NT, Eshghi H, Attaran N, Shanei MM. Therapeutic effects of acoustic cavitation in the presence of gold nanoparticles on a colon tumor model. J Ultrasound Med. 2013 Mar;32(3):475-83.

Park MJ, Kim YS, Yang J, Sun WC, Park H, Chae SY, Namgung MS, Choi KS. Pulsed high-intensity focused ultrasound therapy enhances targeted delivery of cetuximab to colon cancer xenograft model in mice. Ultrasound Med Biol. 2013 Feb;39(2):292-9.

Cheung TT, Poon RT, Yau T, Tsang DS, Lo CM, Fan ST. High-intensity focused ultrasound as a treatment for colorectal liver metastasis in difficult position. Int J Colorectal Dis. 2012 Jul;27(7):987-8.

T Leslie, R Ritchie, R Illing, G Ter Haar, R Phillips, M Middleton, F Wu, D Cranston. High-intensity focused ultrasound treatment of liver tumours: post-treatment MRI correlates well with intra-operative estimates of treatment volume. Br J Radiol. 2012 Oct; 85(1018): 1363–1370. doi: 10.1259/bjr/56737365

Ritchie, Robert W, Tom A Leslie, Gareth D H Turner, Ian S D Roberts, Leonardo D'Urso, Devis Collura, Andrea Demarchi, Giovanni Muto, and Mark E Sullivan. Laparoscopic High-intensity Focused Ultrasound for Renal Tumours: a Proof of Concept Study. BJU International 107, no. 8 (April 2011): 1290-1296. doi:10.1111/j.1464-410X.2010.09620.x.

Monzon L, Wasan H, Leen E, Ahmed H, Dawson PM, Harvey C, Muhamed A, Hand J, Price P, Abel PD. Transrectal high-intensity focused ultrasonography is feasible as a new therapeutic option for advanced recurrent rectal cancer: report on the first case worldwide. Ann R Coll Surg Engl. 2011;93(6):e119-21.

 


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