- Last Updated: December 1, 2016
Colorectal cancer refers to cancers of the large intestine and rectum. They 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.
According to the National Cancer Institute, colorectal cancer accounted for more than 142,000 new cases and 50,000 deaths in 2013. About 90% of all colorectal cancers occur in individuals older than 50 years.
Current TreatmentEarly 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, laparoscopic 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. In advanced cases, surgery may be performed to remove blockages of the colon and mediate symptoms associated with the cancer. This surgery is not meant to cure the cancer but rather to make the patient more comfortable.
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 is often used in late stage colorectal cancer.
Focused UltrasoundFocused ultrasound could treat colorectal cancer by heating and destroying the tumor. In 2004, researchers in China published a study suggesting that focused ultrasound combined with radiation could be safe and effective in patients with rectal carcinoma. In 2008, researchers at the University of Lyon described an endoscopic transducer for focused ultrasound treatment of tumors in the esophagus, colon, and rectum. To date, this has been used for treatment of small renal tumors.
It should be noted, however, that research on the use of focused ultrasound alone remains limited for colorectal cancer. Part of the reason for this is that the colon wall is very thin, and ultrasonic energy could result in a perforation of the colon, with the likelihood of serious infections and other issues as a result. In addition, focused ultrasound transmission is best accomplished when the ultrasonic pathway does not encounter air, which is commonly found in the colon. Steps to control or evacuate the colonic air adds another challenge to delivery of this type of care. Finally, the colon has a series of periodic contractions and relaxations known as peristalsis. Peristalsis helps propel the contents inside the intestine, but these movements create another variable in terms of having a stable treatment target during the application of focused ultrasound.
Research continues, however focused ultrasound as a definitive treatment option for colorectal cancer remains at a very early stage. Most effort is looking at using focused ultrasound to target metastatic colonrectal cancer that has gone to the liver or other locations.
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