Considerations and Treatment Options in Colorectal Cancer

The three papers contained in this supplement to ONCOLOGY were designed to serve as practical "keep on the shelf" references for the current management of metastatic colon cancer and screening and management of patients at high risk of colon cancer. All of the authors are leading authorities on their subject, and yet they have provided us with three focused reviews. From understanding colon cancer genetics to the choice of therapies and management of toxicity, all oncologists should be current on colon cancer therapy in 2007 after reading these papers. What each paper discussing treatment emphasizes is that we must all balance our enthusiasm for the new agents with the knowledge that they can cause side effects and should be used judiciously to optimize length and quality of life. There is no single best treatment for colon cancer anymore and treatments must be tailored to individual situations and therapeutic goals. Our great understanding of inherited syndromes should force changes in surgery, chemotherapy, and follow-up for those affected patients. These changes must be in effect immediately for all patients with colon cancer in 2007.

The challenge for today is to push the standard therapy even further. While we can claim some success, we must recognize that we are far from the end of our quest to cure colon cancer. Therefore, read these excellent papers to ensure you are practicing the best current care, but also focus your thoughts on how we can make the future even better for our patients. Participate in clinical trials whenever possible. Do not become complacent with the present. Inspire your patients and your community to join in the fight against this common and deadly disease. As clinical trial designs change with emphasis on regular tumor biopsies and molecular responses, help lead this effort instead of offering another patient another cycle of the standard of care.

—John L. Marshall, MD

Disclosures:

Dr. Marshall has received research support from Genentech, Pfizer, Amgen, Roche, Bristol-Myers Squibb, and Boehringer Ingelheim; has served on speakers bureaus for Roche, Pfizer, Sanofi, Genentech, and Bristol-Myers Squibb; and is a consultant for Boehringer Ingelheim.