Norman Ng: Rethinking colorectal cancer – New developments in treatment options and drugs
Norman Ng, Director of Patient Advocacy and Public Affairs at Healthcare Thinkers, shared a post on LinkedIn:
“Rethinking colorectal cancer. New developments in treatment options and drugs.
Colorectal Cancer Education Information
Colorectal cancer is one of the most common cancers in Hong Kong, with more than 5,000 new cases each year. With the introduction of the Government’s Free Screening Programme (for residents aged 50-75), more patients can be diagnosed and treated early, significantly increasing the cure rate. Even if the cancer has progressed to stage 4 or metastasis (e.g. liver, lung), there is still a chance to reverse the disease or even recover completely with advanced treatments.
Staging and Treatment
Colorectal cancer is classified as stage 0 to 4, and treatment depends on the stage:
- Stage 0 (carcinoma in situ): The tumour is confined to the mucosal layer and can be cured endoscopically or surgically removed.
- Stage 1: Tumour invades the submucosa but does not metastasize, and surgical resection is the mainstay.
- Stage 2-4: The tumour penetrates or spreads through the intestinal wall in combination with surgery, chemotherapy, targeted drugs, or radiation therapy.
- Stage 4: If metastases to other organs, the disease can be controlled with multidisciplinary treatment (e.g., liver metastases surgery combined with chemotherapy).
New Developments in Drug Therapy
1. Targeted Drugs:
- Anti-angiogenesis drugs (VEGF inhibitors): block tumor angiogenesis and inhibit cancer cell growth.
- Epidermal growth factor inhibitors (EGFR inhibitors): indicated for patients with certain genotypes, but may be used in conjunction with genetic testing.
- Dual inhibitors (e.g., VEGFR inhibitors): Highly safe and suitable for older or frail patients.
2. Immunotherapy:
- Targeting specific genetic mutations, such as microsatellite unstable MSI-H, activates the immune system to clear tumors, and in some cases does not require surgery or chemotherapy.
Precision Medicine and Genetic Testing
- Genetic Profiling:
- Detect tumor genes (e.g., KRAS, NRAS, BRAF, etc.) and avoid ineffective drugs (e.g., EGFR inhibitors are not available for RAS mutants).
- Rare genetic abnormalities (e.g., HER2 amplification) can be found to target therapy.
Prevention and Early Screening
- Free Screening Programme: Members of the public aged 50-75 can receive a Fecal Occult Blood Test, and those who are positive will need further colonoscopy.
- Early symptoms: Blood in the stool, changes in bowel habits, unexplained weight loss, etc., should be sought medical attention as soon as possible.
- Endoscopy: Early polyps or small tumors can be directly removed to reduce the risk of cancer.
Key Message
- Colorectal cancer has a high cure rate, and early diagnosis is key.
- New drugs and precision medicine have greatly improved the survival rate of patients with advanced disease.
- Regular screening, a healthy diet (high fiber and low fat), and quitting smoking and alcohol can be effective in prevention.
Thank you, Dr. Goh Kam Pong
Dr. Ng Kim Pong, Kenny
Medical oncologist.”
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Yvonne Award 2024
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OncoThon 2024, Online
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Global Summit on War & Cancer 2023, Online
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