Colorectal Cancer Survivors' Stories Become More Common

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By Tomise Martin, Staff Writer

Once a radio station owner, talk show host and Texas senator, colorectal cancer survivor Mike Richards looks forward to a future enjoying life with his wife, children and eight grandchildren.

At 72, Richards has no physical restrictions and plenty of energy.

"I'm fortunate to enjoy my favorite pastimes still," Richards says. "I walk outside or on a treadmill about five times a week, and my wife and I recently celebrated our 50th wedding anniversary with an Alaskan cruise. And I just returned from a month in Colorado."

Cancer comes calling

Healthy most of his life, Richards became concerned when he found himself short of breath from climbing just a few stairs and had abdominal pain.

When doctors found a tumor during a colonoscopy, Richards was referred to M. D. Anderson, where he was diagnosed with stage II colorectal cancer and scheduled for surgery. The tumor was removed in January 2006, and no additional therapy was needed. His surgeon was Lee Ellis, M.D., professor in M. D. Anderson's Department of Surgical Oncology.

About a year later, however, the cancer had metastasized (spread) to his liver. In March 2007, Richards had surgery to remove tumors from his liver, followed by a six-month regimen of chemotherapy.

More people live to tell the tale

Survivors of metastatic colorectal cancer (colorectal cancer that has spread to other parts of the body) are becoming more common.

To better understand this increase, investigators decided to study databases of metastatic colorectal patients, says Scott Kopetz, M.D., assistant professor in the Department of Gastrointestinal Medical Oncology at M. D. Anderson and the study's senior author.

In the study, which was published in the Journal of Clinical Oncology, Kopetz and his team found the overall survival rates for metastatic colorectal cancer patients like Richards had tripled since two distinct occurrences in treating the disease:

•    Increased use of liver resection (surgery to remove part of the liver)
•    Advancements in chemotherapy

Large patient sample examined

Researchers analyzed data from tumor registries at two institutions. These included:

•    1,614 patients at M. D. Anderson
•    856 patients at Mayo Clinic

Patients were diagnosed between 1990 and 2006 with follow-up through 2008.

As a comparison, 45,459 metastatic colorectal cancer patients from the National Cancer Institute Surveillance Epidemiology and End Results (SEER) database were evaluated. These patients were diagnosed between 1990 and 2005.

Data show good news

Prior to 1990, when the combination of two drugs, 5-FU and leucovorin, was the sole therapy, overall survival for metastatic colorectal cancer patients was eight to 12 months.

Survival for patients diagnosed in 1990 through 1997 increased to 14.2 months.

Since then, survival has continued to increase. It was:

•    18 months in 1998 through 2000
•    18.6 months in 2001 through 2003
•    29.3 months in 2004 through 2006

Better treatments, surgery make a difference

Overall five-year survival showed a similar increase. It was:

•    9.1% for patients diagnosed from 1990 through 1997
•    13% for patients diagnosed from 1998 through 2000
•    19.2% for patients diagnosed from 2001 through 2003

The five-year survival rate is not available yet for people diagnosed after 2003, but Kopetz projects it will be approximately 30%.

"This is a dramatic change in survival that can compare to the success story for breast cancer 10 years ago," Kopetz says. "The efforts to develop and use better chemotherapies, as well as better identify patients for liver surgery, contribute to these findings."

Cancer worry decreases

Since completing chemotherapy in September 2007, Richards has been free of cancer.

"I feel great," he says. "My cancer diagnosis doesn't cross my mind until I have my follow-up every six months. I've done everything I could to beat this disease. Without my faith and the great team at M. D. Anderson, I wouldn't be here today."

M. D. Anderson resources:

Advances in the Treatment of Colon Cancer

Colon cancer

Department of Gastrointestinal Medical Oncology

Additional resources:

Journal of Clinical Oncology

Colon and Rectal Cancer  (National Cancer Institute)

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