Cancer of the Colon and Rectum
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Date
2013-12-09
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Abstract
The global incidence of colorectal cancer currently exceeds 1.2 million new cases per year with a third of cases coming from developing countries where hitherto the disease was thought to be uncommon. In Africa there has been a steady increase in the annual incidence of new cases colorectal cancer over the past five decades. An aging African population may be accounting for this trend although environmental factors may also be contributing to the rising incidence of the disease. Whereas the mortality rate from colon cancer is declining in western nations it continues to have a devastating effect on half of its victims worldwide. Surgical excision remains the linchpin in the management of colorectal cancer and offers the only chance of cure in approximately half of the patients. Local and distant recurrences of the disease are not uncommon. Adjuvant chemoradiation has been and is still the standard of care for rectal cancers staged beyond Dukes Stage B1 as it has been shown to improve disease-free survival and overall survival. Newer chemotherapeutic agents have recently been introduced for the treatment of metastatic cancer with moderate outcomes. Novel molecular targeting therapies have been incorporated into a multimodality treatment of metastatic colorectal cancer and they have shown promising response rates and progression-free survival. With the introduction of thermal ablation techniques patients with inoperable and local recurrent colorectal cancer may have some hope as early results are encouraging.