Leading expert in liver cancer surgery, Dr. Graeme Poston, MD, explains how metastatic colon cancer treatment is advancing. He emphasizes that surgical resection of liver metastases offers a potential cure for stage 4 patients. Dr. Poston identifies a critical need for better doctor education and wider adoption of multidisciplinary teams. The future of treatment lies in precision surgery guided by genetic tumor markers. Patients are encouraged to seek medical second opinions to ensure they receive the most aggressive and modern care available.
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Modern Strategies for Treating Stage 4 Colon Cancer with Liver Metastases
Jump To Section
- The Critical Education Gap in Metastatic Cancer Care
- Patient Empowerment Through Information and Second Opinions
- Expanding Surgical Training for Liver Metastases Resection
- The Essential Role of Multidisciplinary Cancer Teams
- The Future is Precision Medicine and Precision Surgery
- Advanced Treatment Options for Liver Metastases
- Full Transcript
The Critical Education Gap in Metastatic Cancer Care
Dr. Graeme Poston, MD, highlights a significant barrier to optimal stage 4 colon cancer treatment. Many doctors still hold outdated beliefs that liver metastases are an immediate death sentence. This attitude leads to inaction and denies patients potentially curative surgical options.
Research conducted in the United Kingdom confirms this knowledge gap. Dr. Poston's team measured the attitudes of surgeons and colorectal specialists. They found that a substantial number do not believe operating on liver metastases is beneficial. This persists despite overwhelming clinical trial data proving that liver resection improves survival and quality of life for metastatic colon cancer patients.
Patient Empowerment Through Information and Second Opinions
Dr. Anton Titov, MD, and Dr. Graeme Poston, MD, discuss the vital role of patient advocacy. The internet provides patients with direct access to information about the best treatment methods for advanced colon cancer. Patients can now research outcomes and question their doctors about available options.
Seeking a medical second opinion is a crucial step. A second opinion confirms the accuracy of a stage 4 colorectal cancer diagnosis. More importantly, it can verify whether a patient is a candidate for liver metastases surgery. This process empowers patients to demand state-of-the-art care and pushes the entire medical system toward better outcomes.
Expanding Surgical Training for Liver Metastases Resection
A major advancement in metastatic colon cancer treatment is the growth of specialized surgical expertise. Dr. Graeme Poston, MD, recalls that 25 years ago, only three surgeons in England performed liver metastases resections. Today, that number has grown to approximately 150 specially trained liver surgeons.
However, Dr. Graeme Poston, MD, notes that this is still insufficient to treat all eligible patients. The complex surgery required to remove metastatic lesions from the liver demands significant skill. A continued focus on training the next generation of surgeons is essential to making this life-saving procedure widely accessible.
The Essential Role of Multidisciplinary Cancer Teams
Optimal treatment for stage 4 colon cancer requires a collaborative approach. Multidisciplinary teams (MD Ts) bring together surgeons, oncologists, radiologists, and other specialists. This team collectively creates the best personalized treatment plan for each patient.
Dr. Graeme Poston, MD, points out that MD T use is a legal requirement in several European nations, including the UK and France. However, it is not mandated in other major countries like Germany and Italy. There is a global clamor for knowledge on how to build and run effective MD Ts, as evidenced by oversubscribed workshops in places like Shanghai. This integration of expertise is a major step forward in cancer care.
The Future is Precision Medicine and Precision Surgery
The next frontier in metastatic colon cancer treatment is precision medicine. Dr. Graeme Poston, MD, and Dr. Anton Titov, MD, discuss a future where treatment is guided by the genetic profile of a patient's tumor. Precision surgery will be tailored based on specific tumor mutation status.
This approach ensures the correct treatment is directed to the correct patient for the best results. Dr. Poston is convinced that by 2020, this model will be a reality. The integration of precision medicine with precision surgery represents the ultimate personalized care for colon cancer patients.
Advanced Treatment Options for Liver Metastases
Modern treatment for stage 4 colon cancer with liver metastases involves a spectrum of advanced modalities. The best treatment often combines surgery with other localized and systemic therapies. Aggressive intervention is key to achieving long-term survival or even a cure.
Treatment options include liver resection, chemoembolization, and Selective Internal Radiation Therapy (SIRT). Transarterial Chemoembolization with Drug-Eluting Beads (TACE/DEBIRI) is another option. Irreversible electroporation is also used to ablate metastatic lesions. A medical second opinion helps patients and their doctors choose the most effective combination of these therapies.
Full Transcript
Dr. Anton Titov, MD: What advances in stage 4 colon cancer treatment can we expect?
Education of doctors about benefits of liver and lung metastases resection is important. Patients with metastatic colon cancer can achieve long-term survival. Cure of stage 4 colon cancer is possible.
Precision surgery and precision chemotherapy based on genetic tumor markers. Assessment of evolution of colon cancer tumor in real time. Best treatment for colon cancer stage 4.
Dr. Graeme Poston, MD: Metastatic liver colon cancer must be treated surgically. Doctors must resect metastases in treatment of stage 4 colon cancer. Liver metastases resection must be done in stage 4 advanced colorectal cancer.
Video interview with leading British liver cancer surgeon specializing in colorectal cancer metastases resection. Patients must search for best liver cancer surgeon and colorectal surgeon on internet.
Colorectal cancer liver metastases treatment is possible. Advanced stage 4 colon cancer surgery for liver metastases must be widely available.
Dr. Anton Titov, MD: Medical second opinion confirms that stage 4 colorectal cancer diagnosis is correct and complete.
Medical second opinion also confirms that liver metastases surgery is possible in stage 4 colon cancer.
Best treatment for advanced stage 4 colon cancer with liver metastatic lesions is surgery, chemoembolization, SIRT, TACE DEBIRI and irreversible electroporation of colon cancer metastases.
Medical second opinion helps to choose the best treatment for stage 4 colorectal cancer with liver metastases. Get medical second opinion on advanced colorectal cancer and be confident that your treatment is the best.
Best colorectal cancer treatment center for liver metastases.
Dr. Graeme Poston, MD: Video interview with leading expert in colorectal cancer liver metastases treatment surgery.
Dr. Anton Titov, MD: Best treatment for colon cancer stage 4. What is the future?
Colorectal cancer treatment has changed dramatically over the last decade. In particular, stage 4 metastatic colorectal cancer treatment has achieved remarkable progress.
Yes. We spoke at length about liver metastases treatment in colon cancer patients. It is a very exciting field.
How do you see the future of colorectal cancer therapy? What advances in stage 4 metastatic colorectal cancer treatment will be possible? What new advances can we expect in the next several years?
Dr. Graeme Poston, MD: The first thing is still education. It is still convincing other doctors that resection of liver metastases in stage 4 colon cancer patients is worth doing.
There are still huge gaps in knowledge amongst doctors. Many doctors still think, "Oh, my God! Cancer is in the liver. You're going to die." Many doctors then do nothing to treat patients with advanced metastatic colon cancer.
Dr. Anton Titov, MD: This is a very important point. For many diseases it is known that the majority of patients do not get state-of-the-art treatment of their disease. That includes metastatic colon cancer. I would just like to emphasize this point.
Dr. Graeme Poston, MD: Yes. We have studied that in the United Kingdom. We found outdated attitude of many doctors to metastatic stage 4 colon cancer treatment.
We have measured it. We have measured doctors' attitudes. We measured how doctors behave with patients who have advanced cancer. We published our results.
We have shown that there are many doctors, surgeons, colorectal surgeons. They still don't believe that operating on the liver in metastatic colon cancer is a good thing to do.
Dr. Anton Titov, MD: Despite all the data? The data shows that resection of liver metastases in stage 4 colon cancer improves patient's survival and quality of life.
Dr. Graeme Poston, MD: Despite all the data! I have told doctors around the world to repeat those clinical trials that we have done. You repeat clinical trials on liver metastases resection in stage 4 advanced colon cancer treatment in Russia.
You will find the same result. You repeat them in the United States, you have the same result. Doctors just don't understand what you can now do for advanced colon cancer patients.
Many doctors have not progressed in 30 years in understanding how to treat advanced colorectal cancer with liver metastases for best results.
Dr. Anton Titov, MD: Perhaps it is time for colon cancer patients to become more active and demand the state-of-the-art colon cancer treatment?
Dr. Graeme Poston, MD: This is why the Internet is very important. Patients can actually look at the best treatment methods for colon cancer treatment.
Dr. Anton Titov, MD: Patients can find on the internet about the best methods to treat stage 4 colon cancer. Patients can say, "Why can I get these results at that hospital? But my doctor at my hospital says that it is not possible?" That is the first thing.
Dr. Graeme Poston, MD: That will be a major step in the correct direction to cure more patients with advanced colon cancer. That will push a major improvement in outcome of treatment for metastatic stage 4 colon cancer.
The second crucial goal is this. We are getting more and more surgeons trained to do resection of liver metastases in patients with advanced colorectal cancer.
Surgery to remove colon cancer metastases from the liver is not easy. But more and more surgeons are trained to do that operation.
I started doing resection of liver metastases in stage 4 colon cancer patients 25 years ago as a surgeon in Liverpool. We had three patients in England doing this surgery.
We have now got 150 liver surgeons doing metastatic lesion resections. We still haven't got enough surgeons to treat all patients who need surgical operation to treat liver metastases.
It is important to get the young surgeons. They must train how to do resection of liver metastases in advanced colon cancer patients.
It is also important to establish more multi-disciplinary teams.
Dr. Anton Titov, MD: They must work on treatment of advanced metastatic colorectal cancer. It is a legal requirement to use multidisciplinary teams to make treatment plans for cancer patients in Britain, in France, in Belgium, in Spain, in Scandinavia, the Netherlands, Ireland.
But there is no legal requirement to have multi-disciplinary cancer treatment team in Germany. It is not a requirement in Italy. Multidisciplinary team assessment of a cancer patient is not required in a lot of countries around the world.
Dr. Graeme Poston, MD: I do a lot of work in China. I have been in China twice this year. I will go back to China in November.
We ran workshop in Shanghai about how to build a multi-disciplinary cancer treatment team for colorectal cancer patients. It was over-subscribed. Doctors are clamoring for this kind of knowledge.
How to make an MD T, multidisciplinary team. How to make it work for best colon cancer treatment results. That will be the major step forward. We have to integrate the MD T outcomes.
Dr. Anton Titov, MD: We must make sure that we are using the best treatment.
The last thing is probably equally important. It will be the precision surgery based on the genetic tumor markers.
Precision surgery will be based on genetic behavior of the patient's colon cancer tumor.
Dr. Graeme Poston, MD: We can direct the correct treatment to the correct patient. Choice of treatment is based upon the colon cancer tumor mutation status.
I'm convinced that by 2020, we will have that treatment approach.
Dr. Anton Titov, MD: It is precision medicine and precision surgery. They are matched to each other.
Dr. Graeme Poston, MD: Yes. Yes.
Dr. Anton Titov, MD: I spoke to Professor David Kerr of Oxford University. We discussed the precision medicine. We discussed the use of colon cancer tumor markers both in the tumor and in the patient.
Dr. Graeme Poston, MD: Yes. Yes. Yes.
Dr. Anton Titov, MD: It is all coming together. Precision medicine and precision surgery. This gets best treatment results for colon cancer patients.
Dr. Graeme Poston, MD: It is all coming together.
Dr. Anton Titov, MD: Professor Poston, thank you very much for this very interesting conversation about very exciting future for the colorectal cancer treatment. In particular, it was great to discuss surgical treatment of liver metastatic disease in patients with stage 4 colorectal cancer.
That gives a lot of hope to patients. Thank you very much.
Dr. Graeme Poston, MD: My pleasure. Thank you very much.
Dr. Anton Titov, MD: Thank you. Best treatment for colon cancer - you must treat metastatic colon cancer very aggressively. Cure or long-term survival in stage 4 colon cancer is possible.