Chemotherapy in rectal cancer can lead to eradication of tumor without surgery. How to use Xeloda with other chemotherapy medications in rectal cancer treatment? What are controversial aspects of Xeloda treatment in rectal cancer?
I already have spoken about optimal treatment of colon cancer. But we also have rectal cancer. Rectal cancer is 40% of all colorectal cancer. Dr. Anton Titov, MD. Rectal cancer is more dangerous because it is growing in locally and regionally in pelvis. There is 25% to 35% risk of death from locally advanced rectal cancer. Prof. Dr. Hans-Joachim Schmoll, MD. Rectal cancer is often treated by chemotherapy and radiation therapy before surgical operation. 5-Fluorouracil is used for chemotherapy for rectal cancer. Chemotherapy and radiotherapy can reduce and sometimes eradicate rectal cancer tumor before surgery. Patients with rectal cancer should also get chemotherapy after the surgery to remove rectal cancer. Dr. Anton Titov, MD. The big question is whether chemotherapy in rectal cancer should be the same as in colon cancer. Rectal cancer is in a lower part of colon. But there could be molecular differences between rectal cancer and colon cancer. Prof. Dr. Hans-Joachim Schmoll, MD. For example, there is a difference in molecular and genetic characteristics between cancer in left and right parts of large bowel. Genetic difference in colon cancer at different locations is a recognized feature of colorectal cancer. Dr. Anton Titov, MD. There were three different clinical trials recently on rectal caner treatment. I have done one of them. It was a worldwide trial, in Europe and Australia and Germany. These clinical trials showed that oxaliplatin can be added to 5-fluorouracil in rectal cancer therapy. Prof. Dr. Hans-Joachim Schmoll, MD. We know this chemotherapy works in colon cancer. This combination chemotherapy can reduce the rate of rectal cancer relapses. It reduces death from rectal cancer. However these clinical trials were small. One clinical trial was in Korea, one in Germany. I have done a larger European clinical trial on rectal cancer chemotherapy. But we are not sure whether oxaliplatin and 5-fluorouracil chemotherapy improves overall survival in rectal cancer. Because these trials aren't big enough. The number of the patients in total isn't big enough to show that oxaliplatin and 5 fluorouracil chemotherapy has major benefits in rectal cancer treatment. Clinical guidelines for rectal cancer in Europe and in the United States, say "yes". Oxaliplatin and 5-fluorouracil for stage 2 and stage 3 rectal cancer treatment. Oxaliplatin can be added to capecitabine . It is called XELOX chemotherapy regiment. But in Europe still 50% of colorectal cancer doctors say: "no no no, we only can use 5-fluorouracil or capecitabine alone. Without adding oxaliplatin." Dr. Anton Titov, MD. But other doctors say that rectal cancer chemotherapy should be done the same method as colon cancer chemotherapy. it is a little bit controversial now. Prof. Dr. Hans-Joachim Schmoll, MD. But patients with rectal cancer should have combination of chemotherapy after surgical operation. Leading colorectal cancer oncologist and research expert discusses colon cancer diagnosis and treatment options. Chemotherapy with radiotherapy for rectal cancer before surgery is often used. Neoadjuvant Capecitabine is a New Standard in rectal cancer chemotherapy before surgical operation. Capecitabine (Xeloda) is also used in Patients With Metastatic Colorectal Cancer. Rectal cancer is significant and often discovered in locally advanced stage. There is 25% to 35% risk of death from locally advanced rectal cancer. Chemotherapy and radiotherapy can reduce and sometimes eradicate rectal cancer tumor before surgery. clinical trials showed that oxaliplatin can be added to 5-fluorouracil in rectal cancer therapy. we can use Oxaliplatin and 5-fluorouracil for stage 2 and stage 3 rectal cancer treatment.