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Welcome!Colorectal Cancer
Newly Diagnosed: Where to go from here…
Part of Fight Colorectal Cancer’s Monthly Patient Webinar Series
Our webinar will begin shortly
www.FightColorectalCancer.org877-427-2111
Fight Colorectal Cancer
1. Tonight’s speaker: Dr. Edward Crane, MD
2. Archived webinars: Link.FightCRC.org/Webinars
3. Follow up survey to come via email. Get a free Blue Star of Hope pin when you tell us how we did tonight.
4. Ask a question in the panel on the right side of your screen and look for hyperlinks during throughout the presentation.
5. Or call the Fight Colorectal Cancer Answer Line at 877-427-2111
www.FightColorectalCancer.org877-427-2111
Fight Colorectal CancerDisclaimer
The information and services provided by Fight Colorectal Cancer are for general informational purposes only.
The information and services are not intended to be substitutes for professional medical advice, diagnosis, or treatment.
If you are ill, or suspect that you are ill, see a doctor immediately. In an emergency, call 911 or go to the nearest emergency room.
Fight Colorectal Cancer never recommends or endorses any specific physicians, products or treatments for any condition.
www.FightColorectalCancer.org877-427-2111
Fight Colorectal Cancer
Up coming webinars
Research and Treatment News:Highlights from the 2014 Gastrointestinal Symposium
Wednesday, February 19th 2014 4:00pm – 5:00pm EDT
Take the Wheel:Healthy lifestyle changes that may reduce your risk of a
CRC recurrenceWednesday, March 26th 2014
3:00pm - 4:00pm EDT
Fight Colorectal Cancer
www.FightColorectalCancer.org877-427-2111
Dr. Edward Crane, MD
“Good listening is the key to taking excellent care of patients. I always tell my patients that he or she is the captain of the ship
and my job is to help with navigation”…
Colon CancerNewly Diagnosed? Where to go from here…
January 22, 2014
The Presenter: Dr. Ed CraneBoard certified in medical
hematology, medical oncology, internal medicine and palliative care
OHC physicianwww.OHCare.comTrained in oncology and
hematology at Moffitt Cancer Center in Tampa, FL
Chair of the cancer program at West Chester and Mercy Fairfield Hospitals
Enjoys exercising and spending time with family in spare time
What is the colon?
Last part of the digestive system
Extracts water, sodium and some fat soluble vitamins
Approximately 5 feet in length
How does a cancer form in the colon?
Most colon cancers begin as a polyp
The whole process may take 5-10 years
As the polyps grow, they can develop cancerous cells that then multiply to become a tumor
Some cancers in a genetic cancer syndrome can bypass the polyp phase
How is colon cancer staged?
Stage I very superficial with minimal invasion
Stage II through most if not all of the layers of the colon but no lymph node involvement
Stage III lymph node involvement but has not travelled away from the colon
Stage IV travelled away from the colon
Colon Cancer IncidenceOver 100,000/year diagnosed with colon
cancer in the United States Over 40,000/year diagnosed with rectal
cancerAverage age is in the 60’s but I have treated
patients from 28-90
Risk FactorsColon polypsFamily historyInflammatory bowel diseases (Ulcerative
Colitis or Crohn’s Disease)Type II diabetesRed meats and processed meatsSmoking
Hereditary Cancer SyndromesHNPCC- Hereditary Non-Polyposis Colorectal Cancer
Accounts for 3% of all colon cancerAge less than 50 or strong family historyTends to be right sided colon cancer but not alwaysSkips the polyp step in cancer formationThose with the gene have an 80% chance of developing
colon cancerRisk of uterine cancer
Familial Adenomatous PolyposisHundreds of polyps throughout colon and rectum100% chance of one becoming cancer before age 40 if not
removed
What is the most important aspect of care when a patient is diagnosed with colon cancer?
ThePatient!
Positive QuoteSedona, AZ
“You yourself, as much as anybody in the entire universe, deserve your love and affection.” – Buddha
What do you need as a patient?A team of doctors that communicate
What does it mean to have multidisciplinary clinics?GastroenterologistMedical Oncologist
Who helps the physicians?Treatment nurses/treatment suiteProximity of officePersonality/Professionalism/Bedside mannerAvailability of clinical trials
Surgeon: Importance of colorectal fellowship?Laparascopic trained?Complication rates/average length of stay in the hospital
Radiation oncologist
Other Support ServicesSupport GroupsCancer Support Community Cancer Family CareAmerican Cancer SocietyPhysical Therapy/Dietary at local hospitalExercise groups at local YPersonal TrainerFriends and Familywww.clinicaltrials.govwww.nccn.org for patients tabwww.OHCare.comwww.FightColorectalCancer.org
http://www.nccn.org/patients/guidelines/colon/index.html#1
Important Issues to Keep in MindA patient is not a diagnosisA patient is not a statisticThere is a certain social undertone to having
been diagnosed with cancerThere is nothing wrong with you as a person
You do not have to let it dominate your life or conversation unless you need it to be that way
Half Dome viewed from Glacier Point, Yosemite National Park
Surround yourself with people who are going to lift you higher
Treatment for Colon CancerIt depends upon the stageA standard treatment after surgery for stage III and
some stage II colon cancers is FOLFOXGiven every 2 weeks and requires a home infusion pump
Diarrhea and mouth soresNumbness and tinglingCold sensitivityFatigue and increased risk of infectionChemobrain
Xeloda, a pill, can be used as treatment, too. Utilized when side effects of FOLFOX might be too harsh
for the patient
Treatment for Colon CancerFor stage IV cancers, Avastin is usually added
to the chemotherapyMultiple treatment option including FOLFIRI,
Xeloda, Cetuximab, Panitumumab, Regorafenib
May have surgery or radiation, as wellA few stage IV cancer still have the
opportunity for cure, determined by the number and size of tumors in the liver, if they are localized to only one lobe, and if they reduce significantly in size with chemotherapy
Treatment for Rectal Cancers Combined chemotherapy (infusion Mon-Fri)
or Xeloda with radiationSurgeryFurther chemotherapy either FOLFOX or
Xeloda
On the HorizonSomewhere in the Caribbean
Personalized MedicineDetermining aspects of
the tumor that create sensitivity or resistance to certain treatments
Oncotype DX testing to determine who might benefit from adjuvant chemotherapy
Prevention through improved screening
Questions?Mariposa Grove, Yosemite National Park
No question is too big or too small
If you have further questions later after the talk, I can be e-mailed from our website: www.OHCare.com
Thank You!Best of luck to you in your journey!
Fight Colorectal CancerCONTACT US
Fight Colorectal Cancer1414 Prince Street, Suite 204
Alexandria, VA 22314(703) 548-1225
Toll-Free Answer Line: 1-877-427-2111www.FightColorectalCancer.org
Email us: [email protected]