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BOWEL (COLORECTAL) CANCER


Overview


The bowel is part of the body’s digestive system, which connects the stomach to the anus. The function of the bowel is to finish digesting food by absorbing water and nutrients.

Together the colon and rectum are known as the large bowel. Bowel cancer is a diseased growth that usually develops inside the large bowel. Most bowel cancers develop from small growths inside the colon or rectum called polyps, which look like small spots on the bowel lining or like cherries on stalks.

Not all polyps become cancerous. If polyps are detected and removed, the risk of bowel cancer is reduced. This usually happens during a colonoscopy, where a flexible tube called a colonoscope is carefully fed from the rectum into the colon. The colonoscope is fitted with a camera and light, which is used by a doctor to look at the wall of the rectum and colon for any signs of disease. If a polyp is found, the doctor can remove it then and there. Bowel cancer, haemorrhoids and other damage or disease in the bowel are also diagnosed during a colonoscopy.

Statistics


Bowel cancer (or colorectal cancer) is the most common internal cancer in Australia, with approximately 12,800 new cases diagnosed each year. After lung cancer, bowel cancer kills more Australians than any other cancer, with almost 90 deaths per week. The disease does not discriminate between the sexes, both men and women are at risk of developing bowel cancer.

Tthe rate of bowel cancer varies from country to country, but seems to be more common in North America, Europe, Australia, New Zealand and Japan, compared with quite low rates in India. In 2001 about 944,717 people worldwide developed bowel cancer, and 492,411 died as a result of the disease. There is a growing trend of bowel cancer diagnosis worldwide, which is often blamed on a poor diet, low in fibre and high in fat, and reduced physical activity.

What we are doing to improve treatments


We are conducting nine clinical trials in colorectal cancer, and working to initiate two new trials. These trials are:
  1. SCOT – In patients who have had surgery to remove all of their bowel cancer, this study will determine if 12 weeks of chemotherapy is as effective and less toxic that 24 weeks
  2. PETACC 6 – In patients with rectal cancer, to assess whether adding oxaliplatin (a newer chemotherapy drug) to standard chemotherapy and radiotherapy, before and after surgery, improves outcomes
  3. CO.20 – To determine whether a combination of biological agents is better than one biological agent in treating advanced colorectal cancer in patients for whom chemotherapy is no longer effective
  4. QUASAR 2 – To determine whether a combination of chemotherapy and a biological agent is better than chemotherapy alone for improved survival in patients who have had surgery to remove the cancer
  5. DAVINCI – testing single agent chemotherapy versus combination chemotherapy in the treatment of bowel cancer that has spread
  6. MAX – testing a combination of chemotherapy treatments in bowel cancer that has spread
  7. C06 – testing a chemotherapy pill for the treatment of colon cancer
  8. CO7 – adding a drug to chemotherapy in early-stage colon cancer treatment
  9. CO.17 – testing an antibody in the treatment of advanced bowel cancer
  10. Liver metastases (EORTC 40983)– adding chemotherapy before and after surgery in the treatment of bowel cancer that has spread to the liver.
  11. TROG 01.04 – Randomised trial of short versus long course radiotherapy prior to surgery for rectal cancer.