New Online Support Group for People Affected by Gastrointestinal Conditions: IBS, Crohn’s, UC, GERD, Cancer and More

Are you suffering from a gastrointestinal (GI) tract condition? You are not alone! TheGIConnection is now available for patients, caregivers, […]

Sandostatin Ineffective in Preventing Diarrhea in Anal and Rectal Cancer Patients Treated with Chemoradiotherapy

Sandostatin® (ocreotide acetate) does not prevent diarrhea in patients with anal or rectal cancer treated with chemotherapy and radiation therapy. […]

No Benefit with Addition of Platinol® to Treatment for Anal Cancer

No Benefit with Addition of Platinol® to Treatment for Anal Cancer Addition of the drug Platinol® (cisplatin) to 5-FU (5-flourouracil), mitomycin, and radiation may not improve outcomes for patients with anal cancer. These findings were recently published by the Journal of the American Medical Association. Anal cancer is a rare form of cancer that develops in the tissues of the anus. Although treatment for anal cancer if often very effective, with most patients experiencing a cure, anal cancer can be a serious condition. The American Cancer Society estimates that 680 people will die of anal cancer in 2008. Current treatment options include surgery, radiation, and chemotherapy. Current standards for treating anal cancer include chemotherapy and radiation. The five-year survival rate, however, following treatment with 5-FU, mitomycin, and radiation is only about 65%. Researchers in the current study sought to determine if the addition to standard therapy of Platinol, an alkylating agents that kills cancer cells by damaging their DNA, could improve outcomes of patients with anal cancer. Study participants included 682 patients diagnosed with anal cancer between 1998 and 2005. Patients were further categorized according to their gender and tumor features. Participants received either 5-FU, mitomycin, and radiation (341 patients) or Platinol, 5-FU, mitomycin, and radiation. The goal of the study was to measure five-year survival rates, as well as overall survival and time to relapse. Results were evaluated from 644 patients. The average patient age was 55 years; 69% were women; 27% had tumors that were greater than 5cm; and 26% had positive lymph node involvement.® Five-year survival rates were 60% among the patients treated with 5-FU and mitomycin compared with 54% among the patient treated with Platinol. Among the patients treated with 5-FU/mitomycin, the five-year local recurrence rate was 25%, and the distant metastasis rate was 15%. Among the patients treated with Platinol as well as 5-FU/mitomycin, these recurrence rates were higher at 33% and 19%. Fewer patients needed a colostomy among the 5-FU/mitomycin group than the Platinol group (10% versus 19%). Patients in the 5-FU/mitomycin treatment group, however, reported more frequent severe hematologic side effects, such as low blood counts. Researchers concluded that the addition of cisplatin to traditional treatment with 5-FU and mitomycin did not improve disease-free survival and contributed to significantly worse colostomy rates. These findings do not support the use of Platinol in addition to 5-FU and mitomycin in the treatment of anal cancer. Reference: Ajani, J., Winter, K., Gunderson, L., et al. Fluorouracil, Mitomycin and radiotherapy vs. fluorouracil, cisplatin and radiotherapy for carcinoma of the anal canal. Journal of the American Medical Association . 2008; 299(16) 1914-1921. Related News:® 5-FU/Mitomycin Remains Standard of Care for Anal Cancer (07/26/2006)

5-FU/Mitomycin Remains Standard of Care for Anal Cancer

5-FU/Mitomycin Remains Standard of Care for Anal Cancer According to results recently reported at the 2006 semi-annual meeting of the Radiation Therapy Oncology Group (RTOG), treatment including the chemotherapy agents 5-fluorouracil?and?mitomycin-C (Mutomycin?) plus?radiation therapy remains the standard of care for patients with anal cancer. Anal cancer is a fairly uncommon cancer and refers to cancer originating at the end of the rectum. Depending on the stage of disease (extent of disease at diagnosis) and other factors, cancer of the anus may be treated with surgery, chemotherapy, and/or radiation therapy. Treatment is aimed at a cure or improving the duration of survival, as well as maintaining the ability to control bowel function (fecal continence). A colostomy is sometimes required for patients with anal cancer if bowel function is lost; a colostomy is an opening created from the skin to the bowel to help dispose of waste. Treatment for anal cancer typically consists of surgery, chemotherapy, and/or radiation therapy. The standard chemotherapy combination for the treatment of anal cancer has been mitomycin plus 5-FU. Researchers affiliated with RTOG recently conducted a clinical trial to directly compare mitomycin plus 5-FU to Platinol? (cisplatin) plus 5-FU in the hopes of improving outcomes among patients with anal cancer. This trial, referred to as the RTOG 98-11 study, was a phase III trial that included 632 patients who underwent surgery and radiation therapy with either 5-FU/mitomycin or 5-FU/Platinol. At five years, cancer-free survival was 59% for patients treated with 5-FU/mitomycin, compared with 53% for those treated with 5-FU/Platinol. At five years, overall survival was improved by nearly 30% for patients treated with 5-FU/mitomycin compared to those treated with 5-FU/Platinol. At five years, 90% of surviving patients treated with 5-FU/mitomycin did not require a colostomy, compared with 81% for those treated with 5-FU/Platinol. The researchers concluded that 5-FU/mitomycin remains the standard of care in terms of chemotherapy for treatment of anal cancer. The authors stressed that the addition of targeted agents in combination with this regimen are the next step in improving outcomes for patients with anal cancer. Patients with anal cancer may wish to speak with their physician regarding their individual risks and benefits of participating in a clinical trial evaluating new therapeutic regimens for the treatment of anal cancer. Reference: Radiation Therapy Oncology Group. A Phase III Randomized Study of 5-Fluorouracil, Mitomycin-C, and Radiotherapy versus 5-Fluorouracil, Cisplatin and Radiotherapy in Carcinoma of the Anal Canal. Proceedings from the 2006 semi-annual meeting of the Radiation Therapy Oncology Group. June? 2006. Ontario, Canada. ? ?

Radiation to the Pelvis Increases Risk of Pelvic Fractures

Radiation to the Pelvis Increases Risk of Pelvic Fractures According to a recent article published in the Journal of the American Medical Association (JAMA), women who undergo radiation to the pelvis for cancers of the cervix, rectum, or anus are at an increased risk for pelvic fractures compared to women with these types of cancer who do not undergo pelvic radiation as part of their treatment regimen. Radiation to the pelvis is a rather common treatment for patients with cancers involving the cervix, rectum, or anus. Unfortunately, older women are at an increased risk for bone fractures than their younger counterparts, particularly hip fractures. These bone fractures result in a significant decline in quality of life, often necessitating surgery, hospital stays, and rehabilitation. Researchers from the University of Minnesota and the University of North Carolina School of Medicine reviewed extensive data to determine if radiation to the pelvis may be associated with the risk of pelvic fractures. This study included 6,428 women diagnosed with cancers of the cervix, rectum, or anus between 1986 and 1999. The women were aged 65 or older; approximately half had received radiation to the pelvis as part of their treatment regimen, while the other half had not received pelvic radiation. Pelvic radiation was associated with an increased risk of pelvic fractures among these women: Among women with cervical cancer, 8.2% who underwent radiation to the pelvis had a pelvic fracture, compared to 5.9% of those who did not undergo pelvic radiation. Among women with rectal cancer, 11.2% who underwent radiation to the pelvis had a pelvic fracture, compared with 8.7% of those who did not undergo pelvic radiation. Among women with anal cancer, 14% who underwent radiation to the pelvis had a pelvic fracture, compared with 7.5% of those who did not undergo pelvic radiation. The majority of fractures (90%) were hip fractures. Women with anal cancer who were treated with pelvic radiation had the highest risk of developing a pelvic fracture. The researchers concluded that elderly women diagnosed with cervical, rectal, or anal cancer who undergo radiation to the pelvis as part of their treatment regimen have a significantly higher risk of developing a pelvic fracture than those who do not undergo pelvic radiation. Elderly women who are to receive pelvic radiation for treatment of cancer may wish to speak with their physician regarding possible ways to reduce the risk of developing a pelvic fracture. Reference: Baxter N, Habermann E, Tepper J, Durham S, Virnig B. Risk of Pelvic Fractures in Older Women Following Pelvic Irradiation. Journal of the American Medical Association. 2005; 294:2587-2593. ?

Intensive Chemotherapy and Radiation Therapy Combo May Improve Outcomes for Persons with Cancer of the Anus

Intensive Chemotherapy and Radiation Therapy Combo May Improve Outcomes for Persons with Cancer of the Anus Persons who have cancers of the anus that have spread to the nearby lymph nodes or are large in size may require more aggressive therapy than individuals with smaller cancers. Now, researchers say that chemotherapy with fluorouracil and cisplatin, followed by a combination of radiation therapy and chemotherapy with fluorouracil and mitomycin, may help preserve bowel function and improve survival for persons with this type of disease. Cancer of the anus , the opening at the end of the rectum, is an uncommon cancer. Depending on the stage of disease (extent of disease at diagnosis) and other factors, cancer of the anus may be treated with surgery, chemotherapy, and/or radiation therapy. Persons who have surgery for anal cancer sometimes need a colostomy , an opening created from the skin to the bowel to help dispose of waste; however, a colostomy is usually temporary. Persons who have anal cancer that can be operated upon are often treated with surgery followed by a combination of radiation therapy and chemotherapy with fluorouracil and mitomycin. Seventy percent of these individuals are cured and maintain bowel functioning. However, persons with anal cancers that are large in size or have spread to the lymph nodes, do not respond as well to the standard therapies and need more aggressive treatment. Researchers from the Cancer and Acute Leukemia Group B conducted a study with the hope of improving survival rates and preserving bowel function for persons with cancer of the anal canal that were large in size or had spread to the lymph nodes. Forty-five patients first received chemotherapy with fluorouracil and cisplatin. They then received a combination of radiation therapy and chemotherapy with fluorouracil and mitomycin. Thirty-six patients had a complete response to the therapy. After an average of 21 months, 78% of the patients were alive and 67% were free from any signs and symptoms of cancer. Fifty-six percent of those who were alive were without a colostomy. The researchers concluded that this more aggressive combination of chemotherapy and radiation therapy appears to result in better survival and better preservation of bowel functioning than the standard regimens for persons with more advanced anal cancer. Persons with this type of disease may wish to talk with their doctor about the risks and benefits of receiving intensive chemotherapy with radiation therapy or of participating in a clinical trial in which other promising new therapies are being studied. Two sources of information on ongoing clinical trials that can be discussed with a doctor include a comprehensive, easy-to-use service provided by the National Cancer Institute ( cancer.gov ) and the Clinical Trials section and service offered by Cancer Consultants.com ( www.411cancer.com ). ( Proceedings of the American Society of Clinical Oncology Thirty-Fifth Annual Meeting , Vol 18, Abstract 909, pp 237a, 1999)

Treatment of Anal Cancer: Protective Drug, Called Amifostine, Reduces the Side Effects of Chemotherapy and Radiation Therapy

Treatment of Anal Cancer: Protective Drug, Called Amifostine, Reduces the Side Effects of Chemotherapy and Radiation Therapy The side effects of chemotherapy and radiation therapy as treatment for anal cancer may be reduced with the use of a drug called amifostine, according to new research findings by German doctors. Cancer of the anus, the opening at the end of the rectum, is an uncommon cancer. Depending on the stage of disease (extent of disease at the time of diagnosis) and other factors, anal cancer may be treated with surgery, chemotherapy, and/or radiation therapy. Radiation and chemotherapy are often administered after surgery (called adjuvant treatment) to help control the cancer, but these treatments often cause side effects. Over the past 50 years, many drugs, called radiation protectors, have been tested in the laboratory for the prevention of damage to healthy cells and tissues from radiation therapy. For such drugs to work effectively, they must protect the healthy cells, but not the cancerous cells. Amifostine is the only agent of this category to be approved by the US Food and Drug Administration for use in patients receiving radiation therapy for cancer of the head and neck. This drug has also been shown to reduce the side effects from chemotherapy in patients with cancer of the ovary. Doctors in Germany studied the protective effects of amifostine in patients receiving both chemotherapy and radiation therapy for cancer of the anus. In this study, 30 patients with advanced cancer of the anus underwent surgery, then 5 weeks of radiation therapy and chemotherapy. Half of the patients also received amifostine in weeks 1 and 5 of treatment, while the other half received no amifostine. The results show that amifostine was associated with a reduction in side effects of the skin, bowel, and blood. The side effects associated with amifostine use included low blood pressure and nausea. The researchers concluded that amifostine may be a useful agent in preventing the side effects caused by radiation therapy and chemotherapy in patients with cancer of the anus. Further studies of the protective effects of amifostine against radiation therapy and/or chemotherapy for other types of cancer are needed. ( Presented at the 41st Annual Meeting of the American Society of Therapeutic Radiology and Oncology , October 31, 1999, San Antonio, Texas)