Engelsk titel: Markers of significance for diagnosis and treatment of intestinal cancer
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Författare:
Hofsli, Eva
;
Sjursen, Wenche
Email: wenche.sjursen@stolav.no
Språk: Nor
Antal referenser: 15
Dokumenttyp:
Översikt
UI-nummer: 10033316
Sammanfattning
Background: Colorectal cancer is the second most frequent form of cancer in Norway with 3 375 new cases in 2007. Median debut age is about 70 years, but the disease also appears at a younger age. If the debut age is less than 50 years familiar predispositions often exist and some of the patients have a well defined inherited cancer syndrome with known genetic cause. In these families it is important to identify individuals with inherited mutation in order to carry out regular controls, which may reduce the mortality caused by colorectal cancer.
Material and method: The manuscript is based on own clinical experience and search in PubMed with search words ”colorectal cancer” and “microsatelitte instability (MSI), carcinoembryonic antigen (CEA), hereditary, targeted treatment”.
Results and interpretation: Symptoms of colorectal cancer are often changes in bowel habits, together with blood or mucus in the stool. Blood in the stool is a warning signal that should always be examined more closely. The diagnosis is made by recto-/colonoscopy and biopsy. The stage of the disease at time of diagnosis decides the treatment strategy. The tumour marker carcinoembryonic antigen (CEA) is frequently elevated and is used both in diagnosis and in response evaluation of the treatment. By curative intention, the treatment is surgery, sometimes combined with chemotherapy. If the cancer is locally advanced in the rectum preoperative radiation therapy is used in order to shrink the tumour before surgery. Colorectal cancer with distant metastases is treated with various kinds of chemotherapy, sometimes combined with surgery. Surgery carried out on metastases may cure some patients. Targeted therapy, using antibodies against the epidermal growth factor receptor (EGFR) and vascular endothelial growth factor, is now an established treatment option. More recently it has been shown that patients with an activating mutation in the KRAS gene do not respond to treatment with EGFR antibody. Thus, it is possible to select patients that may benefit from such treatment.