We recently shared a look at how research at Baylor Scott & White is helping to crack the code to detect colon cancer earlier.
Detection, however, isn’t the only variable to consider where colon cancer is concerned. Once diagnosed with the disease, attention turns to treatment options.
For T1 colorectal cancer (CRC) patients, in particular, the daunting idea of a colectomy, or surgical removal of part of the colon, is almost always on the table. If a patient is diagnosed with T1 CRC, that means the tumor has grown into the submucosa, the layer of tissue underneath the mucosa or lining of the colon, but has not yet spread to nearby lymph nodes.
Based on current screening methods, 70 to 80 percent of T1 CRC patients are considered high-risk, resulting in a substantial number of colectomies performed every year — but could there be a better alternative?
Why a colectomy?
A colectomy treats conditions like colon cancer or ulcerative colitis by removing the infected areas of a colon, also known as the large intestine. Colon removal, even in part, affects the digestive system and as a result, how waste leaves the body. This “side effect,” and the quality of life changes that come with it, is why colectomies are generally only performed on patients screened as “high-risk” for lymph node metastases, or a spreading of the condition.
However, post-surgery tests show that fewer than 16 percent of these identified “high-risk” patients actually have lymph node metastases, meaning for many, these colectomies could’ve been avoided.
To improve quality of life for patients with colon cancer, researchers are now looking at the necessity of this procedure, and whether there might be a more effective test.
Creating a better option
The data behind these screening results show exactly how difficult gauging metastases for T1 CRC can be, but Ajay Goel, PhD, director of the center for gastrointestinal research at Baylor Scott & White Research Institute (BSWRI), could be on the verge of introducing a new, more accurate test.
A study published in Gastroenterology chronicles how a new screening method developed by Dr. Goel has proven to be more accurate in identifying high-risk patients than any other screening currently available.
“Colon removal permanently impacts a patient’s quality of life, and now we can determine with greater accuracy if a colectomy is truly needed,” Dr. Goel said. “Our research proves we have a more accurate risk assessment screening that could drastically change patients’ treatment options and introduce less invasive tumor removal as a viable treatment method.”
For people who would ordinarily have no choice but to undergo a colectomy, this new screening method could make all the difference.
Harnessing the power of microRNA
To develop the test, Dr. Goel’s team used a method called RNA-sequencing, which allows scientists to profile strands of RNA. They collected data from the Cancer Genome Atlas and identified five RNA fragments, called microRNA, that could be linked to lymph node metastases in patients with T1 CRC.
Dr. Goel and his team conducted multiple clinical trials to test patient biopsies against the signature and see if this has the potential to be the basis for a new, more reliable screening method. Consistently, the signature identified high-risk tumors with more accuracy than has previously been recorded using traditional screening methods.
These results hold great promise, and research efforts will continue to try to pave this new path. If successful, T1 CRC patients could soon have a far less invasive treatment option to explore and an entirely new outlook on life after treatment.