Colorectal cancer is the third most common cancer diagnosed in both men and women in the U.S. Although the death rate from colorectal cancer has been dropping for the past 30 years, it is still the third leading cause of cancer death for both men and for women in the U.S.
- There are currently more than one million colorectal cancer survivors in the U.S.
- The overall lifetime risk of developing colorectal cancer is 1 in 23 for men and 1 in 25 for women.
- With regular screenings, colorectal cancer can be preventable.
- The age for colorectal cancer screening is now 45 years instead of 50 years.
- Several factors may place you at a higher risk for colorectal cancer, including age, personal history of polyps or cancer, inflammatory bowel disorders, type 2 diabetes, family history, genetics and lifestyle choices, such as low physical activity, obesity, smoking, moderate to heavy alcohol use, very low intake of fruits and vegetables, and diets high in red and processed meats.
Source: American Cancer Society’s Cancer Facts & Figures 2021
Signs and Symptoms
A symptom is a change in the body that a person can see and/or feel. A sign is a change that the doctor sees during an examination or on a laboratory test result. If you have any of the symptoms below, it does not mean you have cancer but you should see your doctor or health care professional so that the cause can be found and treated, if needed.
- A change in bowel habits, such as diarrhea, constipation, or narrowing of the stool, that lasts for more than a few days
- A feeling that you need to have a bowel movement that’s not relieved by having one
- Rectal bleeding with bright red blood
- Blood in the stool, which might make the stool look dark brown or black
- Cramping or abdominal (belly) pain
- Weakness and fatigue
- Unintended weight loss
Source: American Cancer Society 2021
Colorectal Cancer Research
In addition to specific projects listed below, genomics research is helping us attack colorectal cancer – and all types of cancer. NFCR has distinguished itself from other organizations by emphasizing long-term, transformative research and working to move people toward cancer genomics.
With NFCR funding since 1991, Dr. Yung-Chi Cheng and his team developed YIV-906, a botanical drug that enhances anti-cancer activity in immunotherapy, chemotherapy and radiotherapy. YIV-906 also reduces the unpleasant gastrointestinal side effects of chemotherapy. Patients with colon and rectal cancers were some of the first patients to experience these beneficial properties of YIV-906 in early Phase I clinical trials.
With support from the NFCR AIM-HI Translational Research Initiative, Dr. Cheng has now brought YIV-906 to a global Phase II clinical trial in 2020. YIV-906 is first treating Hepatitis B Virus (HBV)-associated liver cancer patients in combination with sorafenib, a front-line drug that has modest response rates and serious toxicities. If YIV-906 improves patients’ outcomes, it could become one of the first FDA-approved oral herbal medicines for anti-cancer treatment. Its acceptance as an approved drug would facilitate future clinical trials to benefit patients with other types of cancer. Significantly, since YIV-906 affects multiple biological systems, it will usher in a new model for drug discovery to treat patients holistically.
The best chance for a cure for many cancers is complete and successful surgery. Dr. Jim Basilion has developed a “smart” probe that when topically applied to cancer during surgery, lights up only cancer cells and improving the surgeon’s ability to detect tumor margins. Usually, an assessment of margins is done after the surgical procedure and patients return home. The smart probe will fulfill the unmet clinical need to reduce repeat surgeries and remove remaining colon, prostate, breast and lung cancer. Significantly, the ‘smart’ probe may reduce the chance of cancer spreading, increasing the rate of a surgical cure. With support from the NFCR AIM-HI Translational Research Initiative, the probe is being optimized towards a Phase I clinical trial initially for lumpectomies to further enhance cure rates for patients with early stage breast cancer. Success with this trial will facilitate clinical use of this “smart” probe for patients with colon and other cancers.
Dr. Daniel Von Hoff has developed an antibody pipeline to create strategic therapies of ‘monoclonal antibodies’ – proteins that specifically bind and inhibit one substance. The first monoclonal antibodies in development are those that bind to a key molecular ‘target’ found on fibrotic cells that surround many types of cancer. Targets bound with antibody can no longer signal to tumor cells to metastasize from the primary tumor. Dr. Von Hoff has personally been involved in over 200 clinical trials and his team is focusing the first monoclonal antibody therapy for patients with metastatic colorectal cancer who no longer respond to their current medicine. With NFCR funding, promising monoclonal antibodies are in final pre-clinical stages and may soon enter clinical trials to treat colorectal cancer patients who need a new effective treatment to save their lives. The strategic monoclonal antibodies to stop metastasis in pancreatic and lung cancer will be a future application.
Dr. Wei Zhang is a leader of precision oncology, using NFCR support since 2006 to characterize underlying genetic mechanisms responsible for cancer growth and progression. His research addresses the variability in cellular properties, within and across cancer types, which often leads to treatment resistance and poor survival in patients. Dr. Zhang previously identified microRNAs (miRNAs) as biomarkers to improve colorectal cancer prognosis and predict treatment response. Dr. Zhang’s precision oncology approach has the potential to improve outcomes for patients with colorectal cancer.
Aminoacyl-tRNA synthetases (aaRS) are vital ancient enzymes that make proteins in all living things. Dr. Paul Schimmel and Dr. Xiang-Lei Yang, experts in aaRS research, also study the enzyme’s other unexpected roles. One aaRS, SerRS, inhibits a pro-cancer gene and thwarts cancer’s growth and may play a role in activating the immune system to inhibit tumor progression. Expression of SerRS positively correlates with greater survival in patients with triple negative breast cancer as well as those with rectal, esophageal, kidney, and thyroid cancers as well as gliomas (brain cancer). SerRS may also be a suppressor of metastasis as enzyme levels are significantly decreased in breast tissue during metastasis. This critical research may lead to a novel way to treat cancer, offering hope to patients.