In the last decade there is evidence of a decrease in the age of onset of the disease/ShutterStock
About 3,200 Israelis are diagnosed with colon cancer every year, making this type of cancer the second most common malignant disease in Israel (in first place are breast cancer in women and prostate cancer in men).
Malignant tumors in the large intestine are more common among the older population, and most patients are over 60. However, in the last decade there is evidence of a decrease in the age of onset of the disease and it is recommended to start performing periodic screening tests starting at age 50, and in risk groups even earlier.
Colon cancer mortality rates are considered relatively high (the second leading cause of death among men and the third among women).
The initial stage in the diagnosis of the disease begins with tests that include imaging tests and a biopsy on which a pathological examination of the tumor is performed together, all of these will determine the stage of the disease and the characteristics of the tumor.
According to the findings, patients are offered dedicated treatment.
"I thought I lost weight because of stress and pressure"
"It all started with inexplicable weight loss," says Tsila, 64, from the south, who was diagnosed with colon cancer.
"At the end of October last year, after a lot of persuasion and pressure from family members, I decided to do a fecal occult blood test. This happened in view of a cumulative weight loss of 12 kilograms in just one year. To be honest, I was not personally stressed by it and believed that the weight loss was caused by stress, but the persuasion from the family members They did their thing, and I decided to do the test," she says.
"After a few days, I received an answer from the doctor that I found occult blood and now I have to perform a diagnostic test using a colonoscopy in order to understand whether the source of the bleeding is a polyp or a malignant tumor in the colon. A month later I performed the test, and only two hours after it was over, I received a call from the hospital where I was asked to do Another examination the next day at the surgical department at Soroka Hospital," Tsila recalls.
Colorectal cancer is the second most common malignant disease in Israel/ShutterStock
What did this test reveal?
"They found a mass in the large intestine that was stuck to one of the ovaries, so an urgent operation was scheduled to remove the tumor. During the surgical procedure, a sample was sent to the pathology laboratory and after about three weeks, the findings came that indicated that the finding was malignant," recalls Tsila.
While in the past quite a few patients with colon cancer were referred for chemotherapy treatment after surgery, today, thanks to innovative genomic tests, it is possible in some cases to prevent the need for this treatment.
In the case of Cila, a sample from the surgically removed tumor tissue was sent for Oncotest's "Colon Oncotype" test.
The test provides information on the unique biological characteristics of the tumor by measuring the expression of several genes in the tumor tissue that have been found to be related to colon cancer.
The test results provide data on the chance of cancer recurrence in the future.
The test is performed on tissue from the tumor removed during surgery and the result is obtained as a numerical value from 0-100 called the Recurrence Score.
A recurrence index with a high value indicates a higher chance of disease recurrence after surgery, while a low recurrence index indicates a lower chance of disease recurrence.
Tsila also performed the Guardant Reveal test (based on a blood sample known as a "liquid biopsy"), in order to find out if there is a minimal residual disease that could turn into metastases in the future.
In this test, which is also marketed by the Oncotest company, the free DNA secreted into the bloodstream from tumor cells, if any remain after surgery, is tested, and this is to determine if there is a remnant of a disease that cannot be seen through imaging tests or other tools.
In the case of Zilla, both tests indicated For the fact that the chance of the disease returning is very low and that there is no evidence of the presence of remnants of the disease, and thus, as mentioned, she was prevented from severe chemotherapy treatment that could cause side effects in the short and long term. Thanks to the two tests she performed, Tsila is currently satisfied with only follow-up.
"The innovative genomic-molecular tests are a significant advance in the treatment of colon cancer"/ShutterStock
"The innovative genomic-molecular tests are a significant advance in the treatment of colon cancer and in the individual treatment decisions for each patient," notes Dr. Alexander Gluzman, a senior physician in the oncology department at the Soroka Medical Center. After all, nowadays through the genomic tests we can build a personalized treatment according to the individual situation of each patient." "
The two main tests are Oncotype colon (OncotypeDX colon) and Guardant Reveal (Guardant Reveal) which we use more and more in colon cancer when it is diagnosed in stages 2 and 3 with each having its own defined goal," explains Dr. Glosman.
"The colon oncotype test uses the tumor tissue to check the chance of the disease returning with or without chemotherapy based on the calculation of the expression levels of 12 genes (7 genes related to colon cancer and 5 control genes) in the cancer cells. The test is especially important for patients in stage 2. The test was performed until today among thousands of patients and she was able to identify with high levels of accuracy the chances of disease recurrence. In fact, this test helps us not only to avoid unnecessary chemotherapy treatment among patients with low chances of recurrence, but also to understand which patients this treatment will particularly benefit, which may allow for a longer life expectancy ".
"The Guardian Rebil test is performed using a liquid biopsy which is actually a simple blood test, so there is no need for an invasive biopsy," adds Dr. Gluzman. secreted from the tumor cells into the bloodstream. If there is a minimal residual of the disease among stage 2 patients, then there is justification for chemotherapy treatment. We also use the test among patients in stage 3 - a more advanced stage who are already receiving chemotherapy treatment. The test is performed at the end of the treatment in order to find out whether There is a minimal remaining of the disease that requires additional lines of treatment."
"Actually, these are two different but complementary tests," concludes Dr. Gluzman.
These tests are huge news in the treatment of colon cancer, and therefore the scope of their use is increasing."
Sponsored by Oncotest
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