Do you know the cost of gene testing for targeted therapy? Let me tell you in detail below

With the development of world medicine, clinical medicine technology is constantly improving. In recent years, many new methods and technologies for treating rectal cancer have emerged in the world. However, according to current clinical research, the best treatment for rectal cancer is still surgery and chemotherapy.

Examples of targeted therapy

Below are some examples of targeted treatments. Ask your health care team for more information.

Breast cancer. About 20 to 25 percent of breast cancers have too much of a protein called human epidermal growth factor receptor 2 (HER2, also pronounced HER). This protein enables tumor cells to grow. If the cancer is HER2-positive, several targeted therapies are available.

Colorectal cancer. Colorectal cancers often make too much of a protein called epidermal growth factor receptor (EGFR). Drugs that block EGFR may help stop or slow the cancer's growth. These cancers don't have a mutated KRAS gene. Another option is a drug that blocks vascular endothelial growth factor (VEGF). This protein helps make new blood vessels. Learn more about targeted therapies for colorectal cancer.

Lung cancer. Drugs that block a protein called EGFR may stop or slow the growth of lung cancer. This may be more likely if EGFR has certain mutations. Lung cancers that have mutations in the ALK and ROS genes may also use drugs. Doctors may also use angiogenesis inhibitors to treat certain lung cancers. Learn more about targeted therapies for non-small cell lung cancer.

Melanoma. About half of all melanomas have mutations in the BRAF gene (pronounced hummingbird). Researchers know that BRAF mutations are good drug targets. So the FDA has approved several BRAF inhibitors. If you don't have a BRAF mutation. Learn more about targeted therapies for melanoma.

It may seem simple to use one drug to treat a specific cancer. But targeted therapies are complex and not always effective. It’s important to remember:

If the tumor has no target, targeted treatment will not work.

Having a target does not mean that the tumor will respond to the drug.

Response to treatment may be temporary.

For example, the target may not be as important as doctors initially thought. So the drug may not help much. Or the drug may work at first but then stop working. Finally, targeted therapy drugs can cause serious side effects. These are often different from the effects of traditional chemotherapy. For example, people who receive targeted therapy often have skin, hair, nail, or eye problems.

Targeted therapy is an important type of cancer treatment. But so far, doctors can only treat a few cancers with these drugs. Most people also need surgery, chemotherapy, radiation therapy, or hormone therapy. As researchers learn more about the specific changes in cancer cells, they will develop more targeted drugs.

Why do genetic testing?

Before colorectal cancer treatment, patients can undergo genetic testing. Why do we need genetic testing?

First of all, most people with colorectal cancer have genetic changes in their bodies, and some genes can indicate the prognosis of cancer.

Secondly, with the development of genetic technology and medical technology, new targeted therapeutic drugs have emerged in the treatment of colorectal cancer. These drugs have certain targets and indications. The use of targeted drugs can achieve good therapeutic effects for specific types of advanced patients. For example, RAS gene testing can be used for wild-type advanced metastatic colorectal cancer. Cetuximab can be used for treatment.

Third, for some commonly used chemotherapy drugs, different gene types may have different effects or adverse reactions, and testing of these genes may provide guidance for treatment.

It should also be pointed out that as research deepens, more meaningful genes and detection technologies may emerge in the future.

Colon cancer surgery is divided into radical and palliative

There are many clinical treatments for rectal cancer, the most common ones are:

1. Surgical treatment

At present, the treatment of colorectal cancer generally adopts the principle of comprehensive treatment with surgery as the main treatment. According to the purpose of treatment, surgery can be divided into radical and palliative. The treatment plan is determined according to the patient's general condition and the function of each organ, the location of the tumor, the clinical stage, the pathological type and the biological behavior. The aim is to cure the tumor to the greatest extent, protect the organ function and improve the patient's quality of life.

Surgery may be considered in the following cases:

1. The patient's general condition and organ functions are able to tolerate surgery.

2. The tumor is limited to the intestinal wall or invades surrounding organs, but it can be removed in one piece and the regional lymph nodes can be completely cleared.

3. There are distant metastases, such as liver metastasis, ovarian metastasis, lung metastasis, etc., but they can be completely removed. The metastatic lesions can be removed simultaneously or in stages as appropriate.

4. If the tumor is extensively invaded or has distant metastasis, but is accompanied by symptoms such as obstruction, massive bleeding, or perforation, palliative surgery should be chosen.

Surgery is not recommended in the following cases:

1. The general condition and organ functions cannot tolerate surgery and anesthesia.

2. Extensive distant metastasis and external invasion, unable to be completely removed, without serious complications such as obstruction, perforation, massive bleeding, etc.

Whether to have a fistula is related to the size of the tumor.

Some patients may ask, why do some colorectal cancer patients need to have a fistula? Whether to choose a fistula operation is mainly related to the location, size, and distance from the anus of the tumor. Doctors usually try to use non-fistula operations, but sometimes fistula operations are needed to achieve the purpose of cure. Generally, the doctor will communicate with the patient and his family before the operation, and the doctor and family should do a good job of ideological work for the patient. In addition, some advanced patients may undergo palliative fistula operations to prevent intestinal obstruction or if intestinal obstruction has already occurred.

Adverse reactions vary among chemotherapy drugs

2. Chemotherapy

For patients with colon cancer, there may be micro-metastases or tumor cells left after surgery. Through adjuvant chemotherapy, these metastases or tumor cells can be killed as much as possible. This theory has been confirmed by large-scale clinical studies internationally. However, not all patients need and are suitable for chemotherapy. For example, patients in the early stage (stage I) do not need chemotherapy.

The importance of chemotherapy in the treatment of colorectal cancer is mainly reflected in the following aspects: first, preoperative chemotherapy can shrink the lesions and increase the surgical resection rate; second, postoperative chemotherapy, as an adjuvant treatment for surgery, can kill residual lesions, reduce recurrence and metastasis, and thus achieve the purpose of radical cure of colorectal cancer; finally, for patients with advanced colorectal cancer, chemotherapy can be used as a palliative treatment to improve the patient's quality of life and prolong survival time.

Adverse reactions may vary depending on the chemotherapy drug choice. Common adverse reactions include:

1. Gastrointestinal reactions: nausea, vomiting, and some may experience constipation, diarrhea, abdominal pain, etc.

2. Bone marrow suppression is also a common adverse reaction, among which leukopenia is the most common, followed by thrombocytopenia;

3. Manifestations of liver and kidney damage;

4. Hair loss, the incidence is low, and hair can often regrow;

5. Local adverse reactions of chemotherapy, such as phlebitis and local tissue necrosis caused by local chemotherapy drug penetration;

6. Allergy, the chance of occurrence is low;

7. Neurotoxicity is more common with platinum drugs;

8. Others, such as cardiac toxicity, skin toxicity, etc., have relatively low incidence rates.

Preoperative radiotherapy can effectively shrink tumors

3. Radiation therapy

Preoperative radiotherapy, chemotherapy before surgery, can effectively shrink the tumor, greatly improve the removal rate, reduce regional lymph node recurrence and metastasis, intraoperative cancer cell spread and partial recurrence and metastasis. Note: Simple chemotherapy, through long-term clinical diagnosis and observation, found that for advanced rectal cancer cases, the use of small doses of radiotherapy can sometimes achieve a comprehensive effect of temporary hemostasis and analgesia.

Combining targeted therapy with chemotherapy to enhance therapeutic effect

Targeted Therapy

Molecular targeted therapy is a new and proven effective treatment method. According to the different specific sites of the tumor, anti-tumor drugs act on them in a targeted manner to kill tumor cells, while having little effect on normal tissues. Targeted therapy is generally used in combination with chemotherapy, which can enhance the effect of chemotherapy but will not significantly increase the side effects of chemotherapy.

If you have symptoms of colon cancer, digital examination is the most important method of examination

People with symptoms of colorectal cancer need to go to the hospital for examination. To confirm the diagnosis, they need to undergo a colonoscopy and a pathological biopsy of suspicious areas. Only a pathological biopsy can finally determine whether they have colorectal cancer.

In clinical practice, colorectal cancer examination methods can be divided into the following types.

1. Rectal digital examination: Rectal digital examination is simple and easy to perform. Rectal digital examination is still the most basic and important examination method in a series of examinations before rectal cancer surgery.

2. Laboratory examination: fecal occult blood test, hemoglobin test, serum carcinoembryonic antigen.

3. Endoscopic examination: Patients with blood in stool or changes in bowel habits and no abnormalities found in rectal examination should undergo routine sigmoidoscopy or fibercolonoscopy.

4. CT diagnosis: CT cannot be used as a method for early diagnosis, but CT is important for the staging of colon cancer, especially for patients who are estimated not to be able to undergo direct surgery but may be able to undergo surgical resection after external radiation or local intracavitary radiotherapy.

5. Ultrasound imaging: Endorectal ultrasound imaging is a new diagnostic method aimed at detecting the external invasion of rectal cancer and the degree of tumor infiltration into the rectal wall. It has been used in clinical practice since 1983.

6. Magnetic resonance imaging: Some researchers claim that magnetic resonance imaging (MRI) is more meaningful than CT for the external invasion of rectal cancer. However, there are still many technical issues that need to be improved, and the understanding of the images provided by MRI needs to be further deepened. At the same time, compared with intracavitary ultrasound imaging, the high cost of MRI examination is also an obstacle to its widespread application.

Keep the artificial anus clean after discharge

Family members also play an important role in the treatment of colorectal cancer. First of all, they should provide spiritual and material support to patients, enlighten them, give them confidence to overcome the disease, encourage them to accept appropriate treatment plans, and maintain an optimistic attitude. Secondly, they should do a good job of preoperative and postoperative care, such as preparing meals that patients usually like to eat (foods approved by doctors), chatting with patients more often, and giving appropriate massages, etc. After discharge from the hospital, the artificial anus (colostomy) should be kept clean and cared for.