ESMO 17 th World Congress on Gastrointestinal Cancer, page-14

Hey all

I don't mean to patronise with this post but thought it might help to understand things ( I hope) or how I interpret it anyways

Cancer is a rebellious cell that says forget the rest of you cells... Im going to make more of myself and break all the rules ( perhaps like the Nazi Party) . I don't care where I go or how much I take of the bodies nutrients. I don't respect borders anymore and I am real selfish. The more bizarre the cells of the cancer the more aggressive they can be

Colon cancer in particular is deadly because its silent. You don't know you have one until sometimes too late allowing it to spread.

There are common patterns that each type of cancers spread. There is no order. It doesn't have to go to the Liver first( although frequently does). It does what it wants. It gets bigger in the colon then depending on whether it encounters the lymph system, or the blood system it will then "ship off" to the next location to spread its evil

With Colon cancer

If it hits lymph it will go to local lymph nodes. The more nodes the worse. And also unlike breast cancer where the lymph nodes can relatively easily be removed, in colon cancer its much harder because of surrounding anatomy.

If it hits blood stream, depending which vessel system results in where the tumour may go, the most common being to the liver ( via the portal system). or the lung being the next most common and then the peritoneum ( lining of the abdomen). Doesn't HAVE to go to liver first. Fortunately the way it spreads anatomically to the liver usually makes them more amenable to SIR spheres treatment because of the unsusal blood supply/ system of the liver.

AS all have said , best is when you get early and you can cut them out. If you have isolated cancer with isolated metastases then the team looking after you is much more likely to be aggressive and try for a "cure".

If you have widespread disease then there is likely they will try and palliate you and keep you comfortable.

SIR spheres to me has major possibilities to up the ante.
1.There are reported cases of "cure" . Although 6% have shown this its unlikely that it will be the main stay of Sphere use but certainly that possibility will encourage many to use earlier
2. Reducing the size of the liver mets to allow for surgical control especially in liver dominant disease
3. Symptomatic relief of liver failure causing death ( qualitative and perhaps quantitative improvement in palliative cases)

Agreed absolutely that oncologist are conservative. It would be highly unusual for all to walk away fully convinced. having to been to many conferences.. anything different is greeted that way. Every industry needs people/companies to be cutting edge but it leaves you open to doubters ( fair enough for sure)and supporters. Some of these ideas/treatments go on to revolutionise medicine. Others fall by the way side. Either now or eventually.

I sit completely comfortable to the fact that many oncologists want more data. OS is most important. I also know from chatting to my oncologist friends that many state they cannot ignore the impressive liver PFS difference. OS is likely to be improved but not definite.
The continual increase in dose sales and innumerable positive research papers also bodes very well from a medico point of view.

I think the biggest danger to SRX will be the cure for cancer when someone makes that special pill. or genetic manipulation. Until then I expect this will continue to have an increasing place in treatment.

I've researched this pretty hard. Im having a roll. Could definitely be wrong so don't follow me. Just thought be nice to summarise in layman's terms some of the cancer stuff.