The drugs Avastin, Erbitux and Vectibix will not be routinely available on the NHS for people with metastatic bowel cancers, those that have spread to the rest of the body. The decision by the National Institute for Health and Clinical Excellence (Nice) came despite the fact that there is evidence that two of the drugs can prolong life. However, patients should still be able get the medicines if their doctors believe they would benefit from them, through the 200million Cancer Drugs Fund set up by the Coalition last year. Mike Hobday, head of policy at Macmillan Cancer Support, said last night: This decision is very disappointing news for people with bowel cancer. In draft guidance unveiled yesterday, Nice said it could not recommend the use of the three drugs for metastatic colorectal cancer that has progressed after chemotherapy. None of the treatments have been approved for use in Scotland. Nice admitted Erbitux, also known as cetuximab, prolonged life for cancer sufferers who had tried other drugs that had failed, while Vectibix (panitumumab) also provided a survival benefit, although the length of this was uncertain. The organisation said there was no evidence that Avastin (bevacizumab) prolonged life for people with this type of cancer. However, none of the drugs were deemed to be cost effective, with a treatment of Erbitux costing 90,000 a year and Vectibix up to 150,000. Andrew Dillon, NICEs chief executive, said: Metastatic colorectal cancer is when the primary cancer has spread from the colon or rectum to other parts of the body, such as the liver. It can be a devastating disease for both the patient and their family. We have already recommended six treatments for various stages of colorectal cancer and are disappointed not to be able to recommend cetuximab, bevacizumab and panitumumab for this stage, but we have to be confident that the benefits justify the cost of the drugs ‘At present, the independent appraisal committee who drafted the recommendations does not feel it has enough clear evidence, especially in the case of bevacizumab, to be able to recommend these drugs for use on the NHS. Members of the public, doctors and drugs companies involved are now invited to respond to a consultation on NICEs recommendation. Last year the Coalition brought in the Cancer Drugs Fund, providing 200million for people unable to access drugs because of NICE decisions to get them funded. The public, doctors and drugs companies are now being invited to respond to a consultation on Nices recommendation.
Differences in Staging and Treatment Likely to Be Behind UK’s Low Bowel Cancer Survival
They also examined the proportion of patients at each stage of disease who survived for one year and three years after diagnosis, after correction for the impact of other causes of death. Two-thirds (67%) of colon cancer patients in the UK survived for at least one year, compared with 80% in Sweden. Three-quarters (75%) of rectal cancer patients in the UK survived for one year or more, compared with 84% in Sweden. Low overall survival in a particular country can arise either because the patients there tend to be diagnosed at a later stage of disease than in other countries, or because survival at each stage of disease is lower than in other countries. The proportion of colon cancer patients diagnosed at the earliest stage (stage A) was lowest in the UK — only 8% compared with 11-17% elsewhere. But UK patients were also less likely to be diagnosed at the most advanced stage (20% at stage D, compared with 24-31% elsewhere). For both colon and rectal cancer, survival among UK patients diagnosed at the earliest stage of disease (stage A) was similar to that in the other five countries (96%, compared to 92-98% elsewhere), but survival in the UK was consistently lower for those diagnosed at a more advanced stage (5-11% lower than elsewhere). The researchers used population-based data for all patients diagnosed in a given country or region, not just the small proportion of patients included in clinical trials. The international differences in survival may arise from differences in the availability or use of diagnostic tests, and in the use of surgery, chemotherapy or radiotherapy at each stage of diagnosis. Countries do not all collect information on stage at diagnosis in the same way, however, and this can cause artefacts in international survival comparisons. Camille Maringe, lead author based at the Cancer Research UK Cancer Survival Group at the London School of Hygiene & Tropical Medicine, said: “Accurate investigation of how far the cancer has spread (the stage) when it is diagnosed is essential for clinicians to be able to offer their patients the most appropriate treatment. This will increase survival. Investigation does not appear to be as thorough in the UK as in other countries, and except for patients with local tumours, survival is lower than in other countries at each stage of disease.
the advantage http://www.sciencedaily.com/releases/2013/04/130416214738.htm
Staging Colon and Rectal Cancer
The treatment options at this stage include polypectomy or local excision to remove the tumour and an extensive surgery (resection) to remove larger colon cancers. Stage I Stage I, is also known as Dukes. At this stage, the abnormal cancer cells spread beyond the inner walls of the colon and into the muscle layers of the colon. The treatment involves surgery to remove the cancer and a small amount of tissue around the tumour. Moreover, aggressive surgery to remove all of the cancer offers a great potential for treatment. Stage II The tumour spreads to the muscular wall of the colon and into the outer layer of the serosa, the outmost layer of the colon. The standard treatment at this stage is surgical removal of the cancer and an area surrounding it. Moreover, chemotherapy may also be given as a precaution against cancer recurrence. Stage III The stage III of colon cancer is characterised by tumour spreading beyond serosa, into the lymph nodes. The cancer may also form tissue around or near the lymph node gland and starts to hinder its functions. Treatment options at this stage involves surgery to remove the tumour and all involved lymph nodes, chemotherapy after surgery to ward off the risk of recurrence. If the tumour is large and is invading the tissue surrounding the colon, radiation may be needed.
browse this site http://www.onlymyhealth.com/stages-of-colon-cancer-1372502687
Stages of Colon Cancer
This staging process allows doctors to determine the best treatments for the particular cancer. It also allows them to determine if the cancer is getting better with treatment or not responding. Staging Colon Cancer Stage 0 Stage 0 cancer of the colon is very early cancer. The cancer is found only in the innermost lining of the colon. Learn more about treatments for stage 0 colon cancer . Stage I The cancer has spread beyond the innermost lining of the colon to the second and third layers and involves the inside wall of the colon. The cancer has not spread to the outer wall of the colon or outside the colon. Learn more about treatments for stage I colon cancer . Stage II The tumor extends through the muscular wall of the colon, but there is no cancer in the lymph nodes (small structures that are found throughout the body that produce and store cells that fight infection). Learn more about treatments for stage II colon cancer . Stage III The cancer has spread outside the colon to one or more lymph nodes (small structures that are found throughout the body that produce and store cells that fight infection). Learn more about treatments for stage III colon cancer . Stage IV The cancer has spread outside the colon to other parts of the body, such as the liver or the lungs. The tumor can be any size and may or may not include affected lymph nodes (small structures that are found throughout the body that produce and store cells that fight infection).
updated blog post http://www.webmd.com/colorectal-cancer/guide/staging-colon-rectal-cancer
The Little Magnificent Physical Exercise Web Resource 