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New test may point to need for chemotherapy in colon cancer

North Carolina residents who have a family history of colon cancer may be interested in a study published in the New England Journal of Medicine on Jan. 21 that has identified a genetic marker that may indicate when certain types of colon cancer can benefit from chemotherapy in the early stages of the disease. Usually, stage 2 colon cancer is treated with surgery but not chemotherapy. However, researchers found that tumors are more likely to reoccur if they are the kind that do not produce the protein CDX2.

Screening the tumors for the presence of this protein is easily done with an antibody test. Most patients survive stage 2 colon cancer after five years, but until this study, doctors did not have a way of identifying tumors that were more likely to recur.

Of the patients in the study who had tumors that did not produce the protein, approximately 56 percent who did not receive chemotherapy also did not have a reoccurrence after five years compared to 91 percent of patients who did receive chemotherapy. Researchers cautioned that more studies need to be done before they can be certain that chemotherapy will lead to a better prognosis, but doctors are likely to begin putting it into practice anyway.

This study points to the importance of identifying a disease like colon cancer early because a failure to diagnose could lead to delay in treatment. For example, a person who has symptoms of colon cancer while in stage 2 without the family history or risk factors might be initially misdiagnosed. The cancer might not be detected until stage 3 or 4, and at that point, chemotherapy and other treatments might be less successful. If this happens, the patient or the family of the patient may want to consult an attorney about whether medical malpractice may have occurred.

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