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Catching Colon Cancer At Home

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ELKRIDGE, Md. ( Ivanhoe Newswire) - Colon cancer touches the lives of 150,000 people in the U.S each year, and is the second leading cancer killer. While one of the deadliest, it's also one of the most preventable, if caught early. Now a new test could help save thousands from it.

Nothing makes Reba Streaker happier than surrounding herself with flowers. And just like her precious plants, she knows she has to take care of herself and that means screening for colon cancer.

"I had a friend who did not have a colonoscopy or any of the screenings or anything and then it became so obvious that it was too late and she lost her life to it," Reba Streaker told Ivanhoe.

That's why Reba enrolled in a study for a new DNA test to detect colon cancer. All colon cancers start as polyps. As those polyps develop, they shed cells into the stool stream. Some of these cells contain altered DNA. The new investigational test detects the abnormality in the patient's stool.

"It's a huge breakthrough. If it works as well as it seems to, then it will be a much easier way of screening for colon cancer then having them go through the colonoscopy," Steven geller, M.D., DeeP-C Study principal investigator and medical director at the Centennial Medical Group in Elkridge, MD, explained.

The in-home test could catch cancerous and precancerous tumors early, before they turn deadly.

"You can cut it out before it ever becomes cancerous and so nobody has to die from colon cancer," Dr. Geller said.

In another recent study, researchers found the test detected 87 percent of colorectal cancer in curable stages. Once detected, you still need to have a colonoscopy to find the cells and remove them, but the new non-invasive test could help persuade those who'd ordinarily shy away from a colonoscopy.

"It tells you if this test is positive, you definitely need a colonoscopy," Dr. Geller said.

A test Reba is positive about too.

"I hope this works for other people and other generations so we can save lives," Rena said.

The so-called DeeP-C Study is currently recruiting participants in more than 80 locations across the U.S. and Canada. For information on how you can participate, log onto www.exactsciences.com. If approved by the FDA, the test could be available to patients in 2014.

RESEARCH SUMMARY

BACKGROUND: Colorectal cancer is the second leading cancer killer in the United States. In the U.S. 1 in 17 people will develop colorectal cancer. The National Cancer Institute estimates there will be about 143,000 new cases of colorectal cancer diagnosed in 2012 and that almost 52,000 people will die from the disease. Colorectal cancer is more common in older Americans. About 60 percent of newly diagnosed people are age 65 or older. (SOURCE: The National Cancer Institute)

SCREENING: Screening is recommended for everyone beginning at age 50. Depending on the screening method used and individual risk factors, these tests should be repeated at 1-year, 3-year, 5-year and 10-year intervals. (SOURCE: American Cancer Society)

More than 40% of adults age 50 and older have not been screened or are not up to date with colorectal cancer screening. (SOURCE: CDC)

Colorectal cancer is highly treatable if caught early. Yet 60 percent of patients are diagnosed with the disease in its late stages, primarily due to poor screening compliance. (SOURCE: Mayo Clinic)

RISK FACTORS: No one knows exactly what causes colorectal cancer, but there are certain risk factors including age, colorectal polyps, family or personal history of colorectal cancer, genetic alterations, ulcerative colitis or Crohn's disease, diet and smoking. (SOURCE: The National Cancer Institute)

EXACT SCIENCES TEST: If approved by the FDA, the Exact Sciences test will be a new, non-invasive, in-home stool-based DNA (sDNA) screening test for the early detection of colorectal cancer. Results of two studies suggest that the test is highly accurate and significantly more sensitive than other non-invasive tests at detecting pre-cancerous tumors and early stage cancer. The test was developed by Exact Sciences and the Mayo Clinic. The Exact Sciences test detects altered DNA from pre-cancerous or cancerous polyps anywhere in the colon. All colon cancers start as polyps, and as polyps develop, they shed cells into the stool that contain altered DNA associated with both colorectal pre-cancer and cancer. If a patient's results are abnormal, a colonoscopy is required to confirm the results.

INTERVIEW

Steven Geller, MD of the Centennial Medical Group in Elkridge, MD, talks about an at home test to catch one of the deadliest forms of cancer before it's too late.

Can you talk about the scope of the problem with colorectal cancer?

Dr. Geller: First of all colorectal cancer is the third most common cancer in the United States and it's the second most deadly kind of cancer in the United States. The reason for that is we don't do a good enough job for screening for it. What's really crucial about that is colon cancer is one of the few cancers that we can catch at a precancerous stage and we can therefore prevent cancer from developing and yet we don't do a very good job screening for it. The main reason that occurs in my opinion is that the screening procedures that we have available to us aren't always accepted by the patients as well as they could be. What we're trying to do is achieve a better way of screening for colon cancer and therefore prevent the colon cancer from developing.

Because it's more invasive, do people don't want to have to go out and get screened?

Dr. Geller: Right. What happens is the major way of screening for colon cancer these days is colonoscopy. What happens with that is you have to take some type of laxative to clean your colon out the night before and they have the procedure done. While the procedure itself is really not that big of a deal, patients don't like the preparation for the procedure itself and therefore they don't do it. Frankly it's really not as bad as they think it is, but despite that people still don't do that. In the United States what we've found is that only about sixty percent of the people who are eligible for colon cancer screening actually have it done, the other forty percent don't. That's a shame because it causes the death rate from colon cancer even much higher than it needs to be.

Tell us about the new test.

Dr. Geller: What they're trying to develop is a test that uses a stool analysis by measuring the DNA in the stool looking for signs of colon cancer in the stool. Therefore the hope is that by just giving a stool sample that the test will predict what the colonoscopy will show and will find the findings of advanced adenoma which is a precancerous state or cancer at an early stage. We can therefore catch cancer when it's curable.

How does it work?

Dr. Geller: What they found is that cancer cells produce certain types of DNA that are mutations compared to what the normal DNA is supposed to be. By searching for those mutations in the cells that are in the stool, they can find the findings that are suggestive of colon cancer. Therefore by finding the mutated cells you can actually see that there's going to be colon cancer that's going to develop or is already present in the stool.

That's a big breakthrough.

Dr. Geller: It's a huge breakthrough. If it works as well as it seems to, then it will be a much easier way of screening for colon cancer than having to go through the colonoscopy. Now bear in mind that if you did find an abnormality on the stool test you would still need a colonoscopy because then you would have to go and look for it and remove it. But at least this would be a lot easier than having to have everybody go through a colonoscopy. You'd be going for a much better reason. You would know that you are at a much higher risk if the stool test was positive. Some people would be much more accepting of doing it in that case.

Who's at risk?

Dr. Geller: I would strongly encourage every person who is over fifty to follow the screening guidelines, which means basically get a colonoscopy every ten years or sometimes even more often depending on what your risk factors are. It's still the best test that's out there right now and clearly it's one of the most preventable cancers, more so than almost any other kind of cancer.

What has the success rate been so far with this study?

Dr. Geller: As far as we know there was a study that was published in Gastroenterology Magazine about a year ago that showed there was an eighty seven percent chance of picking up advanced adenomas or colon cancer by the stool test. Now obviously this study is still underway so we don't know the results of this study but that's the one piece of data that's been seen before.

How far along is this study?

Dr. Geller: The study is about half way done it appears to me. Their goal is to achieve somewhere between ten and twelve thousand patients.

Are they still recruiting then?

Dr. Geller: They're definitely still recruiting. You can look on the Exact Sciences website and they can give you information there of how to get to a study site to recruit patients.

How many sites nationwide?

Dr. Geller: There are about eighty sites nationwide. They are all over the US and also in Canada. There's probably going to be a site close to you wherever you are at because they're all over the country.

What has been the response to this from the people who have been in the trial?

Dr. Geller: It's very simple and everybody has been very accepting of it and this is easy. I have not heard any complaints from anybody so far.

Can you talk about the risks for colon cancer, what makes you more at risk?

Dr. Geller: There are certain things that make you more at risk for colon cancer. The risk factors are obviously a family history of it, if your parents had it you are at more risk. If you're African American you are more likely to get it than if you are Caucasian. Those are the two primary ones. There's also if you're heavier – if you are obese you have a slight increased risk of having colon cancer as well.

The genetic risks, what are your chances if you have someone in your family who has it? How much higher would you say they are?

Dr. Geller: I don't know the exact numbers but your chances are significantly higher if you have a first degree relative, (meaning if your parents or your sibling or your child had colon cancer) you are at significantly increased risk compared to someone who didn't have a family history.

What do you see for the future for colon cancer?

Dr. Geller: Hopefully this kind of test will be more and more successful. Clearly there may be future versions of this test that are even more successful than this one as they learn a little bit more. But the hope is that just by stool testing you'll be able to diagnose hopefully all cases of colon cancer at a very early stage or hopefully even better at a stage what they call adenoma, which is before it becomes cancerous, so you can cut it out and nobody has to suffer from colon cancer.

It seems like it's a really easy test.

Dr. Geller: It's as easy as it comes, it really is easy.

So why wasn't it thought of before?

Dr. Geller: I think they needed the technology of DNA sequencing to be able to figure out how to detect the sequences of the abnormal DNA that's really the issue. The technology to do that has become more prevalent and faster and less expensive over time and that's been the major issue.

Why is colon cancer so preventable?

Dr. Geller: We know that it follows a path. Most colon cancers start off as benign polyps, which can then be removed and if you remove them when they're in a benign polyp stage that they never become cancerous. We know there's a progression from benign adenoma to more advanced adenomas, (which are sort of precancerous) to cancer. You can cut the polyps out when they are in a benign stage or at the precancerous stage and you prevent colon cancer from developing.

Is it typical more in men or women or is it about equal?

Dr. Geller: It's fairly equal. There is some slight change but it is fairly equal.  

FOR MORE INFORMATION, PLEASE CONTACT:

Exact Sciences
American Cancer Society

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