Take care of the person and not the disease. It is often said. And it is important that the approach is not limited to medical treatment, but that it integrates multidisciplinary skills and personalized responses. All to give more time, improving the prospects of patients Through early diagnosis and access to therapeutic innovation, and more life, helping patients to best live all the time of their path.
These are the objectives of an awareness campaign on the experience of people with metastatic tumor of the colorectal “More – more cure. More time. More life“.” But more generally, the challenge to this noise that represents the third more widespread neoplastic form in the world According to the International Agency for Cancer Research, it must pass through the changes of the care, increasingly effective, and above all on early diagnosis. Also because the numbers are impressive. According to the report to the AIRTUM “Cancer numbers in Italy”, In 2024 they were estimated about 48,706 new diagnoses And 442,600 living people in our country are after a diagnosis of colorectal cancer.
Color-recto carcinoma originates from colon cells, or large intestine, and rectum. In most cases it develops from small benign growths of the intestinal mucosa, called polypsthat if not removed they can suffer a malignant evolution. The fundamental is the prevention In addition to adherence to screening programs which allow to identify with specific diagnostic tests (occult blood in the stool and colonoscopy) formations and removing them in time.
How the colorectal tumor changes
The number of people who die after receiving a diagnosis of colorectal cancer is gradually decreasing over the years: the data is regularly confirmed year after year for about twenty years, thanks to the programs screeningof the Improvements of surgery and to progress of medical therapies.
While the a little less positive appearance concerns the‘incidence, That is, the number of new cases diagnosed every year. As indicated Gianluca Masi, Director of Oncology Department at the Pisan University Hospital,
“There is a decrease in the new diagnoses in the typical age group for the onset of colon tumors, that is to say 50-60 years, and it starts to observe in the North European countries, in the United States and in some areas of Asia an increase in these tumors, renamed Early-Onset, or Early onset tumorsin young-adults, between 20 and 45 years. This phenomenon, linked to environmental factors and lifestyles, raises some concern in clinicians. The colon-rectum cancer in 75% of cases is considered sporadic, in the sense that it arises and affects an individual in a completely random way, without a specific causality. About 10% of the colonctal tumors occurs as a result of a familiarity and predisposition to develop these neoplasms and then we have about 5% properly called hereditary “.
So, genetics It is certainly a very important and decisive risk factor, even if today we are able to identify the subjects who present genetic changes. The onset of most of the colonctal tumors is therefore linked to incorrect life habits: poor fiber diet, excessive consumption of animal fats and red meats, intake of processed foods (sausages), overweight/obesity, cigarette smoke and poor physical activity. These are risk factors, but they cannot be considered etiological factors. Further risk factors are chronic inflammatory intestine diseases.
The value of early diagnosis
In Italy survival is gradually increasing over the years, thanks to the screening programs, the improvements of surgery and the progress of medical therapies. However, in the face of one decrease in new diagnoses in the age group between 50 and 60 years oldwe begin to observe an increase in these tumors, renamed Early-Onset, or early onset tumors, in young-adults, between 20 and 45 years old. Just on the screening, there are many attention. As Tiziana Pia Latiano, National Councilor Aiom-Italian Association of Medical Oncology Association, recalls, screening for Color-Retto cancer has a crucial role in early diagnosis and reduction of mortality.
“Currently the programs of screening offered free of charge by the SSN In the 50-69 age group they are based on the search for occult blood in the stool and the execution of colonoscopy. Screening is able to identify the presence of neoplasm in asymptomatic people, through the identification of precancerous lesions and adenomas, the so -called polyps, benign formations potentially capable of transforming into cancer. Identifying and removing polyps is fundamental Because in these cases the possibilities of care and healing are significantly higher. The studies of the scientific literature send us a very strong message: it is essential to participate in screening, which is actually able to reduce the mortality from the colon-rect of over 30% thanks to the early diagnosis that allows immediate treatment of precancerous injuries “.
Unfortunately, it should be added that in Italy the adhesion to the screening programs for colorectal cancer is still subfottimal in many regions. It is essential to promote awareness campaigns to improve participation and guarantee fair access to prevention tools, focusing attention on population bands more at risk.
The objectives of the care
In the early stages, the tumor can be completely treated, proof of the importance of early diagnosis. The main therapeutic strategies include surgery, chemotherapy, radiotherapy, immunotherapy, molecular target drugs (target therapy). Finished the therapeutic paththe phase of the follow up which allows you to keep the quality of life and the psychological well -being of the patient and the disease under observation, identifying any appearance of recurrence or metastases early.
Obviously the picture changes in the most advanced cases such as metastatic colorectal carcinoma: treatments have the aim of slowing down the growth of cancer and preventing or delaying the formation of new metastases, maintaining the quality of life. In short, arriving soon is fundamental. But also in cases of more advanced disease, such as the metastatic carcinoma of the colorectal, the main objective is to slow down the growth of cancer and prevent or delay the formation of new metastases, while maintaining the quality of life. In short, we focus on the “Continuum of Care“, Which means” continuity of care “.
“It is a very important factor that contributes significantly to the constant decrease in the mortality recorded year after year-Masi says. This approach has its own effectiveness and validity in the specific case of colon-rectum tumor in advanced and metastatic phase. In cases where colorectal cancer is diagnosed in the initial phase, it is treated with surgery and medical therapies with Good chances of healing. In the event that the disease is advanced and has already spread metastases in other organs it is more difficult to curse – even if in some cases it can be – and it is much more complex to manage it. These patients benefit from the Continuum of Care, which consists in developing treatment strategies that provide for thesequential use of all active drugstrying to customize the therapeutic sequences to the maximum on the basis of clinical and/or biological elements (molecular characteristics of the tumor). The wealth of pharmacological options of which we have today allows us to think of a treatment strategy for advanced forms that cannot be healed with a single therapeutic act. This means that a patient can receive a first line of therapy, followed by a maintenance, a break, then resume the therapy or move on to second -line therapy and gradually to subsequent third, fourth, fifth line therapies, which from time to time allow keep the disease under control or of regret it“.
The Continuum of Care approach has scientific evidences that demonstrate how patients who manage to benefit from multiple active drugs are precisely those who have the best illness control and, therefore, a better prognosis. The oncologist today must be able to manage the sequence of treatments in order to guarantee the patient a disease control for more and longer times and balancing it with possible side effects. The continuum in these cases becomes truly a very significant added value. In this path, non -pharmacological treatments can also be associated, which are made possible thanks to the success of drug therapies. In all this, the patient also needs a psychological support which serves to physically and mentally strengthen its treatment resistance. The main benefits are related to improving the quality of life and a variable extension of survival. There chronicization of the disease It is the goal that the oncologist argues with oral therapies, with a load of commitment and side effects for the smallest patient.
