Yet among those with early-stage cancer, about half will experience a recurrence (relapse) following surgery because small, undetectable levels of it have spread to other areas (micro-metatastic cancer). This creates a dilemma for oncologists who must decide whether to recommend against post-surgical treatment, thereby running the risk that the cancer will return, or advising a patient to undergo unnecessary chemotherapy, thus erring on the side of caution. Just as half of those with early stage cancer will experience relapse, about half will either be over- or under-treated because there are no good methods for identifying who is (and is not) at high risk for relapse.

Serious ramifications stem from the decisions about post-surgical therapy. If a decision is made not to treat a patient who has potentially micro-metatastic disease, the opportunity to destroy the tumor in its early stage, when only a few tumor cells exist, is lost. When the cancer reaches detectable levels in these patients it is generally difficult to save their lives. Conversely, treating someone who is not at risk of relapse from micro-metatastic disease subjects him or her to the debilitating effects of chemotherapy. Depending upon the chemotherapy used, these patients are unnecessarily subjected to adverse long-term consequences such as mutated DNA, secondary cancers, and premature aging.

Can Apoptosis Proteins Predict Survival in Early Colon Cancer?

John Reed, MD, PhD, is the President and CEO of the Burnham Institute, La Jolla, CA, where he leads a team of some 40 researchers who are examining diagnostic testing methods aimed at pinpointing the likelihood of cancer relapse among patients with early-stage breast, colo
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Contact: Donna Krupa
djkrupa1@aol.com
703-527-7357
American Association for Clinical Chemistry
21-Jul-2003