Treatment of colorectal cancer
More than 40,000 individuals are affected by colorectal cancer per year, making this one of the commonest cancers in France. When it is detected at an early stage, it can be cured in 9 cases out of 10. Each year Gustave Roussy sees more than 3,000 patients with the condition. The Digestive Diseases Committee is responsible for the management of these patients.
Colorectal cancer arises from the transformation of a benign tumour into a malignant one, a transformation which takes about 10 years. Screening combined with colonoscopy is, therefore, of fundamental importance in ensuring that tumours and polyps are removed in a timely fashion before they degenerate.
Screening
Organised screening of colorectal cancer is offered routinely and free of charge in France to individuals aged 50-74 years. Until 2015 it had been performed using a guaiac technique known as Haemoccult II. A new «immunological» test is going to be put in place by the government from mid-2015.
This test has:
- greater sensitivity than the Haemoccult II, resulting in improved detection of cancer and precancerous lesions (80 % of cancers detected compared with 50%),
- only one stool specimen is required which markedly simplifies its use and facilitates automated reading of results.
If the test is positive, colonoscopy is performed to examine the inside of the colon in order to detect the abnormality which is causing bleeding. This can be carried out at the Institute.
A multidisciplinary committee
The Institute takes on the comprehensive management of digestive tract cancer from diagnosis to treatment. This includes colonoscopy, surgery, radiotherapy, chemotherapy targeted therapy, etc. A multidisciplinary gastrointestinal disease consultative committee meets weekly. This brings together the Gustave Roussy medical and surgical teams as well as the radiologists and pathologists.
In view of the large number of patients seen with gastrointestinal disease and its leading role in this field over many years, the Digestive Diseases Committee conducts numerous programmes of clinical and translational research.
Genetic predisposition
Colorectal cancer is unusual before the age of 50 years. Those cancers which do appear before that age are usually due to a genetic predisposition. Gustave Roussy provides an outpatient oncogenetic service for individuals at elevated or very elevated risk of colorectal cancer. This helps in the provision of advice on monitoring and also on specific management for young patients with a predisposition and for their family members.
