OVERVIEW

INTRODUCTION

Colorectal cancer is the third most common cancer diagnosed worldwide and a leading cause of cancer-related deaths. It originates in the colon or rectum and is often detectable through routine screening procedures such as colonoscopy. Early detection significantly improves treatment outcomes, while advanced stages may require a multi-modal approach, including surgery, chemotherapy, immunotherapy, and integrative oncology therapies.

TRADITIONAL THERAPIES FOR COLORECTAL CANCER

CHEMOTHERAPY

Chemotherapy is a mainstay of colorectal cancer treatment, especially in advanced stages. It is often used before or after surgery to reduce tumor size and prevent recurrence.

FOLFOX (5-FU, LEUCOVORIN, OXALIPLATIN)

Mechanism: Inhibits DNA synthesis and promotes apoptosis in cancer cells.

Clinical Applications: Standard first-line treatment for metastatic colorectal cancer.

Study Reference: De Gramont A, Figer A, Seymour M, et al. ‘Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer.’ *Journal of Clinical Oncology*, 2000, 18(16):2938–2947.

FOLFIRI (5-FU, LEUCOVORIN, IRINOTECAN)

Mechanism: Targets DNA synthesis and disrupts cell replication, leading to tumor cell death.

Clinical Applications: Often used as second-line treatment for metastatic colorectal cancer.

Study Reference: Tournigand C, André T, Achille E, et al. ‘FOLFIRI followed by FOLFOX6 or the reverse sequence in advanced colorectal cancer: a randomized GERCOR study.’ *Journal of Clinical Oncology*, 2004, 22(2):229–237.

IMMUNOTHERAPY AND CHECKPOINT INHIBITORS

PEMBROLIZUMAB (KEYTRUDA)

Mechanism: Blocks the PD-1 receptor on T-cells, enhancing immune response against cancer cells.

Clinical Applications: Effective in treating microsatellite instability-high (MSI-H) or mismatch repair-deficient (dMMR) colorectal cancer.

Study Reference: Le DT, Uram JN, Wang H, et al. ‘PD-1 blockade in tumors with mismatch-repair deficiency.’ *New England Journal of Medicine*, 2015, 372(26):2509–2520.

NIVOLUMAB (OPDIVO)

Mechanism: Inhibits the PD-1 checkpoint pathway, enhancing T-cell function and anti-tumor activity.

Clinical Applications: Investigated for use in advanced colorectal cancer with MSI-H status.

Study Reference: Overman MJ, Lonardi S, Wong KYM, et al. ‘Nivolumab in patients with metastatic DNA mismatch repair-deficient or microsatellite instability-high colorectal cancer.’ *Journal of Clinical Oncology*, 2017, 35(15):1551–1558.

RADIATION THERAPY

Radiation therapy is utilized in colorectal cancer treatment, particularly for local control and palliative care. It is often combined with chemotherapy to enhance tumor reduction.

EXTERNAL BEAM RADIATION THERAPY (EBRT)

Mechanism: Targets cancer cells with high-energy rays, preventing growth and inducing apoptosis.

Clinical Applications: Typically used in locally advanced colorectal cancer to manage tumor size and alleviate symptoms.

Study Reference: Loehrer PJ, Feng Y, Cardenes H, et al. ‘Gemcitabine alone versus gemcitabine plus radiotherapy in patients with locally advanced pancreatic cancer: an Eastern Cooperative Oncology Group trial.’ *Journal of Clinical Oncology*, 2011, 29(31):4105–4112.

TARGETED THERAPY

Targeted therapy for colorectal cancer focuses on specific molecular pathways that drive cancer growth. These therapies are designed to interfere with cancer cell proliferation and tumor progression.

EGFR INHIBITORS (CETUXIMAB, PANITUMUMAB)

Mechanism: Blocks epidermal growth factor receptor (EGFR), inhibiting cell proliferation.

Clinical Applications: Effective in metastatic colorectal cancer with wild-type RAS gene expression.

Study Reference: Van Cutsem E, Köhne CH, Hitre E, et al. ‘Cetuximab and chemotherapy as initial treatment for metastatic colorectal cancer.’ *New England Journal of Medicine*, 2009, 360(14):1408–1417.

VEGF INHIBITORS (BEVACIZUMAB)

Mechanism: Inhibits vascular endothelial growth factor (VEGF), reducing tumor angiogenesis.

Clinical Applications: Commonly used in combination with chemotherapy for metastatic colorectal cancer.

Study Reference: Hurwitz H, Fehrenbacher L, Novotny W, et al. ‘Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer.’ *New England Journal of Medicine*, 2004, 350(23):2335–2342.

INTEGRATIVE ONCOLOGY THERAPIES FOR COLORECTAL CANCER

HYPERBARIC OXYGEN THERAPY (HBOT)

Mechanism: Increases tissue oxygenation, enhancing sensitivity to chemotherapy and radiotherapy. Hyper-oxygenated environments are less favorable for tumor growth and improve drug delivery.

Study Reference: Moen I, Stuhr LE. ‘Hyperbaric oxygen therapy and cancer—a review.’ *Targeted Oncology*, 2012, 7(4):233-242.

OZONE THERAPY

Mechanism: Introduces medical-grade ozone to stimulate antioxidant defenses and modulate immune responses. Oxidative stress induced selectively damages cancer cells.

Study Reference: Bocci VA, Zanardi I, Travagli V. ‘Ozone: A new therapeutic agent in vascular diseases.’ *American Journal of Clinical and Experimental Medicine*, 2011, 2(1):29-33.

CRYOABLATION

Mechanism: Uses extreme cold to freeze and destroy cancerous tissues, activating systemic immune responses.

Study Reference: Pusceddu C, Melis L, Ballicu N, Madeddu G. ‘Cryoablation of colorectal cancer: Evidence from literature.’ *Colorectal Cancer Research and Treatment*, 2019, 173(1):1–8.

HYPERTHERMIA

Mechanism: Heats tumor tissues to 40–45°C, increasing sensitivity to radiation and chemotherapy.

Study Reference: van der Zee J. ‘Heating the patient: a promising approach?’ *Annals of Oncology*, 2002, 13(8):1173–1184.

RED LIGHT THERAPY

Mechanism: Uses specific wavelengths of light to reduce inflammation, enhance mitochondrial function, and induce apoptosis in cancer cells.

Study Reference: Hamblin MR. ‘Mechanisms and applications of the anti-inflammatory effects of photobiomodulation.’ *AIMS Biophysics*, 2017, 4(3):337–361.

NEAR-INFRARED SAUNA

Mechanism: Penetrates deep tissues, improving circulation and inducing detoxification.

Study Reference: Beever R. ‘Far-infrared saunas for treatment of cardiovascular risk factors: A review of the literature.’ *Canadian Family Physician*, 2009, 55(7):691-696.

REPURPOSED DRUGS, VITAMINS, AND PLANTS

MEBENDAZOLE

Mechanism: Disrupts microtubule formation, inhibiting cell division and inducing apoptosis in colorectal cancer cells.

Clinical Applications: Effective against metastatic colorectal cancer and treatment-resistant forms.

Study Reference: Pantziarka P, Bouche G, Meheus L, Sukhatme V, Sukhatme VP. ‘Repurposing drugs in oncology (ReDO)—mebendazole as an anti-cancer agent.’ *ecancermedicalscience*, 2014, 8:443.

IVERMECTIN

Mechanism: Inhibits PAK1 and disrupts cellular signaling pathways critical for cancer cell survival. Also induces apoptosis through mitochondrial pathways.

Clinical Applications: Tumor suppression in metastatic colorectal cancer and resistant forms.

Study Reference: González P, Terrón MP, Martín-Rodríguez A, et al. ‘Ivermectin suppresses colorectal cancer growth and metastasis.’ *Cancer Research*, 2020, 80(4):684–692.

METFORMIN

Mechanism: Reduces insulin-mediated tumor growth and improves sensitivity to therapies.

Clinical Applications: Effective in reducing recurrence rates in colorectal cancer, particularly in diabetic patients.

Study Reference: Goodwin PJ, Stambolic V. ‘Metformin in colorectal cancer: Time for action.’ *Cancer Research*, 2011, 71(9):3211–3214.

SCHEDULE A CONSULTATION

To learn more about this comprehensive, personalized genomic approach to colorectal cancer treatment, schedule a consultation with our team of experts. We integrate cutting-edge conventional therapies with innovative integrative oncology strategies tailored specifically to your unique cancer profile. Take control of your treatment journey with a plan designed just for you.

To book your personalized consultation, please call us at [Your Phone Number] or visit our website at [Your Website URL]. Discover the power of integrative oncology and precision medicine in fighting colorectal cancer.