New treatments for colon cancers not yet available in Ireland, conference hears

Two new treatments with the potential to cure certain colon cancers have yet to be made available in Ireland, a conference in Dublin heard on Friday.

Colon cancer, also known as bowel cancer, rectal or colorectal cancer, is the second most common cause of cancer death in Ireland. While some Irish oncologists are already trained to deliver the new treatments, they are yet to be made available in Irish hospitals.

"These aren't expensive treatments," consultant oncologist and cancer geneticist at the Mater Private Hospital, Dr David Gallagher, said. "They are both cost-effective innovations that currently aren't available here and they could make a considerable difference to how we treat colon cancer in this country."

Dr Gallagher is one of a number of Irish doctors trained in the new methods at New York's Memorial Sloan Kettering Cancer Centre, a colon cancer treatment leader. Organiser of the Innovations in Colorectal Cancer conference in Dublin, he invited leading oncologists from Sloan Kettering to talk about the new treatments.

Colon cancer most commonly presents in people in their 60s though it can occur at any age, Dr Gallagher said. While a family history of the disease can indicate a predisposition, most commonly it is not hereditary. Symptoms include a change in bowel habit, blood in the stool or a change in stool quality. Weight loss and abdominal pain can occur if the disease is advanced.

Colorectal cancers develop from tiny growths called “polyps” which can over time become cancerous. The national colon cancer screening programme Bowel- Screen now under way is aimed at catching polyps before they become cancerous.

Dr Gallagher said survival rates had improved in the past decade, from about six months for someone with advanced colorectal cancer to about three years.

With new treatments such as those presented at last week's conference however, oncologists can now approach patients with advanced colorectal cancer with curative intent. Sloan Kettering oncologist Dr Diane Reidy explained the new treatments, the first aimed at those whose colorectal cancer had spread to the liver.

“One of the things unique to Sloan Kettering is we have a hepatic arterial infusion treatment where during surgery a catheter is inserted and chemo is directed right to the liver.” Enabling chemo to be delivered at much higher concentrations to a specific location, she said multiple studies had shown an increased response rate from the tumour. “By shrinking the tumours, you can actually then allow these patients to potentially go for curative surgery which is very exciting.

“Ireland has surgeons who have trained with us who would be more than capable of doing that,” Dr Reidy said.

The second treatment, aimed at those whose colorectal cancer has spread to the peritoneum, or abdomen lining, puts the chemo directly into the abdominal cavity.

“That has also shown improved outcomes and overall survival, and more and more patients are living longer,” she said.

Dr Gallagher said currently Irish patients must travel to the UK for this peritoneal surgery. “Irish patients go abroad at considerable expense to the Irish government but there are surgeons here, two in the Mater, who have been trained in that procedure and with relatively little investment that service could be delivered in Ireland,” Dr Gallagher said.

With some patients too unwell to travel and those who do travel spending weeks in the UK in post-surgery recovery – “at an average cost of around €100,000 per patient” – he’s calling for investment so that the surgery can be done here.

With the national bowel cancer screening programme now under way, there was likely to be an increase in colon cancer diagnosis, he said. This makes it all the more urgent that such pioneering treatments are available to Irish patients.

People concerned about bowel cancer can speak to a specialist cancer nurse by calling the Irish Cancer Society’s National Cancer Helpline on Freefone 1800 200 700.