Colorectal Cancer Diagnosis and Therapeutic Updates

Colorectal Cancer is a complex disease caused by the interaction of hereditary and environmental factors that can be classified based on their importance. Colorectal Cancer Diagnosis and Therapeutic Updates provides comprehensive information about the diagnosis and treatment of colorectal cancer. Chapters first cover the fundamentals of colorectal cancer diagnosis, progressing further towards explaining therapeutic modalities and recent advances in the understanding of the disease. Key Features - 11 organized, reader-friendly chapters that provide a complete overview of colorectal cancer - Covers the colorectal cancer diagnosis, screening and histopathology - Covers multimodal treatment of colorectal cancer, including chemotherapy, radiotherapy and robotic surgery - Covers the management and surveillance of colorectal cancer - Explains the key biochemical mechanisms involved in colorectal cancer treatment - Covers recent information about colorectal cancer theranostics and drug delivery - Includes references for further reading in every chapter The book serves as an introductory reference for medical students and residents on the subject of colorectal cancer. It also serves as a quick reference on the disease for the practicing general physician. Cover 1 Title 2 Copyright 3 End User License Agreement 4 Contents 6 Foreword 11 Preface 12 Acknowledgement 14 List of Contributors 15 Colorectal Cancer Diagnosis 16 Sankha Bhattacharya1,*, Amit Page1,*, Kapil Gore1,* and Amaiyya Agrawal1,* 16 INTRODUCTION 16 Invasive Examination 17 NON-INVASIVE DIAGNOSIS METHODS 18 Fecal Occult Blood Test 18 Non-enzymatic Tumor Markers 19 Lysosomal Exoglycosidases as Potential CRC Markers 20 CONCLUSION 21 CONSENT FOR PUBLICATION 21 CONFLICT OF INTEREST 21 ACKNOWLEDGEMENTS 21 REFERENCES 21 Screening for Colorectal Carcinoma 23 Sankha Bhattacharya1,*, Saurabh Maru1,* and Aseem Setia2,* 23 INTRODUCTION 23 DETECTION OF EARLY COLORECTAL CARCINOMA 24 EARLY DIAGNOSIS OF COLORECTAL CARCINOMA 24 WHAT IS SCREENING? 24 WHO SHOULD BE SCREENED? 24 SCREENING PEOPLE AT AN AVERAGE RISK FOR COLORECTAL CARCINOMA 25 Fecal Occult Blood Test 25 Flexible Sigmoidoscopy 26 Combination of FOBT and Flexible Sigmoidoscopy 26 Colonoscopy 26 SCREENING PEOPLE AT INCREASED RISK FOR COLORECTAL CARCINOMA 27 Genetic Syndromes 27 NEW SCREENING TESTS 28 CT Colonography 28 Faecal Occult Blood Test 28 CONCLUSION 28 CONSENT FOR PUBLICATION 28 CONFLICT OF INTEREST 28 ACKNOWLEDGEMENTS 28 REFERENCES 29 Histopathology 31 Sankha Bhattacharya1,*, Shilpa Dawre1,* and Dyanesh Saindane1,* 31 INTRODUCTION 31 NORMAL HISTOLOGY OF COLORECTAL AREA 31 GENERAL PRESENTATION IN COLORECTAL CANCER 32 NEED FOR HISTOPATHOLOGICAL INSPECTION IN COLORECTAL CARCINOMA 33 FACTORS INVOLVED IN THE HISTOPATHOLOGICAL ANALYSIS OF COLORECTAL CARCINOMA 33 HISTOPATHOLOGIC DIAGNOSIS OF COLORECTAL CANCER 34 HISTOLOGIC VARIANTS 35 GRADING OF COLORECTAL CARCINOMA USING HISTOPATHOLOGICAL ANALYSIS 35 Process of Grading the Cancers 36 Issues with PDC System and their Rectification 37 CONCLUSION 37 CONSENT FOR PUBLICATION 37 CONFLICT OF INTEREST 37 ACKNOWLEDGEMENTS 37 REFERENCES 37 Chemotherapy and Colorectal Cancer 39 Kapil Gore1,*, Dnyanesh Saindane1,* and Sankha Bhattacharya1,* 39 INTRODUCTION 39 CHEMOTHERAPY AND COLORECTAL CANCER 39 Administration of Chemotherapeutic Agents 39 CHEMOTHERAPY IN DIFFERENT STAGES OF COLORECTAL CANCER 40 COMPONENTS OF CHEMOTHERAPY 41 5-Fluorouracil (5-FU) 41 Irinotecan 42 Oxaliplatin 42 NOVEL THERAPIES FOR COLORECTAL CARCINOMA 42 Agarose Microbeads 42 Anti-inflammatory Agents 43 Probiotics 43 Functional Foods 43 TARGETED THERAPIES 44 Targeting EGFR 44 Cetuximab and Panitumumab 44 BRAF Inhibitors 45 HER-2 Inhibitors 45 Targeting VEGF 45 Bevacizumab 45 Novel anti-VEGFR Agents 46 HGF/C-MET Pathway 46 HGF Inhibitors 47 MET Antagonists 47 TKIs 47 IMMUNE CHECKPOINT BLOCKADE 47 ADJUVANT AND NEOADJUVANT THERAPY USING TARGETED MEDICINE 48 CONCLUSION 49 CONSENT FOR PUBLICATION 49 CONFLICT OF INTEREST 49 ACKNOWLEDGEMENTS 49 REFERENCES 49 Robotics for Rectal Cancer 52 Dnyanesh Saindane1, Ajay Madrewar1 and Sankha Bhattacharya1,* 52 INTRODUCTION 52 TOTAL MESORECTAL EXCISION 52 Techniques Abdominoperineal Resection 53 Coloanal Anastomosis 53 LOCAL EXCISION 53 Transanal Excision 53 Transcoccygeal Excision 54 Transsphincteric Excision 54 Transanal Endoscopic Microsurgery 54 DISADVANTAGES OF SURGICAL TREATMENT FOR RECTAL CANCER 55 Short Term Effects of Surgery 55 Long Term Effects 55 LAPAROSCOPIC SURGERY 55 ADVANTAGES OVER CONVENTIONAL SURGICAL METHODS 55 Short Term Advantages Are: 55 Long Term Advantages 56 Limitations of Laparoscopic Surgery 56 ROBOTIC SURGERY FOR COLORECTAL CANCER 57 Components of the da Vinci surgical System 57 Operation of the System 57 OUTCOMES OF DA VINCI SURGICAL SYSTEM 58 Short Term Outcomes 58 Long Term Outcomes 58 CONCLUSION 59 CONSENT FOR PUBLICATION 59 CONFLICT OF INTEREST 59 ACKNOWLEDGEMENTS 59 REFERENCES 59 lncRNA NLIPMT Inhibitors in Colorectal Cancer Management 61 Aseem Setia1, Sankha Bhattacharya2,* and Amaiyya Agrawal2 61 INTRODUCTION 61 LNCRNA IN COLORECTAL CANCER 64 HOTAIR 65 H19 67 MALAT 1 69 INVOLVEMENT OF LNCRNAS IN CRC PATHOGENESIS 70 Wnt/β-Catenin Pathway 71 EGFR/IGF-IR SIGNALING (PI3K AND KRAS PATHWAYS) 74 TGF-Β SIGNALING PATHWAY 75 P53. PATHWAY 75 EMT PROGRAM 76 DETAIL DISCUSSION OF EXPERIMENTAL DATA CONDUCTED FOR COLORECTAL CANCER (CRC) 76 lncRNA Overexpression TGF-β1 Downregulation by NLIPMT Inhibits Colorectal Cancer Cell Migration and Invasion 76 The Activation of KPNA3 by LncRNA DLEU1 Leads to the Advancement of Colorectal Cancer 77 CONCLUSION 78 ABBREVIATIONS 78 CONSENT FOR PUBLICATION 79 CONFLICT OF INTEREST 79 ACKNOWLEDGEMENTS 79 REFERENCES 79 Pathways in Colorectal Cancer 86 Ajay Madrewar1,*, Kapil Gore1 and Sankha Bhattacharya1 86 INTRODUCTION 86 CHROMOSOMAL INSTABILITY PATHWAY 86 Adenomatous Polyposis Coli gene and wnt Signaling Pathway 87 TP-53 Mutation 87 18q Loss of Heterozygosity (LOH) 87 MICROSATELLITE INSTABILITY PATHWAY 88 EPIGENETIC INSTABILITY AND CPG METHYLATION 88 PI3K/AKT PATHWAY, PTEN, AND TGFΒR2 89 SIGNALLING PATHWAYS IN COLORECTAL CANCER 90 EGFR/MAPK Signaling Pathway 90 Notch Signaling Pathway 90 PI3K Signaling Pathway 91 TGF-βsignalling Pathway 92 Wnt Pathway 93 CONCLUSION 94 CONSENT FOR PUBLICATION 94 CONFLICT OF INTEREST 94 ACKNOWLEDGEMENTS 94 REFERENCES 94 Radiotherapy in Colorectal Cancer 96 Amit Page1, Dnyanesh Saindane2 and Sankha Bhattacharya2,* 96 INTRODUCTION 96 TYPES OF RADIATION THERAPY 97 CLINICAL TRIALS OR RESEARCH STUDIES OF RADIATION AND CHEMO-RADIATION THERAPY IN COLORECTAL CANCER 98 Neoadjuvant Radiation Therapy 101 Probable Side Effects of Radiotherapy 101 CONCLUSION 102 CONSENT FOR PUBLICATION 102 CONFLICT OF INTEREST 102 ACKNOWLEDGEMENTS 102 REFERENCES 102 Surveillance for Colorectal Cancer 105 Saurabh Maru1, Kapil Gore1 and Sankha Bhattacharya1,* 105 INTRODUCTION 105 COLONOSCOPY 106 FLEXIBLE SIGMOIDOSCOPY 107 CONCLUSIONS 108 CONSENT FOR PUBLICATION 108 CONFLICT OF INTEREST 108 ACKNOWLEDGEMENTS 108 REFERENCES 108 Recent Theranostics in Treatment of Colorectal Cancer 110 Shilpa Dawre1, Ajay Madrewar1 and Sankha Bhattacharya1,* 110 INTRODUCTION 110 NANOFLATFORMS FOR DRUG DELIVERY AND THERANOSTICS 111 NANOLIPOSOMAL BASED THERANOSTIC NANOPARTICLES 112 Prodrug Approach 113 SUPER MAGNETIC IRON-OXIDE NANOPARTICLES (SPIONS) 114 CONCLUSION 115 CONSENT FOR PUBLICATION 115 CONFLICT OF INTEREST 115 ACKNOWLEDGEMENTS 116 REFERENCES 116 Management of Colorectal Cancer 118 Sankha Bhattacharya1, Amit Page1, Saurabh Maru1 and Shilpa Dawre1 118 MANAGEMENT OF COLORECTAL CANCER 118 HOW CAN YOU PREPARE PATIENTS FOR SURGERY? 119 Enhanced Recovery After Surgery (ERAS) 119 Stomal Therapy 119 Bowel Preparation 119 Nutritional Interventions 120 LOCAL RECTAL TREATMENT OF RECTAL CANCER (CLINICS IN THE COLON A RECTAL) 120 Tumor Evaluation 120 Electrocoagulation 121 Contract Radiotherapy 122 Local Excision 122 ENDOSCOPIC TREATMENT 123 Snare Polypectomy 123 Endoscopic Mucosal Resection (EMR) 123 Endoscopic Submucosal Dissection 124 WHAT IS THE SURGICAL OPTION FOR COLORECTAL CANCER? 124 Open Surgery 124 Laparoscopic Surgery 125 WHAT ARE POSSIBLE COMPLICATIONS? 125 Immediate 125 Long Term 125 WHAT IS THE ROLE OF ADJUVANT CHEMOTHERAPY IN COLORECTAL CANCER TREATMENT? 126 CONCLUSION 126 CONSENT FOR PUBLICATION 127 CONFLICT OF INTEREST 127 ACKNOWLEDGEMENTS 127 REFERENCES 127 Subject Index 130 Back Cover 137