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In the fall of 2003, Bridget Beranek, a 44-year-old wife and mother of
two young girls, was gearing up for a busy holiday season filled with
family functions, parties and shopping. So when she began to lose her
appetite and energy, Bridget initially chalked it up to holiday stress.
When the New Year came and went, but Bridget's symptoms were still
present, she knew it was more than stress. After several visits to her
primary care physician, Bridget saw an internist, and underwent a
colonoscopy. In March 2004, she was diagnosed with stage IV colorectal
cancer that had spread to her liver.
"I know it sounds cliché, but I couldn't believe this was happening to
me," said Bridget. "Scheduling a colonoscopy was not a priority for me
because I was under 50 and lived a healthy lifestyle. I ate right,
didn't drink or smoke, and went regularly for a mammogram. One thing I
learned from this experience is that colon cancer is a disease more
people, especially women, need to be better informed about."
The American Cancer Society reports that colorectal cancer, commonly
referred to as colon cancer, is the second-leading cause of
cancer-related death in the United States, second only to lung cancer.
It is also the third most common cancer diagnosed in both men and women.
Risk factors for colon cancer include a family or personal history of
the disease, intestinal polyps or chronic inflammatory bowel disease,
obesity, a high-fat diet, and being age 50 or older. Symptoms may
include changes in bowel habits, abdominal discomfort, vomiting,
fatigue, blood in the stool or unexplained weight loss, though many
people are diagnosed without any symptoms.
The Centers for Disease Control and Prevention (CDC) recommends men and
women over age 50 who have an average risk for colon cancer receive
screening. Higher-risk patients, such as those with a family history of
the disease, should talk with their physicians about when they should
begin screening.
Fortunately for Bridget, a new treatment for metastatic colorectal
cancer had just been approved by the FDA, only weeks before her
diagnosis. Her oncologist decided to treat her with a combination of
traditional chemotherapy and a targeted therapy called Avastin®
(bevacizumab). Though she occasionally has side effects such as
fatigue, Bridget's cancer has responded to the treatment and she is
doing well. She is thankful to be able to spend time with her husband
and daughters, and to practice her favorite hobby, photography.
Typically, metastatic colorectal cancer patients undergo surgery
followed by chemotherapy. Today's targeted therapies, which are
designed to attack cancer cells in a more specific way than
chemotherapy, provide an additional tool for doctors to use in treating
this disease. Avastin, for example, is an angiogenesis inhibitor, which
means it interferes with the blood vessels that feed cancer tumors, to
help prevent tumors from growing and spreading to other parts of the
body. Avastin is approved for use in combination with intravenous
5-fluorouracil-based chemotherapy for first-line treatment of patients
with metastatic colorectal cancer.
It is important to keep in mind that Avastin has been associated with
side effects in colorectal cancer. Serious side effects occur rarely,
but can include gastrointestinal perforation and slow or incomplete
wound healing and blood clot complications. Other more common side
effects seen in clinical trials include nosebleeds, high blood
pressure, proteinuria (too much protein in the urine, which may be a
sign of kidney damage), weakness, pain, diarrhea, and a reduced white
blood cell count.
Because everyone is different, it is not possible to predict what side
effects an individual may experience. If you have questions about side
effects or treatment with Avastin, talk to your doctor or another
member of the health-care team. |