Episode 11: Watch and Wait Protocol

Episode 11 is now available on SoundCloud and iTunes. 

First, the team analyzes a case involving rectal cancer in a 65 year old male patient at a team conference. Guests featured in the segment are Dr. Jeff Wisch and Dr. Harvey Mamon

Second, the podcast is joined by Dr. Rodrigo O. Perez from Brazil who worked on the Watch and Wait approach with Dr. Angelita Habr-Gama. He is an expert on the topic, and shares some of his experiences working with one of the innovators in colorectal cancer treatment. 

According to their team's study and paper in Dis Colon Rectum in 2013, "No immediate surgery (Watch and Wait) has been considered in select patients with complete clinical response after neoadjuvant chemoradiation to avoid postoperative morbidity and functional disorders after radical surgery." 

Below are some references to the topics discussed in this month's episode. Enjoy!


Brazilian protocol, originally proposed by Habr-Gama in 2006:

https://www.ncbi.nlm.nih.gov/pubmed/16813588/

 

(Habr-Gama et al., 2010) – follow-up study looking at short term data

https://www.ncbi.nlm.nih.gov/pubmed/20883957

 

(Habr-Gama et al., 2013) – same group, looking at longer-term outcomes

https://www.ncbi.nlm.nih.gov/pubmed/24022527/

 

MSKCC protocol (Smith et al., 2012)

https://www.ncbi.nlm.nih.gov/pubmed/23154394

 

van der Valk’s presentation at ASCO in 2017 re: update from the International Watch & Wait database

http://ascopubs.org/doi/abs/10.1200/JCO.2017.35.4_suppl.521

 

A recent retrospective study in Dis Colon Rectum that appeared in March 2017 (from Kong and others in Australia) that tracked outcomes with those patients end up needing a salvage operation following “watch and wait”

https://www.ncbi.nlm.nih.gov/pubmed/28177997

 

Reviews:

A recent review by Habr-Gama and others:

https://www.ncbi.nlm.nih.gov/pubmed/28501249/

 

Two good review/perspective piece on the topic of watch and wait in this disease:

Torok et al., 2016

https://www.ncbi.nlm.nih.gov/pubmed/26599064

 

Glynne-Jones and Hughes, 2016

https://www.ncbi.nlm.nih.gov/pubmed/26625960

 


Episode #9: Heated Intraperitoneal Chemotherapy (HIPEC)


Episode #9 focuses on Heated Intraperitoneal Chemotherapy (HIPEC) treatment. For those that may be unfamiliar with the topic, HIPEC is a highly concentrated and heated type of chemo directed at the abdomen during surgery. HIPEC differs from more traditional and systemic treatments due to the delivery of drugs into a patient's body. The chemo does not circulate through the entire body during HIPEC. It only delivers directly to the cancerous cells. 

The experts joining the podcast to discuss this type of care are Dr. Nelya Melnitchouk and Dr. Tom Abrams from the GI team at the Dana Farber/Brigham and Women's Cancer Center in Boston.  

Episode #7: Clinical and Surgical Trials [Pt. 2]

In the second part of our discussion on colorectal cancer trials, Dr. James Fleshman joins Ron to discuss the ACOSOG Z6051 Randomized Clinical Trial. This surgical trial aims to decipher the differences of open versus laparoscopic surgery in the treatment of colorectal cancer. To read more about Dr. Fleshman's findings and reports click here

Dr. Fleshman is the Helen and Stanley Joseph Seeger Professor and Chairman, Department of Surgery at Baylor University Medical Center in Dallas. His professional focus is the treatment of patients with colorectal diseases. He has developed an international reputation in the laparoscopic treatment of colorectal cancer and the development of randomized controlled trials to evaluate the use of laparoscopic techniques in the treatment of colorectal cancer. Click here to read a full bio.

In this episode, Jeff and Ron also answer a listener question and discuss the future of patient trials in this field. 

Episodes available on iTunes, SoundCloud, and Stitcher.

Episode #6: Colorectal Cancer Clinical Trials [Pt. 1]


The How We Treat Colon & Rectal Cancer podcast's next two episodes will feature discussions about clinical trials focused on colorectal cancer treatment. In part one, Dr. Deborah Schrag joins us to provide an inside look at the PROSPECT trial currently taking place. 

PROSPECT is the acronym for Preoperative Radiation Or Selective Preoperative Radiation and Evaluation before Chemotherapy and Total Mesorectal Excision (TME). From the on-going trial, Dr. Schrag and her team hope to decipher and compare the results of standard chemo and radiation treatment using a regimen of drugs named FOLFOX (the drugs 5-fluorouracil (5-FU), oxaliplatin and leucovorin). To learn more about this trial, listeners can click here.




Episode #5: Colorectal Cancer Genetics, Microsatellite Instability and Checkpoint Inhibitors

Episode #5 is now available on SoundCloud and iTunes.  In this episode, our hosts talk over a case with two specialists in immunotherapy from the Dana-Farber: Dr. Osama Rahma and Dr. Matthew Yurgelun. After reviewing the patient and case details, our guests outline the unique set of challenges during treatment due to the patient testing positive for Lynch Syndrome. It is an engaging discussion.


Post your questions and comments here or email howwetreat@gmail.com.

Enjoy!



Listen on iTunes!

All How We Treat Colon & Rectal Cancer Podcast episodes are now available on iTunes. Subscribe to the show today, and click here to access the show's iTunes preview page. 

Stay tuned for Episode #5 later this month. The discussion topic will be "Immunotherapy." Tweet @RonaldBledayMD or comment on this post with your questions/comments. Ron and Jeff will answer them in the upcoming episode.