Australia has one of the highest incidences of colorectal cancer in the world. Also known as bowel cancer, it’s a serious disease, with 102 Australians dying from it every week.
It’s considered one of the silent killer cancers – there are potentially few or no symptoms in early stages. If it’s caught early, however, colorectal cancer is one of the most curable types of cancer.
We spoke to leading cancer researcher Associate Professor Jeanne Tie to learn more about this deadly disease.
What is colorectal cancer?
Fast facts
- The leading cause of cancer death for ages 20–39 in Australia
- An estimated 5,326 deaths in 2022
- Colorectal cancer screening is free for Australians over 50 years old
Risk factors
- Being 50 years old or over
- Diet high in fat and red meat, especially processed and preserved meats
- Heavy drinking of alcohol
- Family history of colorectal cancer, genetic factors or past medical history of inflammatory colorectal disease
Signs and symptoms
- Blood in stool
- Change in colorectal habits or movements
- Feeling of bloating
- Unexplained weight loss, weakness or fatigue
- Rectal or anal pain
- Pain, cramps, swelling or a lump in the abdomen
- Iron deficiency anaemia
Research offers hope for colorectal cancer patients
A/Prof Tie believes there are silver linings to be found due to cancer research, despite the devastating nature of colorectal cancer.
“In Australia, statistics point towards a decline in colorectal cancer death, and I think that’s not possible without research into multiple aspects of cancer care,” she said.
Importantly, many of the advances mean more precise treatment. More colorectal cancer patients now don’t have to be subjected to unnecessary treatment and its side effects, while potentially getting more effective treatment overall.
“There’s a rare type of colorectal cancer that’s driven by what we call mismatch repair deficiency,” said A/Prof Tie. “These cancer cells cannot repair spelling errors, so they accumulate a lot of mutations in the tumour. But they are extremely sensitive to immunotherapy – they respond really well and have very long-term control of the cancer, so we can avoid chemotherapy.”
Moving beyond systemic treatment in Australia
“We need more trials,” said A/Prof Tie. “We need more research, definitely – and getting funding to do research is the next hurdle. Even though colorectal cancer represents the second highest disease burden of any cancer in Australia, it only receives around half the research funding compared to other common cancers such as breast cancer.
“It is really difficult to say, ‘I’m sorry, but all the treatment options that we have at the moment have stopped working… And we have no trial in Australia to offer you.’”
At the GI Cancer Institute, A/Prof Tie is Principal Investigator for the DYNAMIC-III trial. The study looks for circulating tumour DNA in patient blood tests.
“After surgery, the patient should not have cancer DNA floating around anymore,” said A/Prof Tie. “If they do have them floating around and we can detect them, then that means that they have some microscopic disease shedding these tumour DNA.”
The tests guided clinicians in deciding whether patients need further chemotherapy after surgery. The trial “virtually halved” the number of patients taking further chemotherapy.
“We’re hoping that, if we can control the cancer with other means, patients can have a small treatment break.”
This article was featured in The Digest, Issue 1, 2023.