Bowel cancer treatment should be individualized?

  Colorectal cancer, or colorectal cancer, is an important disease that seriously threatens people’s life and health in China, and its incidence rate ranks the third among malignant tumors in China, and is the second most common cancer in Beijing. With the improvement of people’s living standard, the incidence rate of colorectal cancer is still increasing. Compared with western countries, colorectal cancer patients in China have distinctive characteristics, namely, more low-grade rectal cancer and younger incidence. These two points make our colorectal cancer patients suffer more pressure and torment, so the treatment of colorectal cancer is more important.  A colorectal cancer patient comes to us with a series of questions: Can the lesion be removed surgically? If not now, is there any hope to remove it in the future? How far has the disease progressed? Do we need radiotherapy after surgery? What is the most appropriate dose of chemotherapy? What if liver metastases appear? Will the patient benefit from targeted therapy? How should patients be followed up after treatment? Such questions are numerous and complicated, so how can patients benefit the most?  In the past, the principle of colorectal cancer treatment was to remove as many resectable colorectal cancers as possible, while those that cannot be removed should be treated with conservative chemotherapy only. The formulation of individualized comprehensive treatment plan for bowel cancer requires the discussion and analysis and sincere cooperation of multiple departments, such as surgery, chemotherapy, radiotherapy, imaging, pathology, interventional medicine, etc., and the integration of almost all the resources related to the disease for the maximum benefit of patients, which we call MDT (Multiple Disciplinary Team).  In 2007, our hospital was the first in China to carry out MDT consultation for colorectal cancer, and the specific process is shown in the figure below. For patients with complex and inconclusive conditions, we will analyze and discuss them in the MDT consultation room every week, and let physicians from different specialties express their opinions and speak freely, so as to clarify the diagnosis and stage of the disease and formulate a clear treatment plan according to the specific conditions of each patient. During the implementation of the treatment plan, the MDT expert team will follow up the patient’s condition for a long time and adjust the treatment plan at any time according to the results of the follow-up. If the previous treatment model is somewhat like mass production in a factory, then the MDT model can be said to be tailor-made, tailored to the local conditions, providing the most accurate and appropriate individualized comprehensive treatment for patients.  The MDT treatment model has been widely implemented in Western countries, and is now being accepted by more and more hospitals in China. According to foreign reports, MDT-based individualized treatment significantly improves the treatment outcome of colorectal cancer patients, increases overall survival time, reduces disease recurrence, and plays an incomparably important role in the treatment of colorectal cancer, and the results of our hospital also confirm this conclusion. It has always been the core of our traditional philosophy of people’s livelihood, in fact, it is also true for the treatment of diseases. It is believed that with the development and standardization of MDT-based individualized and comprehensive treatment model for bowel cancer, the majority of colorectal cancer patients will surely get more and more benefits.