Oxaliplatin: A Novel Platinum Analog With Activity in Colorectal Cancer

Advanced Colorectal Cancer: Current Treatment and Nursing Management With Economic Considerations

Colorectal cancer is one of the most common cancers affecting men and women in the United States. In 2005, 10% of all new cancer cases in men will be colorectal; for women, 11% of new cases will be colorectal. The disease is the third most frequent cancer occurring in both sexes. Colorectal cancer also is the third most frequent cause of death for men and women, and more than 56,000 cancer deaths in 2005 will be attributed to colorectal cancer. Chemotherapy options for treatment of the disease remained relatively stagnant until the approval of irinotecan in 1996 followed by capecitabine, oxaliplatin, and the new targeted agents. The new agents have improved efficacy of treatment for colorectal cancer and the lives of patients with advanced disease. With the new options for treatment come increased nursing and patient-teaching responsibilities, as well as increased costs associated with the newer drugs in the armamentarium of chemotherapy agents. Formulary budgets are seeing dramatic rises in expenditures for the new, targeted therapy treatments; discussion of the most appropriate therapies may be considered. This article will discuss epidemiology of colorectal cancer, treatment options in advanced colorectal cancer, and nursing care crucial to patients undergoing chemotherapy. Discussion of economic impact also will be presented.

Advances in colon cancer CHEMOTHEAPY NURSING IMPLICATIONS

Adjuvant chemotherapy for colon cancer has changed significantly during the past 5 years. The traditional agent fluorouracil has been joined by new drugs, including capecitabine, irinotecan, oxaliplatin, and targeted agents such as bevacizumab and cetuximab. These new agents bring different mechanisms of action, different side effects, and new home care nursing implications. Significant improvements in disease-free remissions and survival rates are among the many benefits of these therapies to persons with colon cancer. This article covers these newer agents, targeted therapies for colon cancer, and associated nursing and patient implications, including detailed drug information.