Colon cancer pills

Malignant intestinal tumors can occur in any part of the digestive tract. The tumors grow rapidly, affecting surrounding tissues and metastasizing to distant organs with blood and lymph flow. The pathology most often occurs in people over 40 years of age. Pills for intestinal cancer are one of the treatment methods aimed at destroying cancer cells.

The disease has a classification, on the basis of which treatment tactics are developed:

1. The mucous membrane gradually deteriorates, pathological changes in cells occur. Ulcers and seals form in the stomach, and intoxication of the body begins. The patient complains of fever, headaches, and general malaise. There are no metastases, the lymph nodes are not affected.
2. The neoplasm gradually increases in size, but does not block the canal. At the same time, disturbances in the normal functioning of the intestines appear. There are traces of blood in the feces, intoxication increases. The tumor does not metastasize.
3. The tumor grows and presses on neighboring organs. More than ½ of the intestine diameter is blocked, nearby lymph nodes are affected. Malignant cells spread throughout the circulatory system. The patient's general condition deteriorates sharply.
4. The lymphatic system is infected with cancer cells that have penetrated all organs and tissues. Metastases are throughout the body, but the liver is most affected. This stage is the most life-threatening and can cause death.

The effectiveness of treatment depends on early diagnosis of the disease. According to statistics, if treatment is started at the first stage, the survival rate is 90%, at the second stage 70%, at the third 50% and at the fourth 30-20%. Conservative treatment and surgical methods are used as therapy. The first option is used at the early stages and to consolidate the results after surgery. The patient undergoes radiation or chemotherapy, is prescribed various tablets and injections.

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The course of treatment lasts from several days to months. The choice of drug depends on the individual characteristics of the patient. Such treatment causes a number of adverse reactions: nausea, vomiting, general weakness, alopecia, anorexia. Very often, chemotherapy is combined with surgery. This method involves cutting off the diseased section of the intestine and parts of the affected organs. The cut intestine is stitched, bringing its ends out. This condition is difficult, but not life-threatening. After treatment, the patient will undergo a long course of rehabilitation aimed at restoring the body.

5-fluorouracil

The active substance of this chemotherapy drug is the uracil antimetabolite fluorouracil. The mechanism of action of 5-fluorouracil is based on changing the structure of RNA and suppressing the division of cancer cells by blocking the enzyme thymidylate synthetase. Active metabolites penetrate tumor cells and after a couple of hours their concentration in tumor tissues is much higher than in healthy ones.

The drug is produced as a concentrate for the preparation of infusions in ampoules of 250, 500, 1000 and 5000 mg of the active substance. When administered intravenously, the drug quickly spreads through the body's fluids and tissues, penetrates the spinal cord and brain. It is metabolized to active metabolites, excreted through the lungs and kidneys.

• Indications for use: malignant lesions of the intestines and gastrointestinal tract (liver, stomach, pancreas, esophagus), mammary glands, adrenal glands, bladder, as well as tumors of the neck and head.
• The dosage and duration of therapy are determined by the attending physician, individually for each patient. The drug is administered intravenously by jet, drip, intracavitary and intraarterially. The standard dosage is 100 mg per m2 of the patient's body for 4-5 days.
• Side effects: nausea, vomiting, loss of appetite and taste, inflammation and ulceration of the gastrointestinal mucosa, bleeding, confusion, thrombophlebitis, hypoxia, decreased levels of leukocytes, platelets and erythrocytes in the blood. Visual impairment, skin allergic reactions, alopecia, azoospermia are also possible.
• Contraindications: intolerance to the components of the product, renal and hepatic insufficiency, acute infections, cachexia, low levels of leukocytes, erythrocytes and platelets. Pregnancy and lactation are absolute contraindications.
• Overdose is manifested by symptoms of nausea and vomiting, diarrhea, gastrointestinal bleeding, ulceration of the oral cavity and suppression of hematopoiesis are possible. There is no specific antidote, therefore symptomatic therapy and monitoring of the body's condition and hematopoiesis function are indicated.

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Leucovorin

Metabolite of tetrahydrofolic acid, i.e. the chemical formula of folic acid. Leucovorin is involved in the biosynthesis of DNA and RNA, is used as an antidote to cytostatics, causing the death of cancer cells. The drug has selective activity against healthy cells, so it can be combined with other chemotherapy drugs.

Leucovorin completely replaces folic acid in the body's metabolic processes. It is produced as a lyophilized powder for the preparation of a solution for intramuscular or intravenous administration. 1 bottle of the drug contains the following substances: calcium folinate 25, sodium hydroxide and NaCl.

• The medicine is used in conditions associated with relative or absolute deficiency of folic acid in the body. Prevention of toxic effects of cytostatics that block dehydrofolate reductase, therapy of methotrexate lesions of the oral mucosa, bowel cancer. The medicine is prescribed for alimentary hypovitaminosis, folate-dependent anemia, folic acid malabsorption syndrome.
• Intramuscular and intravenous injections are given as prescribed by a doctor. The dosage depends on the indications. For intestinal tumors at thermal stages, the drug is administered at 200 mg per m2 in combination with fluorouracil 370 mg per m2.
• Contraindications: individual intolerance to the components of the drug, anemia, hypervitaminosis of folic acid, renal failure (chronic). Use of the drug during pregnancy is possible with the appropriate doctor's prescription.
• Side effects: skin allergic reactions, anaphylaxis. Since the drug has low toxicity, overdose symptoms have not been recorded.

Capecitabine

An antitumor agent that is activated in tumor tissues, providing a selective cytotoxic effect. Capecitabine, when entering the body, is converted into 5-fluorouracil and undergoes further metabolism. The substance penetrates all tissues and organs, but does not have a pathological effect on healthy cells.

• Indications for use: bowel cancer (colon), breast tumors with metastases. Can be used as monotherapy if medications from the paclitaxel or anthracycline group are ineffective.
• Method of administration and dosage: tablets are taken orally with water. The recommended daily dose is 2500 mg/m2, divided into two doses. Treatment is carried out with weekly breaks, the duration of treatment depends on the body's response to the drug.
• Side effects: increased fatigue, headaches, paresthesia, visual and taste disturbances, confusion, increased lacrimation. Cardiovascular and respiratory system disorders, nausea, vomiting, skin allergic reactions, muscle pain and spasms are possible.
• Contraindications: intolerance to the components of the drug, severe renal failure, combination therapy with docetaxel, dihydropyrimidine dehydrogenase deficiency. It is used with particular caution in metastatic liver lesions, for the treatment of elderly and pediatric patients.
• Overdose: nausea, vomiting, gastrointestinal irritation, bleeding, mucositis, bone marrow suppression. Symptomatic therapy is indicated to eliminate these reactions.

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Oxaliplatin

An antitumor drug whose structure contains a platinum atom bound to oxalate. Oxaliplatin is formed by biotransformation in the DNA structure, inhibiting its synthesis. Its action is manifested by cytotoxic and antineoplastic effects.

Available in 50 ml glass bottles as a lyophilized powder for the preparation of a parenteral solution. 1 ml of the prepared solution contains 5 mg of the active substance - oxaliplatin. During infusion, 15% of the drug enters the general bloodstream, 85% is redistributed in the tissues. The active substance binds to plasma albumins and erythrocytes. It is biotransformed to form metabolites and is excreted in the urine.

• Indications: complex therapy of colorectal cancer with metastases (using fluoropyrimidine drugs), disseminated colorectal cancer, ovarian cancer. The drug can be used both as monotherapy and as part of combined treatment regimens.
• Oxaliplatin is used to treat adult patients only. The drug is administered over 2-6 hours by infusion at a dose of 130 mg/m2 every 21 days or at a dose of 85 mg/m2 every 14 days. In combination therapy with fluoropyrimidines, Oxaliplatin is administered first. The number of cycles and dose adjustments are determined by the physician.
• Side effects: myelosuppressive syndrome with suppression of all hematopoietic germs, nausea, vomiting, stomatitis, bowel disorders. CNS disorders, convulsions, headaches, skin dermatological reactions are possible.
• Contraindications: hypersensitivity to the components of the drug, treatment of children, women in the gestational period and during breastfeeding. Not prescribed for patients with initial myelosuppression with neutropenia 2 x 10 ⁹ /l and / or thrombocytopenia ‹ 100 x 10 ⁹ /l, severe renal dysfunction.
• Overdose manifests itself as an increase in adverse reactions. Symptomatic therapy and dynamic monitoring of hematological parameters are indicated to eliminate it.

Irinotecan

A specific inhibitor of the cellular enzyme topoisomerase I. Irinotecan is a semi-synthetic derivative of camptothecin. When it enters the body, it is metabolized, forming the active metabolite SN-38, which is superior in its action to irinotecan. Due to this, it is integrated into DNA and blocks its replication.

• Indications: rectal or colon cancer with metastases and locally advanced. Can be used in combination with fluorouracil, calcium folinate and for the treatment of patients who have not previously had chemotherapy. The drug is effective in monotherapy of patients with oncology progression after standard antitumor treatment.
• It is used to treat only patients over 18 years of age. The dosage depends on the stage of the disease and other characteristics of the body. Irinotecan is administered as infusions over 30-90 minutes. For monotherapy, 350 mg / m2 every 21 days. When preparing a solution for infusions, the drug is diluted in 250 ml of 0.5% dextrose solution or 0.9% sodium chloride solution. If sediment appears in the vial after mixing, the drug is subject to disposal.
• Contraindications: suppression of bone marrow hematopoiesis, inflammatory bowel disease of chronic nature, intestinal obstruction, pregnancy and lactation, intolerance to the components of the drug, childhood of the patient, bilirubin level higher than 1.5 times the maximum allowable level. It is used with special caution in radiation therapy, leukocytosis and increased risk of diarrhea.
• Overdose: diarrhea and neutropenia. There is no specific antidote, symptomatic therapy is indicated. In case of severe overdose symptoms, the patient should be hospitalized and vital organ functions should be monitored.

Bevacizumab

A drug with recombinant hyperchimeric monoclonal IgG1 antibodies. Bevacizumab selectively binds and inhibits the biological activity of vascular endothelial growth factor. The drug contains framework regions that bind to VEGF. The drug was obtained by recombinant DNA.

• Use: metastatic colorectal cancer. Used in first-line therapy and in combination with fluoropyrimidine-based chemotherapy drugs. Bevacizumab is administered intravenously by drip, jet injection is contraindicated.
• The standard dosage is 5 mg per kg of the patient's weight as a long-term infusion every 14 days. The first dose is administered within 90 minutes after chemotherapy. Subsequent procedures can be performed within 60-30 minutes. If side effects occur, the dosage is not reduced. If necessary, treatment is completely discontinued.
• Contraindications: hypersensitivity to active components, renal or hepatic insufficiency, childhood of patients, metastases in the central nervous system, lactation. Use during pregnancy is possible if the expected effect of treatment is higher than the potential risk to the fetus. The drug is used with special caution in arterial thromboembolism, for patients over 65 years old, perforation of the gastrointestinal tract, bleeding, arterial hypertension.
• Side effects: gastrointestinal perforation, hemorrhage, hypertensive crisis, neutropenia, congestive heart failure, pain of various localizations, arterial hypertension, attacks of nausea and vomiting, stomatitis, upper respiratory tract infections, dermatological reactions.
• Overdose manifests itself as an increase in side effects. There is no specific antidote, symptomatic treatment is indicated.

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Cetuximab

Pharmacological agent – chimeric monoclonal antibody IgG1, directed against epidermal growth factor receptor (EGFR). Cetuximab binds to EGFR, blocks binding of endogenous ligands and inhibits receptor functions. This leads to sensitization of cytotoxic immune effector cells in relation to tumor cells.

Dose-dependent pharmacokinetics are observed with intravenous infusions, with doses ranging from 5 to 500 mg/m2. Stable concentrations of active components in the blood are achieved after 21 applications as monotherapy. Metabolizes in several ways, including biodegradation of antibodies to small molecules, amino acids, and peptides. Excreted in urine and feces.

• Indications: colorectal cancer with metastases during standard chemotherapy, monotherapy of malignant intestinal tumors, locally advanced, recurrent and metastatic squamous cell carcinoma of the neck and head.
• Cetuximab is administered as intravenous infusions at a rate of 10 mg/min. Premedication with antihistamines is required before use. Regardless of the indications, the drug is administered once every 7 days at a dosage of 400 mg/m2 of the patient's body surface for 120 minutes. Subsequent infusions are administered over 60 minutes at a dosage of 250 mg/m2.
• The severity of adverse reactions depends on the dosage used. Most often, patients experience the following symptoms: fever, nausea and vomiting, dizziness and headaches, infusion reactions, urticaria, decreased blood pressure, loss of consciousness, airway obstruction. There are no data on overdose.
• Contraindications: pregnancy and breastfeeding, childhood, severe intolerance to the components of the product. It is prescribed with caution in case of kidney or liver dysfunction, bone marrow hematopoiesis suppression, lung or heart diseases, for the treatment of elderly patients.

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Panitumumab

A drug used for malignant lesions of the body. Panitumumab is a monoclonal antibody identical to human Ig G2. When entering the body, it binds to epidermal growth receptors. By transformation, the active substances activate the proto-oncogene KRAS. This leads to inhibition of cancer cell growth, a decrease in the production of proinflammatory cytokines and vascular growth factor.

• Indications: EGFR-expressing metastatic colorectal cancer with unmutated proto-oncogene KRAS. It is used to treat patients whose disease has begun to progress after using fluoropyrimidine, oxaliplatin and irinotecan.
• The drug is administered as an intravenous infusion using an infusion pump. The standard dosage is 6 mg/kg once every 14 days. If dermatological reactions occur, the dosage is adjusted or treatment is discontinued. Therapy is carried out until stable positive results are achieved.
• Side effects: toxic effects on the skin, nails and hair, allergic reactions of varying severity, abdominal pain, nausea, vomiting, diarrhea/constipation, stomatitis, peripheral edema, disorders of the cardiovascular and respiratory systems.
• Contraindications: hypersensitivity to the drug, pregnancy and lactation, childhood of patients.

Regorafenib

A new drug for the treatment of inoperable or metastatic gastrointestinal tumors with progression or intolerance to other antitumor agents. Regorafenib is an oral multikinase inhibitor. Its action is based on the inhibition of receptor tyrosine kinases involved in tumor formation of blood vessels.

• The tablet increases survival in metastatic colorectal cancer after progression and the use of a standard treatment regimen. Reduces the risk of death by 23% even at the terminal stages of the disease.
• Dosage: tablets are taken 40 mg (4 pcs.) 1 time per day for 21 days. After each treatment cycle, it is necessary to observe a 7-day rest interval. The duration of therapy and the number of cycles will be determined by the attending physician.
• Side effects: infections, decreased platelet count, anemia, decreased appetite, severe headaches and muscle pain, allergic skin reactions, increased fatigue, general weakness, sudden weight loss, stomatitis, speech disorders.
• Contraindications: hypersensitivity to the components of the drug, renal and hepatic insufficiency, pregnancy and lactation, tumors with KRAS mutations in the genetic material, bleeding, taking blood-thinning medications, metabolic diseases, recent surgeries, high blood pressure, prolonged wound healing.