In the digestive system, the parts of the large intestine that can be affected by the disease are the colon and/ or rectum. Similar to other cancers, the process in which colon cancer develop can be initiated by various factors, such as steady environmental stresses or inherited abnormalities. Summarized by Adrouny (2002), the first carcinogenesis phase begins with a healthy cell that gets “turned on” into the pathway by accumulated mutation in its genetic material (DNA); this usually occur in the epithelium of mucosa. The cell would then start to grow and proliferate uncontrollably more than the body needs. In the next step, so-called the polyp phase, these clones undergo further genetic changes and form into a benign neoplasm, which grows and protrudes from the mucous membrane of the colon. After the cells of these polyp matured with further mutations, the polyp has now become a malignant tumor, with the ability to invade an...
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...ctivity by cross-linking the DNA strands, inhibiting DNA transcriptions, triggering immunologic death of cells, and inducing apoptosis. To contribute its anticancer effect, Irinotecan inhibits the release of an enzyme named topoisomerase I; this enzyme is to aid in DNA recombination, multiplication, and repair. If the enzyme is blocked, the DNA of the cells would be tangled and lead to programmed cell death (Scanio and Odle, 2010).
Each of these medications has its benefits in treating colon cancer, but combination regimen has proven to be stronger and recommended for maximum results. A research conducted by Scholefield concluded that combinations of medications using Oxaliplatine or Irinotecan with 5-FU/LV are shown to be more effective than using the 5-FU/LV alone. The synergism shows an increase in both response rate and progression free survival (2006, p.197).
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