Search

The 24th annual Western Canadian Gastrointestinal Cancer Consensus Conference (WCGCCC) was held in Richmond, British Columbia, on 28–29 October 2022. The WCGCCC is an interactive multidisciplinary conference attended by healthcare professionals from across Western Canada (British Columbia, Alberta, Saskatchewan, and Manitoba) who are involved in the care of patients with gastrointestinal cancer. Surgical, medical, and radiation oncologists; pathologists; radiologists; and allied health care professionals such as dieticians, nurses and a genetic counsellor participated in presentation and discussion sessions for the purpose of developing the recommendations presented here. This consensus statement addresses current issues in the management of colorectal cancer.

Background: Colorectal cancer diagnosis and treatment negatively impact sexual health. However, there is still a lack of interventions targeting the sexual healthcare needs of colorectal cancer patients and survivors. This systematic review aimed to identify and summarize the efficacy of available psychological interventions aimed at improving colorectal cancer patients’ and survivors’ sexual health. Methods: This review followed PRISMA guidelines for systematic reviews. A database search was conducted for studies published until July 2023 on EBSCO Host, Web of Science, PubMed, and the Cochrane Library. Manuscripts were screened according to inclusion and exclusion criteria. The risk of bias was assessed using the Quality Assessment Tool for Quantitative Studies. Results: From the 1499 records screened, four studies describing psychological interventions to improve the sexual health of the target population were identified. All studies reported on e-health programs and showed evidence of their efficacy in the improvement of participants’ sexual function. The studies presented low scores on the Quality Assessment Tool for Quantitative Studies. Conclusions: Despite the evidence that tele/e-health psychological interventions have the potential to effectively promote sexual health in colorectal cancer patients and survivors, more robust research is needed to allow for generalization. Future research should further assess the efficacy of e-health interventions (eMental Health) in promoting sexual health in patients with colorectal cancer.

Abstract Background Colorectal cancer (CRC) is among the deadliest cancers, wherein early dissemination of tumor cells, and consequently, metastasis formation, are the main causes of mortality and poor prognosis. Cofilin-1 (CFL-1) and its modulators, LIMK1/SSH1, play key roles in mediating the invasiveness by driving actin cytoskeleton reorganization in various cancer types. However, their clinical significance and prognostic value in CRC has not been fully explored. Here, we evaluated the clinical contribution of these actin regulators according to TNM and consensus molecular subtypes (CMSs) classification. Methods CFL-1, LIMK1 and SSH1 mRNA/protein levels were assessed by real-time PCR and immunohistochemical analyses using normal adjacent and tumor tissues obtained from a clinical cohort of CRC patients. The expression levels of these proteins were associated with clinicopathological features by using the chi square test. In addition, using RNA-Seq data of CRC patients from The Cancer Genome Atlas (TCGA) database, we determine how these actin regulators are expressed and distributed according to TNM and CMSs classification. Based on gene expression profiling, Kaplan–Meier survival analysis was used to evaluated overall survival. Results Bioinformatic analysis revealed that LIMK1 expression was upregulated in all tumor stages. Patients with high levels of LIMK1 demonstrated significantly lower overall survival rates and exhibited greater lymph node metastatic potential in a clinical cohort. In contrast, CFL-1 and SSH1 have expression downregulated in all tumor stages. However, immunohistochemical analyses showed that patients with high protein levels of CFL-1 and SSH1 exhibited greater lymph node metastatic potential and greater depth of local invasion. In addition, using the CMSs classification to evaluate different biological phenotypes of CRC, we observed that LIMK1 and SSH1 genes are upregulated in immune (CMS1) and mesenchymal (CMS4) subtypes. However, patients with high levels of LIMK1 also demonstrated significantly lower overall survival rates in canonical (CMS2), and metabolic (CMS3) subtypes. Conclusions We demonstrated that CFL-1 and its modulators, LIMK1/SSH1, are differentially expressed and associated with lymph node metastasis in CRC. Finally, this expression profile may be useful to predict patients with aggressive signatures, particularly, the immune and mesenchymal subtypes of CRC.

ABSTRACT Background: Studies with biomarkers in TMA (tissue microarray) have been showing important results regarding its expression in colon cancer. Aim: Correlate the expression profile of the OPN and ABCB5 biomarkers with the epidemiological and clinicopathological characteristics of the patients, the impact on the progression of the disease and the death. Method: A total of 122 CRC patients who underwent surgical resection, immunomarking and their relationship with progression and death events were evaluated. Result: The average age was 61.9 (±13.4) years. The cases were distributed in 42 (35.9%) in the ascending/transverse colon, 31 (26.5%) in the sigmoid, 27 in the rectum (23.1%), 17 (14.5%) in the descending colon. Most patients had advanced disease (stages III and IV) in 74 cases (60.9%). There was a predominance of moderately differentiated tumors in 101 samples (82.8%); despite this, the poorly differentiated subtype proved to be an independent risk factor for death in 70%. Metastasis to the liver proved to be an independent risk factor for death in 75% (18/24), as well as patients with primary rectal tumors in 81.5% (22/27). Conclusion: The immunohistochemical expression of the OPN and ABCB5 markers was not associated with epidemiological and clinicopathological characteristics. Regarding the progression of disease and death, it was not possible to observe a correspondence relationship with the evaluated markers.

Introduction: Introduction: Sexual health is a central dimension of overall health and quality of life, yet it remains a largely neglected component in vulnerable populations such as cancer patients. Colorectal cancer (CRC) is currently one of the most prevalent types of cancer worldwide, and its treatments negatively affect people's sexual and relational health and well-being throughout the course of the disease. Notwithstanding the negative impact of treatments on different dimensions of sexual functioning (e.g., changes in sexual desire, sexual arousal, and orgasm experience), on the experience of pleasure and sexual satisfaction of people with CRC, access to specialized support is often hampered due to organizational, geographical, and attitudinal barriers (e.g., stigma). Given their intimate nature, accessibility, and convenience/flexibility, smartphone-based digital interventions can help bridge this gap and be an important supportive tool to effectively address unmet sexual health care needs in people with CRC. However, there is still a lack of studies evaluating the acceptability, feasibility, and effectiveness of smartphone-based sexual health promotion programs for people with CRC. Objective: Objectives: The objective of this study is to evaluate the acceptability, feasibility, and preliminary efficacy of Anathema, a program developed for the promotion of the sexual health of CRC survivors. Methods: Methods: A randomized controlled pilot study is underway and involves 30 CRC survivors randomly assigned to an experimental group (with access to the program) and a waiting list control group (treatment as usual). The program was structured into five modules to be completed in 8 weeks and developed based on the principles of Cognitive-Behavioral Therapy. An institutional Ethical Board approved the study. Acceptability, usability, and feasibility of Anathema were the primary outcomes defined in this study. Sexual and relational satisfaction, sexual functioning and distress, sexual pleasure, and quality of life were defined as secondary outcomes. Results: Results: The participatory design used throughout the different phases of this project anticipates a good acceptability of the program among its primary users. It is also expected that the program and the design adopted will be suitable for the future implementation of an RCT. Improvement in levels of sexual and relationship satisfaction, sexual pleasure, quality of life, and a decrease in levels of sexual distress in people who use the program compared to people in the waiting list group, are also expected. Conclusions: Conclusions: Anathema is a promising program for promoting sexual health and quality of life in CRC survivors. Funding source: This project is jointly funded by the European Commission through the AAL Program (ref. AAL-2020-7-133-CP) and its Member States: Fundação para a Ciência e a Tecnologia, in Portugal (AAL/0005/2020), Austrian Research Promotion Agency (FFG), in Austria, and ZonMw, the Netherlands Organization for Health Research and Development, in the Netherlands. Disclosure: No. [ABSTRACT FROM AUTHOR]