Breakthrough research has revealed bowel cancer can generally be classified as four distinct diseases – each with different characteristics
Bowel cancer can generally be classified as four distinct diseases – each of which has its own characteristics, new research has revealed.
The discovery may lead to doctors treating each type of disease differently, and assist the development of more targeted drugs.
Also known as colorectal cancer, bowel cancer affects the colon and rectum.
The disease is the third most common cancer in the world, with nearly 1.4 million new cases diagnosed in 2012, according to the World Cancer Research Fund.
The new conclusions were drawn after British scientists combined clinical and molecular data collected from 3,443 patients with bowel cancer around the world.
Information on genetic mutations, gene activity, immune system activation, cell metabolism, cancer cell type and invasive ability was analysed.
The scientists found that 87 per cent of cancers fell into one of four distinct groups, or ‘consensus molecular subtypes’ (CMS).
One set of patients, with the CMS4 subtype, were often diagnosed late.
This meant the disease had often spread – and these people therefore had significantly worse survival rates.
Another group, CMS2, had much better survival rates even after the cancer had relapsed.
Study co-leader Dr Anguraj Sadanandam, from the Institute of Cancer Research in London, said: ‘Our study has identified four distinct types of bowel cancer, each with a definite set of genetic and biological characteristics, and some of which are more aggressive and more likely to be fatal than others.
‘This could allow doctors to pick out those patients with more aggressive disease and treat them accordingly.
‘Ultimately, it could lead to development of new tests to diagnose patients by their particular type of bowel cancer, and give them the most effective treatments for that type.’
Professor Paul Workman, chief executive of the Institute of Cancer Research, said: ‘Over the last decade there has been a major change in the way we look at cancer, with an increasing understanding that tumour types such as breast cancer, prostate cancer and now bowel cancer are actually multiple different diseases.
Bowel cancer (pictured) is the third most common cancer in the world, with nearly 1.4 million new cases diagnosed in 2012, according to the World Cancer Research Fund
‘Our researchers and colleagues around the world have analysed huge amounts of data on the genomics and biology of bowel cancers in order to arrive at this new classification.
‘The findings will allow us to understand the behaviours and weaknesses common to each type of bowel cance.
‘That information can then be used to predict how patients are likely to respond to current treatments and to design tailored approaches to therapy.’
The research is published in the latest edition of the journal Nature Medicine.
It comes just three months after Cambridge researchers announced that prostate cancer can be classified into five types, depending on its DNA.
The breakthrough could allow doctors to better distinguish the more common, slow-growing forms of the disease from the deadlier, faster-growing varieties – the ‘holy grail’ of prostate cancer research.