5-ASA - colorectal cancer - cell death : an intriguing threesome

Abstract

Colorectal cancer (CRC) is a complicated disease in which both genetic pre-desposition and environmental factors are important. Patients with inflammatory bowel disease (IBD) have an increased risk of developing CRC, and it is believed that treatment of IBD patients with 5-Aminosalicylic acid (5-ASA) reduces the CRC risk. The general purpose of the studies described in this thesis was to evaluate the effect of 5-ASA on the development of CRC, as well as determining the feasibility of introducing 5-ASA as an adjuvant therapy for CRC patients. Animal research showed that chronic 5-ASA medication has the ability to prevent colitis-associated CRC, confirming results from 5-ASA medication in IBD patients. Although 5-ASA was not able to prevent the development of sporadic CRC, 5-ASA treatment was found to hold a great promise for the treatment of CRC, by exerting CRC growth inhibiting, anti-progression and cell death inducing effects, and should be considered to be implemented in a future treatment strategy to CRC. Besides this, the determination of cell death products in the circulation of CRC patients and within the tumour, holds a great promise for selection of CRC patient treatment and patient folluw-up.