Colorectal Cancer Treatments in Asia: Surgery, Chemotherapy, and Targeted Drugs

Colorectal cancer is the third most common cancer worldwide and is rapidly increasing in Asia due to lifestyle changes, aging populations, and limited screening programs. While surgery and chemotherapy remain standard treatments, targeted drugs and immunotherapies are reshaping outcomes. This article explores colorectal cancer treatments in Asia, highlighting surgical options, chemotherapy, targeted therapy, immunotherapy, and regional trends.

Colorectal Cancer in Asia: The Growing Burden

• Global cases: Over 1.9 million new colorectal cancer cases annually.
• Asia’s numbers: Japan and South Korea: High incidence but strong screening programs. China: Rapid increase linked to dietary changes and aging. India and Southeast Asia: Rising cases, often diagnosed late.
• Risk factors: Low-fiber, high-fat diets. Obesity, diabetes, and sedentary lifestyles. Family history and genetic predisposition.

Surgery: The Cornerstone of Treatment

Early-Stage Surgery

• Polypectomy and endoscopic mucosal resection for very early cases.
• Laparoscopic colectomy widely used in Japan, South Korea, and Singapore.

Advanced Surgery

• Total colectomy or hemicolectomy for localized but invasive cancers.
• Robotic surgery: Expanding in Japan, South Korea, and China for precision.
• Challenges in Asia: Many patients present too late for curative surgery.

Chemotherapy for Colorectal Cancer

Adjuvant Chemotherapy

• Standard after surgery for stage II and III cancers.
• FOLFOX (5-FU, leucovorin, oxaliplatin) most common regimen.

Metastatic Disease

• FOLFIRI (5-FU, leucovorin, irinotecan) widely used.
• Combination with targeted therapies improving survival.

Regional Differences

• Japan and South Korea: Early adoption of advanced regimens.
• China and India: Increasing use but cost remains a barrier.

Targeted Therapy

VEGF Inhibitors

• Bevacizumab (Avastin): Improves outcomes in advanced disease.
• Increasingly available in China, India, and Southeast Asia through generics.

EGFR Inhibitors

• Cetuximab and panitumumab effective for RAS wild-type cancers.
• Widely used in Japan and South Korea.

HER2 and BRAF Targets

• Targeted drugs in clinical trials in Asia.

Immunotherapy

Checkpoint Inhibitors

• PD-1 inhibitors (nivolumab, pembrolizumab) effective in mismatch repair-deficient (dMMR) tumors.
• Japan and China at the forefront of immunotherapy clinical trials.

Combination Therapies

• Ongoing studies combining immunotherapy with chemotherapy or targeted drugs.

Regional Insights

• Japan: Strong colorectal screening programs, high rates of early detection, access to all major therapies.
• South Korea: Similar to Japan; emphasis on robotic and minimally invasive surgery.
• China: Rapid growth in incidence; major expansion of treatment centers and clinical trials.
• India: Rising cases, limited access to targeted drugs, reliance on generics.
• Southeast Asia: Late diagnoses common; advanced therapies less accessible.

Challenges in Asia

1. Low Screening Rates: Many patients diagnosed at advanced stages.
2. Cost Barriers: Targeted therapy and immunotherapy often unaffordable.
3. Healthcare Inequalities: Rural vs urban gaps in access to treatment.
4. Lifestyle Shifts: Westernized diets driving incidence in developing Asia.

Future Directions in Colorectal Cancer Care

1. Expansion of Screening Programs: Widespread use of colonoscopy and fecal tests.
2. Genomic Profiling: Personalized treatment based on tumor mutations.
3. Broader Access to Immunotherapy: Through generics and regional clinical trials.
4. AI-Assisted Diagnostics: Early detection through advanced imaging.
5. Public Health Campaigns: Promoting dietary changes and physical activity.

Conclusion

Colorectal cancer is a rapidly rising threat in Asia, but advances in surgery, chemotherapy, targeted therapy, and immunotherapy are improving survival.

The future of colorectal cancer care in Asia lies in early screening, affordable access to advanced therapies, and integration of precision medicine, helping millions of patients achieve better outcomes.

Written by:MedCure Asia Editorial Team
The MedCure Asia Editorial Team specializes in delivering accurate, well-researched health insights across Asia. Our mission is to provide readers with trusted guidance on medical conditions, treatments, and wellness practices.