South Africa has a high mortality-to- incidence ratio for colon cancer, highlighting the poor outcome relative to incidence and underscoring the urgent need for public health action. Costing studies can be leveraged to understand the treatment cost burden, providing crucial insights for resource allocation. This study aimed to estimate the treatment costs for colon cancer by stage, from the perspective of healthcare providers at a tertiary healthcare facility in South Africa. An ingredient-based approach was used to assess the stage-specific treatment costs of colon cancer at a South African tertiary academic hospital. A two-step costing process was adopted. First, treatment components were defined based on facility guidelines and verified through expert interviews, linking these components to relevant cost items for each cancer stage. Second, a bottom-up costing method was used to estimate and aggregate per-patient costs across treatment components for each stage. All capital items were annuitised using a rate of 3% and sensitivity analyses were conducted. All costs are reported in South African Rands (ZAR) and United States Dollars (USD) as per 2024 exchange rates. Identified colon cancer treatment components at the tertiary hospital include staging and risk assessment investigations, clinical consultations, surgery and chemotherapy. The estimated per-patient costs for treatment were R60,156 ($3216) for stages I and II (low-risk); R75,132 ($4017) for high-risk stage II and stage III; and R171,935 ($9193) for stage IV(resectable cases). Surgery represents a major treatment cost driver. Colon cancer treatment costs are substantial and increase with advancing stage. These findings highlight the potential cost savings from promoting early colon cancer diagnosis. To mitigate these rising costs and reduce the healthcare burden, policies should prioritise early detection and invest in accessible, stage-appropriate interventions that improve patient outcomes and saves cost.

This review highlights recent advances in designing bionanocomposites that combine clay minerals with polysaccharides as multifunctional platforms for cancer therapy. Polysaccharides such as chitosan, hyaluronic acid, alginate, pectin and cellulose derivatives offer biocompatibility, biodegradability and versatile chemical functionality, while clays including montmorillonite, sepiolite, halloysite and layered double hydroxides provide high surface area, ion-exchange capacity, structural robustness and, in some cases, porosity or tubular morphologies. Their integration yields hybrid nanomaterials capable of enhancing the stability and loading of anticancer agents, enabling stimuli-responsive and site-specific drug release, and supporting complementary modalities such as hyperthermia, photothermal therapy, gene delivery and imaging. We examine structure-property relationships governing polysaccharide-clay interactions, representative drug-delivery systems based on 5-fluorouracil, doxorubicin, erlotinib and other therapeutics, and emerging platforms incorporating superparamagnetic iron oxide nanoparticles, metal-organic frameworks and radionuclides. Particular attention is devoted to systems developed for colon, breast, lung and skin cancer treatments. Finally, we outline the challenges hindering clinical translation, including the control of composition and architecture across multiple length scales, comprehensive evaluation of in vivo fate and safety, and the need for scalable and reproducible manufacturing. Addressing these issues should accelerate the development of clay-polysaccharide nanomedicines as complementary tools for more effective and patient-tailored cancer therapies.

Discovery of 8-sulfonamidoquinolines as anti-proliferative agents against colorectal cancer: design, synthesis, and biological evaluation.

Antioxidant peptide from Synechococcus marine microalgae with therapeutic potential against human colon adenocarcinoma

Colorectal cancer is a significant health concern with high incidence and mortality rates. Raloxifene (RLX) is a selective estrogen receptor modulator that blocks estrogen receptors, reducing the risk of estrogen-dependent cancer growth. Rutin (RT), a naturally occurring flavonoid found in medicinal plants, has attracted attention for its potential role in cancer prevention and treatment, including colon cancer. In this study, the nanoparticles were prepared by the ionic gelation method. The synthesized nanoparticles were characterized by release assays and FTIR, SEM, and TEM, while their cytotoxic effects were assessed on the HT-29 colon cancer cell line. The drug loading percentage of RLX/RT/CsNPs was found to be 84% at a 1:2 w/w ratio. SEM and TEM analyses revealed that the RLX/RT/CsNPs exhibited an average size of 57.23 nm with a spherical morphology. Thermogravimetric analysis of the nanoparticles revealed a two-stage weight loss pattern, and the drug release study showed RLX/CsNPs = 44.12%, RLX = 10.68%, and RLX/RT/CsNPs = 47.12% drug release at 24 hrs. The IC50 value of RLX/RT/CsNPs was 23.51 ± 0.60 μM, which was significantly lower compared with the IC50 of RLX/CsNPs (IC50 = 252.20 ± 7.80 μM, p < 0.001) and RT/CsNPs (IC50 = 300.51 ± 52.05 μM, p < 0.001) against the HT-29 colon cancer cell lines. In conclusion, we developed a new nanoparticle system combining RLX and RT showing favorable physicochemical characteristics and synergistic effects in colon cancer cell lines. The designed NPs can be used as a promising drug therapy against colon cancer.

This study aims to develop an alternative nanoparticle-based formulation for targeted colon cancer therapy. A biocompatible thermoplastic polyurethane-oleic acid-polyethylene glycol (TPU-OLE-PEG) copolymer was synthesised. Curcumin (CUR), a natural polyphenol, was loaded into the nanoparticles, followed by folate (FO) conjugation for enable targeted delivery to HT-29 colon adenocarcinoma cells. Optimised nanoparticles exhibited a spherical, homogeneous, and monodisperse morphology with an average size of 249 ± 5.7 nm, a zeta potential (ZP) of −28.9 ± 0.8 mV, and a polydispersity index (PDI) of 0.085. The drug loading efficiency exceeded 95%, while the folate conjugation efficiency reached 98.3%. In vitro release studies indicated sustained drug delivery over 19 days. Flow cytometry analysis revealed that CUR-loaded nanoparticles reduced HT-29 cell viability to 66.35%, and FO conjugation further decreased it to 52.74%. The FO-CUR-TPU-OLE-PEG nanoparticle system exhibits strong potential as a targeted therapeutic platform for colon cancer and represents a promising alternative to currently available formulations.

Lymph Node Harvest and Survival Among Patients With Locally Advanced Appendiceal Adenocarcinoma.

Mannose-functionalized liposomal delivery of levamisole and lipopolysaccharide enhances therapeutic responses through tumor-associated macrophage modulation in colon cancer.

Colon cancer treatment has evolved significantly through earlier detection, less invasive surgery, optimised perioperative care and shortening chemotherapy duration from 6 to 3 months in 2017. These multidisciplinary improvements may contribute to better health-related quality of life (HRQoL), yet population-based data on their real-world impact on HRQoL and functional outcomes remain limited. This cross-sectional study used data from the Dutch Prospective PLCRC cohort, including patients with stage I-III colon cancer who completed patient-reported outcome measures (PROMs) at 12 or 24 months post-diagnosis. HRQoL was assessed using EORTC QLQ-C30, QLQ-CR29 and the LARS score. Patients diagnosed in 2014-2016 (Group A) were compared with those from 2017 to 2019 (Group B). Propensity score matching (1:4) was applied for age, sex and tumour stage. Multivariable analyses were adjusted accordingly, minimally important differences (MIDs) guided clinical relevance and the values were compared with Dutch population values. A total of 1,749 patients were included in the analysis. Following propensity score matching, no clinically meaningful differences in the EORTC QLQ-C30 functional or symptom scales were observed at 12 months post-diagnosis between patients diagnosed in 2014-2016 (Group A) and those diagnosed in 2017-2019 (Group B). At 24 months, Group B demonstrated a modestly better QLQ-C30 summary score (mean difference + 1.3; 95% CI: 0.6-1.9), as well as statistically significant but clinically negligible improvements in role and cognitive functioning, and lower reported levels of fatigue, appetite loss and financial difficulties. Functional outcomes assessed via QLQ-CR29 and LARS score were comparable between groups, with a non-significant trend towards fewer major LARS cases in Group B at 24 months (14.6% vs. 19.9%; p = 0.068). Dutch colon cancer patients reported good HRQoL and functional outcomes up to 2 years post-diagnosis, with no clinically relevant differences between 2014-2016 and 2017-2019. These findings suggest a consistently high standard of care nationwide. Ongoing monitoring remains essential to address individual symptom burden and evaluate the impact of evolving treatment strategies.

Background: Colorectal cancer is the third most frequent cancer globally. Incidence rises with age and has been highest in developed countries, but it is rapidly increasing in many less developed countries and among younger generations in both developed and developing nations. MMP-7 is a key enzyme in the progression of colon cancer, making it a potential therapeutic target.Methods: This study used a computational screening method to determine the efficacy of natural terpenoids as MMP-7 inhibitors. The MMP-7 inhibitor TQI was used as a positive control. A total of 355 natural terpenoid compounds were gathered from literature and public databases. Each compound was obtained in SDF format, converted into 3D structures for molecular docking analyses. PyRx (0.8 version), utilizing the AutoDock Vina docking engine was employed for virtual screening through molecular docking.Results: Three potential candidates, retinol (vitamin A), carnosic acid, and gibberellic acid, were identified as showing strong binding affinities toward MMP-7 compared with the co-crystallized inhibitor TQI. ADMET analysis indicated compound-specific pharmacokinetic and safety profiles: retinol exhibited high predicted oral bioavailability but lower solubility, whereas carnosic acid and gibberellic acid showed more favorable non-toxicity and hERG safety percentiles.Conclusion: These findings highlight the promise of natural terpenoids as novel MMP-7 inhibitors in colon cancer treatment, necessitating further validation and experimental research to determine their efficacy and therapeutic potential.Keywords:Colon cancer, Natural compounds, Terpenoids, Computational analysis

Treatment of colon cancer (CC) may induce late side effects that impact patients' quality of life. The aim of this study was to evaluate self-reported health-related quality of life (HRQoL) one year after diagnosis of CC stage I-III for patients treated with curative intent. The study population included patients registered with a CC diagnosis in the Cancer Registry of Norway in 2019-2020, ≥18 years, and who underwent segmental colon resection, and a control group without colorectal cancer. They participated in the study by completing a survey using validated questionnaires (EORTC QLQ-C30/CR29/CIPN20 and Chronic pain scale). There were 1490 patients and 1693 controls eligible for analysis. Patients had significantly lower functional scores than controls, but only anxiety differed at a clinically relevant level (difference -10.2, 95% CI -12.0 to -8.4, p<0.01). Oxaliplatin-based adjuvant chemotherapy was associated with higher neuropathy scores and worse in patients receiving chemotherapy >3 months. Adjuvant chemotherapy with 5-fluorouracil and oxaliplatin >3 months was associated with lower scores for social function, body image, and anxiety. No significant association was observed between adjuvant chemotherapy and fatigue. Major chronic pain was reported by 177 (11.9%) patients, which impaired their HRQoL across several domains. Overall, patients had lower functional scores than controls, with anxiety being a significant burden. Oxaliplatin-based therapy induced neuropathy, particularly in those treated for over three months, who also reported increased anxiety, reduced body image and social functioning. One out of ten patients had major chronic pain, associated with impaired HRQoL.

Sishen Wan suppresses colon cancer through dual inhibition of PI3K/AKT/mTOR and STAT3-mitophagy pathways: Network pharmacology and experimental validation.

Efficient copper ion transport triggers in situ photothermia and cuproptosis for boosting colon cancer immunotherapy.

ABSTRACT Background Accurate identification of preoperative lymph node metastasis is essential for planning colon cancer treatment. Computed tomography (CT) is widely used for staging, but its diagnostic performance based on size criteria alone remains unclear. This study aimed to evaluate the diagnostic accuracy of preoperative CT for detecting lymph node metastasis in colon cancer. Methods A systematic search of MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials was conducted on June 12, 2025. Studies comparing preoperative CT with pathological evaluation and providing 2 × 2 contingency tables were included. Pooled sensitivity and specificity were calculated using a hierarchical summary receiver operating characteristic model and a bivariate random‐effects model. Subgroup analyses were performed according to cancer location (colon only vs. colon plus rectal cancer) and diagnostic criteria (size alone vs. size plus morphology). Study quality was assessed using QUADAS‐2. Results Twenty‐nine studies involving 5634 patients were included. The pooled sensitivity and specificity of CT for detecting lymph node metastasis were 0.693 (95% CI: 0.636–0.744) and 0.660 (95% CI: 0.581–0.731), respectively, with an area under the curve of 0.727. Meta‐regression showed no statistically significant differences in diagnostic performance between colon‐only studies and those including rectal cancer ( p = 0.561 and 0.316), or between size‐only and morphologic criteria ( p = 0.822 and 0.536). Conclusions CT using size criteria alone for preoperative lymph node staging in colon cancer demonstrated only moderate diagnostic performance. These findings indicate that relying on lymph node size as the primary determinant may be insufficient for reliable clinical decision‐making.

This study aimed to systematically identify and validate KIF15 as a potential diagnostic and prognostic biomarker in colon cancer (CC) using integrated bioinformatics analyses. We further explored its role in the tumor immune microenvironment and its potential value in immunotherapy, and validated its expression and clinical significance through immunohistochemical analysis. Gene expression profiles of CC were obtained from the Gene Expression Omnibus (GEO) database to identify differentially expressed genes (DEGs). A protein–protein interaction (PPI) network was constructed, and key genes were identified using the MCODE plugin in Cytoscape. External validation of candidate gene expression was performed using The Cancer Genome Atlas (TCGA) cohort. Kaplan–Meier survival analysis was conducted to evaluate prognostic significance. Receiver operating characteristic (ROC) and time-dependent ROC analyses were applied to assess diagnostic and prognostic performance. A nomogram model was established based on multivariate Cox regression, and its predictive accuracy and stability were evaluated using calibration curves and decision curve analysis (DCA). To investigate the role of KIF15 in the tumor microenvironment, single-cell RNA sequencing data from the TISCH database were analyzed to determine its expression distribution across immune cell subsets. Functional enrichment and immune correlation analyses were performed to elucidate the potential molecular mechanisms of KIF15 in CC progression and to identify downstream hub genes. Finally, immunohistochemistry (IHC) was conducted to validate the tissue expression pattern and clinical relevance of KIF15. A total of 611 DEGs were identified by integrating three GEO datasets (GSE24550, GSE21815, and GSE44076). Based on PPI network construction and MCODE analysis, 13 key genes, including KIF15, were identified. Combined univariate Cox regression and pan-cancer analysis ultimately determined KIF15 as the core gene of interest. TCGA analysis demonstrated that KIF15 was significantly upregulated in CC tissues (P < 0.0001), with a diagnostic ROC AUC of 0.874. Kaplan–Meier analysis showed that high KIF15 expression was significantly associated with poor prognosis (P = 0.004). Multivariate Cox regression confirmed that KIF15 was an independent prognostic factor. The nomogram model constructed based on KIF15 yielded a C-index of 0.783. Time-dependent ROCanalysis showed AUC values of 0.788, 0.777, and 0.712 for 1-, 3-, and 5-year survival, respectively. Calibrationcurves and DCA indicated good predictive consistency and clinical net benefit. Single-cell analysis revealedthat KIF15 was highly expressed in proliferating T cells (Tprolif). Functional enrichment analysis indicatedthat KIF15 was primarily involved in the cell cycle, DNA replication, mitosis, and the p53 signaling pathway.Immune correlation analysis showed significant associations between KIF15 expression and multipleimmune-infiltrating cells as well as immune checkpoint genes. Four downstream hub genes (TTK, CDK1,CHEK1, and KIF2C) were further identified and were all significantly upregulated in CC. IHC results confirmedthat KIF15 was highly expressed in CC tissues (P < 0.001) and was significantly associated with poorprognosis. Pearson correlation analysis demonstrated that KIF15 expression was positively correlated withimmune markers, including PD-1 and PD-L1. KIF15 is significantly overexpressed in CC tissues and is strongly associated with unfavorable prognosis, suggesting its potential clinical value in the diagnosis and prognostic assessment of CC. Notably, KIF15 expression is closely correlated with immune cell infiltration and multiple immune checkpoint molecules, indicating a potential role in regulating the tumor immune microenvironment. Therefore, KIF15 may serve as a promising biomarker and potential therapeutic target for immunotherapy, as well as a candidate marker for diagnosis, prognosis evaluation, and individualized treatment in CC.

Colon and colorectal cancer treatments are frequently associated with cancer-related fatigue, physical deconditioning, and reduced health-related quality of life (HRQoL). Exercise has been proposed as a supportive care strategy, but evidence remains heterogeneous. This systematic review aimed to evaluate the effects of exercise interventions on cancer-related fatigue, physical function, HRQoL, and selected biological outcomes in adults with colon or colorectal cancer. Searches were conducted in PubMed, PEDro, and Scopus following PRISMA 2020 guidelines. Randomized and controlled clinical trials assessing structured exercise interventions were included. Methodological quality was evaluated using the McMaster Critical Review Form and the PEDro scale. Due to heterogeneity, results were synthesized qualitatively, with limited quantitative synthesis based on single-study effect estimates. Five studies met the inclusion criteria. Exercise interventions delivered during chemotherapy or survivorship consistently reduced cancer-related fatigue, showing moderate-to-large effect. Small-to-moderate improvements in physical function and muscular strength were observed. HRQoL outcomes were generally favorable, particularly in physical and functional domains. Evidence regarding biological outcomes was limited but suggested potential benefits for gastrointestinal function, sleep quality, and selected biomarkers. Overall, structured exercise appears to be a feasible and clinically relevant supportive care intervention for patients with colon and colorectal cancer. Further high-quality trials with standardized protocols are required.

Mutations in p53 have been implicated in poor prognosis and reduced sensitivity to 5-fluorouracil (5-FU) treatment in colon cancer. While p53-dependent mechanisms have been widely studies, less is known about how p53 deficiency reshapes cellular signaling and contributes to 5-FU resistance. In this study, we aimed to profile proteomic alterations associated with p53 loss by comparing colon cancer cells with and without p53 expression. Differentially expressed proteins (DEPs) related to cell cycle regulation were of particular interest, as 5-FU treatment induced G1 phase arrest in HCT116 p53 wild-type (WT) cells, whereas p53 knockout (KO) cells predominantly showed S phase arrest. We identified several DEPs in p53 deficient cells following 5-FU treatment. Notably, F3 expression was increased, while aldehyde dehydrogenase family 1 member A4 (ALDH1A3), histone deacetylase 2 (HDAC2), and protein S100-A4 (S100A4) were decreased. The expression levels of these genes were associated with overall survival in patients with colon cancer. These findings highlight proteomic alterations linked to p53 deficiency and support a proposed model in which differential regulation of specific proteins may be associated with reduced sensitivity to 5-FU, providing a basis for future mechanistic and functional studies.

IGSF9 promotes immunotherapy resistance in colon cancer by orchestrating an immunosuppressive tumor microenvironment and enables combinatorial targeting strategies.

Colorectal cancer is one of the most common and fatal cancers worldwide. Despite therapeutic advancements, patients with stage II and III colon cancer often experience recurrences and metastases, particularly to the liver, leading to suboptimal disease-free survival (DFS) rates and decreased long-term survival. Qu-Shi-Jie-Du decoction (QSJDD), a traditional Chinese herbal formula, may prevent cancer recurrence and spread by boosting immunity, reducing inflammation, and inhibiting tumour growth. Preliminary studies have demonstrated that QSJDD reduces liver metastasis in patients with colon cancer. However, robust clinical evidence is required to confirm its efficacy and safety. This study aims to evaluate the safety and efficacy of QSJDD in preventing colon cancer recurrence and liver metastasis, thereby offering a potential adjunctive therapy to improve patient outcomes. This multicentre, double-blind, randomised, placebo-controlled trial involves 336 high-risk stage II or III colon cancer patients from 10 Chinese hospitals. Post-surgery and chemotherapy, 168 patients will receive either QSJDD compound granules or a placebo for 6 months, with a 3-year follow-up and evaluations every 6 months. The primary endpoint is to measure the 3-year DFS rate, while secondary endpoints include 1- and 2-year DFS rates, overall survival, and changes in the Traditional Chinese Medicine Dampness Syndrome Scale. Safety and adverse events will be tracked, and blood and gut microbiomes will be analysed to assess QSJDD's impact on delaying colon cancer metastasis. This trial will determine the efficacy and safety of QSJDD and provide evidence regarding its role in the adjuvant treatment of colon cancer.

Colon cancer remains a significant global health burden, and although 5-fluorouracil (5-FU) is a cornerstone chemotherapeutic agent, its clinical utility is constrained by systemic toxicity and poor tumor selectivity. This review highlights recent advances in chitosan-based nanoparticles as targeted delivery systems for 5-FU in colon cancer therapy. Chitosan, a biocompatible and biodegradable polymer, offers advantages such as mucoadhesion and pH sensitivity, making it well-suited for colon-specific drug delivery. The review covers formulation strategies, physicochemical characterization, and in vitro/in vivo performance of 5-FU-loaded chitosan nanoparticles. Emphasis is placed on active targeting approaches, including ligand functionalization (e.g., folate and hyaluronic acid) to enhance receptor-mediated uptake in cancer cells. Additionally, the pH-responsive behavior of chitosan systems is discussed as a mechanism for controlled drug release within the acidic tumor microenvironment. Preclinical evidence indicates that chitosan nanoparticles improve the therapeutic index of 5-FU by enhancing tumor accumulation and minimizing off-target toxicity compared to the free drug. Overall, this nanocarrier system represents a promising strategy for safer and more effective colon cancer treatment. Literature was systematically sourced from PubMed, Scopus, Web of Science, and Google Scholar (2000-June 2025).