APC: Options for Cancer Treatment
Cancer Treatment for People with Inherited Mutations
Currently there are no FDA-approved targeted therapies specifically for people with an inherited mutation and FAP or AFAP.
People with FAP or AFAP who are diagnosed with cancer should ask their doctor if they might benefit from testing or if they might qualify for a clinical trial looking for more effective treatments for cancer.
To learn more about standard of care treatment options for specific types of cancer, visit our section on Cancer Treatment by Cancer Type.
How does FAP and AFAP affect treatment options?
Because of the very high risk for a second (or third) colorectal cancer diagnosis, people with FAP who are diagnosed with colorectal cancer are recommended to undergo risk-reducing colectomy.
Colectomy surgeries vary by how much tissue is removed.
- Total proctocolectomy with ileal pouch and anal anastomosis (TPC ) removes thecolon and rectum but spares the anal sphincter (the muscle that controls bowel movement release). People who have this surgery may remain continent with bowel control. The surgeon will use a portion of the small intestine to create an internal pouch, which stores waste until a bowel movement.
- Total abdominal colectomy with ileorectal anastomosis () removes the entire colon but spares the rectum. Not all people are candidates for this surgery, as the intact rectum may still have elevated cancer risk.
- Total proctocolectomy with permanent end ileostomy (TPC-EI) removes the entire colon, rectum and anus and creates an ostomy opening at the end of the small intestine. The end ileostomy is positioned on the abdominal wall and requires the use of an ileostomy bag to manage stool output.
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