Research and Training Grants in Colorectal Cancer

The American Cancer Society funds scientists and medical professionals who study cancer or train at medical schools, universities, research institutes, and hospitals throughout the United States. We use a rigorous and independent peer review process that is competitive and confidential to select the most innovative research projects and creative scientists to fund.

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73

Grants

Total Colorectal Cancer Grants in Effect as of March 1, 2020

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$24

Million

Total Colorectal Cancer Grant Funding in Effect as of March 1, 2020

Spotlight on Colorectal Cancer Grantees

Testing a Tiny Sensor in Mice to Find Colon Cancer Before It Spreads

Grantee: Liangliang Hao, PhD 
Institution: Massachusetts Institute of Technology
Area of Focus: Clinical Cancer Research, Nutrition, and Epidemiology
Grant Term: 2/1/2019 to 1/31/2021

The Challenge:
 Most deaths related to colorectal cancer (CRC) happen because the cancer spreads (metastasizes) from where it started to other places in the body. But commonly used diagnostic tests aren’t always able to find small tumors that are outside the colon or rectum (metastatic tumors). 

The Research: When tumor cells “want” to spread, they carve a path to a new location by trying to change the area around them (called the microenvironment). Liangliang Hao, PhD, hypothesized that the ideal time to find and treat the cancer is when the tumor cells are working to change their microenvironment.

She's developing a tiny tool that acts like a burglar alarm that may help diagnose CRC in mice early, before the cancer spreads. It’s called PRISM, and it includes sensors designed to detect changes in urine that could be related to the spread of cancer.

Hao injects this teeny probe into the mouse’s blood. Then, this is how it should work:

  • A protein in the tumor environment splits the probe, releasing a molecule called a reporter. 
  • If tumor cells start making more of that same protein, the environment becomes “looser,” meaning it’s easier for a cancer cell to move through and spread. 
  • That loosening “trips the alarm.” As a result, the reporter goes into the urine. A urine test identifies the presence of the reporter, showing that cancer is trying to spread.
  • The other molecule in PRISM senses the changed environment and builds up in tumor cells. Their increased numbers act like a beacon during a scan of the body, allowing researchers to easily see where the cancer is trying to grow.

The final piece of Hao’s project is working to find a treatment in mice that acts like police responding to a burglar alarm. The hope is that such a treatment will go only to where new cancer is trying to grow and stop it without affecting other parts of the body.  

The Goal and Long-term Possibilities: PRISM might make it possible to find cancer that’s trying to spread—before it’s spread. PRISM could also become an early player in precision diagnostics, which involves using diagnostic tests on patients to identify treatment options most likely to kill the cancer. 

Encouraging Long-Term Exercise for Survivors

Grantee: Heather J. Leach, PhD 
Institution: Colorado State University in Fort Collins
Area of Focus: Cancer Control and Prevention:  Psychosocial and Behavioral Research 
Grant Term: 7/1/2018 to 6/30/2023

The Challenge: Studies have shown that people who exercise regularly after being diagnosed with colon or rectal cancer have a better quality of life and may live longer than those who don’t exercise. However, many colorectal cancer survivors don't get enough physical activity to enjoy these benefits.

The Research: Does working out with the social support of a group make colorectal cancer survivors more likely to keep exercising? That's one of the things Heather J. Leach, PhD, wants to find out. She’s leading a clinical trial to compare two 12-week physical activity programs. Both programs are led by an exercise specialist trained to work with cancer survivors. One involves working out with a group and the other involves individual, supervised physical activity, like personal training. Leach’s goal is to find out which program is more likely to help colorectal cancer survivors continue to exercise when the programs end.

The study’s participants have been diagnosed with stage II or III colorectal cancer and had surgery within the past 3 to 24 months. Half have one-on-one sessions with the exercise specialist. The other half exercise in groups of 5 to 15 with the leader using behavior change strategies that focus on how members of the group interact with each other. The goal is to encourage bonding with others in the group because such connection has been shown to help people stick with an exercise routine over time. All participants keep a diary to help give information during follow-up visits.

At follow-up visits researchers check the amount of exercise being done, ask each person how much he or she is exercising and ask about the quality of life and group connection. They also test each survivor’s aerobic fitness and muscle strength. Leach’s team is also considering whether someone lives near parks, sidewalks, or fitness centers. The area where a person lives may be especially key for colorectal cancer survivors who have more than one physical limitation.

The Goals and Long-term Possibilities: Insights from this research will help identify ways to encourage life-long exercise in colorectal cancer survivors. The results could even affect physical activity programs provided as part of supportive care for all cancer survivors.

Specially Designed Virus Targets and Kills Colorectal Cancer Cells in Mice

Grantee: Susanne Warner, MD, PhD 
Institution: Beckman Research Institute of the City of Hope in Duarte, CA
Area of Focus: Microbial Pathogenesis and Cancer
Term: 7/1/2016 to 6/30/2021

The Challenge: Traditional chemotherapy drugs kill all fast-growing cells, including cancer cells and healthy cells. The loss of those healthy cells may cause side effects. Susanne Warner, MD, PhD, and her research team have vast experience developing viral treatments that leave healthy cells alone. Now they’re designing new viral treatments that kill cancer cells, called oncolytic viral treatments. They’re learning these viruses work well in mice when combined with certain types of immunotherapy in a treatment called viroimmunotherapy.

The Research:  Warner and her team developed a “super” virus that attacks tumors in 3 ways:

  1. by infecting and killing tumor cells
  2. by shutting down the blood supply to the tumor, which leads to the death of cancer cells
  3. by training a patient’s immune system to attack the tumor

In the lab, Warner’s team inserted a gene into the virus that ultimately allows iodine to enter the cancer cell. The combination kills cancer cells more effectively. It also makes the cancer cells visible on imaging scans, which allows the researchers to watch the tumor shrink as the virus multiplies and cancer cells die.

When the researchers tried to re-grow a colorectal cancer tumor in a mouse that had been treated with the virus-iodine combination, they couldn’t.

The Goal and Long-term Possibilities: This research in mice has been promising so far. Warner’s group is hopeful that after more work, they’ll eventually be able to start testing their viruses in humans. 

To learn more about Susanne Warner's work, listen to this podcast: Ripping a Hole in Cancer Cell's Invisibility Cloak

Stopping Colon Cancer by Targeting a Protein "Turned on" by Mistake

Grantee: Nan Gao, PhD
Institution:
Rutgers, The State University-Newark Campus
Area of Focus: Tumor Biochemistry and Endocrinology
Grant Term: 7/1/2015 to 6/30/2019

The Challenge: Most colorectal cancer (CRC) cells have a change (mutation) in one of two genes—the APC gene or the beta-catenin gene. Research suggests that after the gene mutates, the very first tumor cells can become hypermutated, meaning they develop more mutations, get stronger, and can survive better.

When this happens, the cancer eventually spreads far from where it first started, advancing to a late-stage cancer that’s hard to treat. A better understanding of how CRC cells progress from having only one mutation to having many mutations could help lead to new treatments.

The Research: Nan Gao, PhD, and his team want to find a way to stop those early tumors with only one mutation from getting stronger and having multiple mutations. One suspect is a protein that acts like a switch, called Cdc42-v2. When this protein is “turned on,” it helps tumors grow. If Gao and his team can find a way to “turn off” this protein, they could limit the cancer’s progression and spread.

Cdc42-v2 is normally found in the brain, but this “switch” can get “turned on” by mistake in CRC cells in the intestines. Gao and his team thought that finding out how this protein works in mice could help scientists develop treatments to kill CRC in the early stage.

CRC can be triggered by repeated injuries to the lining of the intestines. Gao’s team discovered that the injured lining of a mouse’s intestine can be changed back to its earlier phase, called a cancer stem cell. These cells divide more slowly and don’t respond well to the drugs that kill 99% of the more rapidly dividing cancer cells. It they’re not stopped, they can “re-seed" the cancer.

He found that these intestinal cancer stem cells in mice need Cdc42-v2 to grow. Removing or “turning off” Cdc42-v2 stops tumor growth. Gao also discovered another group of proteins (called GTPase) that can stop CRC from growing.  

The Goal and Long-term Possibilities:The researchers hope what they learned about Cdc42-v2 will someday translate into treatments that target the protein. If that happens, such treatments could help stop CRC before it really gets started. 

From Our Researchers

The American Cancer Society (ACS) employs a staff of full-time researchers who relentlessly search for the answers that help us understand cancer, including colorectal cancer. 

The Link Between Gluten and Colorectal Cancer

Grantee: Caroline Um, PhD, MPH, RD 
Institution:
American Cancer Society, Intramural Research Department
ACS Research Program: Postdoctoral Fellow, Behavioral and Epidemiology Research Group

The Challenge: There’s strong evidence that eating whole grains may lower the risk of colorectal cancer (CRC). However, it’s not clear how eating gluten, a protein found in some whole grains—wheat, barley, and rye—affects the risk of CRC. Rates of CRC are on the rise among young adults in the US, and the number of people on a gluten-free diet has also grown in the past decade. Because of these increases, it’s important to understand the relationship between CRC and gluten.

The Research: Caroline Um, PhD, MPH, RD, and her ACS colleagues examined how eating whole grains and gluten might affect the risk of CRC. Using the Cancer Prevention Study (CPS) - II Nutrition Cohort study, they looked at both gluten intake and whole grain intake in 50,118 men and 62,031 women. Here’s an overview of what they learned:

  • Eating more whole grains was associated with a decreased risk of CRC in men but not in women.
  • Eating more gluten may increase the risk of cancer in the first and middle areas of the colon (called proximal colon cancer) in both sexes.
  • Eating refined grains like white bread, pasta, and white rice did not increase the risk of any type of CRC.

The Long-Term Possibilities:This is the first time that any research has linked gluten intake to a higher risk of proximal colon cancer. Um’s research also reinforces the evidence that whole grains probably protects against CRC, particularly for men. More studies need to be done to look more closely at these relationships.

 

Overall Death Rates for Colorectal Cancer Are Down

Each year, the American Cancer Society program of Surveillance and Health Services Research analyzes data on colon and rectal cancer as part of the Cancer Facts & Figures report.

Every 3 years, with support from their research teams, ACS epidemiologists Rebecca Siegel, MPH, and Ahmedin Jemal, DVM, PhD, publish Colorectal Cancer Facts & Figures

These publications give estimated statistics about colon and rectal cancer in the United States. They also cover the latest information on risk factors, early detection, treatment, and current research. 

Here are some key colon and rectal cancer estimates and highlights from these publications.

  • In 2020, about 104,610 Americans will be diagnosed with colon cancer. About 43,340 will be diagnosed with rectal cancer.
  • In 2020, about 53,200 people will die from colorectal cancer. Deaths for colon and rectal cancers are combined because a large number of deaths from rectal cancer are misclassified as colon cancer. 
  • Incidence rates are decreasing in adults age 55 and older. However, incidence rates are increasing among those younger than age 55.
  • From 2007 to 2016, the death rate decreased in people older than age 55. But it increased by 1% a year during that time for people younger than age 55. 
  • More than 55% of colorectal cancers in the US are attributable to potentially modifiable risk factors. These risk factors include obesity, physical inactivity, long-term smoking, and not getting enough calcium. Risk factors also include eating too much red or processed meat, drinking too many drinks with alcohol, eating too few fruits, vegetables, and whole grains. 

Additional facts about breast cancer are available at the Cancer Statistics Center website.

New and Persistent Colorectal Cancer Challenges

ACS researchers have recently published several studies describing the unequal progress against CRC. Some groups of people, like those who are poor, part of a minority group, or live in rural locations, don’t benefit from the same improvements that help reduce CRC cases and deaths. These differences are known as disparities.

Healthcare disparities refer to differences in access to, or availability of, health care. Health status disparities refer to differences in disease rates between groups based on their socioeconomic status or where they live. Our ACS researchers explore the potential reasons for these differences and what might be done to improve them. 

Colorectal cancer screening increased in people younger than 50 after the ACS updated its screening guideline. In May 2018, the ACS recommended that people with an average risk of colorectal cancer start getting screened at age 45. A study led by Stacey A. Fedewa, PhD, in the Surveillance and Health Services Research Team at the ACS, found that since that change, CRC screening rates more than doubled in people of average risk between the ages of 45 to 49.

The Affordable Care Act’s (ACA) expanded dependent coverage led to better CRC treatment among adults ages 19 to 25. The ACA allows children and young adults to stay on their parents’ insurance until age 26. A study led by Leticia Nogueira, PhD, MPH, in the Surveillance and Health Services Research Team at the ACS, compared treatment for CRC between people ages 19 to 25 who were covered by their parents’ insurance and those who weren’t. Those who were insured due to the ACA’s dependent coverage expansion had improved access to cancer care, including an earlier diagnosis and a shorter time between surgery and chemotherapy.

Colorectal cancer incidence and death rates are rising in people ages 20 to 24. Researchers and doctors do not yet know the reasons for the increase in disease in this age range. The increased number of cases may be linked with lifestyle habits related to this type of cancer, such as being less active, or conditions like obesity.

Learn the symptoms of colon or rectal cancer. If you or your loved ones have symptoms, no matter how old you are, see a doctor.

The 5-year survival rate for colorectal cancer is 90% when it’s found early and hasn’t spread. The 5-year survival rate drops significantly if the cancer is not found until it’s already spread far from the colon. Unfortunately, young people, and even their doctors, tend to disregard the possibility of cancer by thinking it’s a disease only older people get. That’s one reason why CRC has often advanced to a later stage in young people  who are diagnosed.

African Americans who have colorectal cancer are less likely to survive for 5- years than white people are who have it.
To better understand why, Helmneh M. Sineshaw, MD, MPH, an ACS researcher, collaborated with researchers from the Dana-Farber Cancer Institute at Harvard Medical School. Their data showed that differences in insurance coverage accounted for about half the difference in survival rates. They concluded that “affordable health insurance coverage for all populations could substantially reduce differences in survival times of black versus white patients with colorectal cancer.”

In the US, 3 particular areas are “hotspots” for colorectal cancer death rates. In a 2015 study, ACS researchers identified the areas as:

  • The lower Mississippi delta
  • West central Appalachia
  • Eastern Virginia/North Carolina

The researchers suggest that communities in these areas introduce a “coordinated, targeted” screening program like the one Delaware used to help eliminate disparities in colorectal cancer care, which are differences in access to or availability of healthcare facilities and treatment services . See this interview with the researchers to learn more.

ACS COLORECTAL CANCER RESEARCH News

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