Anal cancers often develop from precancerous lesions called anal dysplasia. While evidence suggests that treating these lesions can prevent the development of anal cancer, researchers still don’t understand exactly how and why a lesion changes to ultimately cause cancer to develop. Learning this information could lead to improved targeting of dysplasia treatment, leading to even greater success in anal cancer prevention, according to Associate Professor of Colorectal Surgery Evie Carchman, MD.
“Recent changes to screening and treatment guidelines are going to significantly increase the number of patients with anal dysplasia that will be identified, which is great from a cancer prevention standpoint. But there are three big unknowns that we still need to tackle to ensure we can provide the best care possible for these patients,” explained Carchman. “First, we haven’t yet identified patient-specific predictors of who is likely to progress to cancer and will thus require more aggressive treatment or surveillance. Second, we haven’t identified factors that determine which patients are likely to respond to current or new therapies. And third, we still have limited treatment options and our currently available therapies are associated with pretty painful side effects and high rates of the lesions coming back. So it’s critical that we identify markers of risk, disease behavior, and response to treatment for patients with precancerous anal lesions so we can better tailor our surveillance and treatment plans.”
With a new one-year, $50,000 research grant from The Research Foundation of the American Society of Colon and Rectal Surgeons, the Carchman Lab will be addressing this very issue. The team will be analyzing samples of both blood and anal lesions that were provided by patients who are in UW Health’s Anogenital Registry. They will use cutting edge technology that allows them to look inside each individual cell in anal lesion samples to see the genes that are active and determine which genes are associated with the lesion developing into cancer versus the lesion remaining stable or even disappearing over time. They will also look for markers of immune system activation in each patient’s blood cells, linking this data to the anal tissue samples to see if monitoring the immune cells that are present in blood could be a tool for identifying the risk of cancer development.
“The results of this study will be an important first step toward ushering in a new era of precision medicine for anal cancer prevention and shifting the paradigm in how we screen for and prevent anal cancer. I’m incredibly honored that The Research Foundation of the ASCRS selected us as a recipient of their Benefiting Research, Innovation, Development, Growth, and Education (BRIDGE) grant and am grateful for their support,” said Carchman.