New therapeutic options in colon cancer: focus on oxaliplatin.

Colon cancer is the third leading cause of cancer death in the United States and the second leading cause in the Northern, Central, and Southern Americas. Appropriate treatment depends on the stage of malignancy, which is determined using the tumor-lymph node-metastases system. In stage III disease, adjuvant chemotherapy increases disease-free and long-term survival following surgery, and chemotherapy is the mainstay of treatment for advanced disease. New therapies are being evaluated, including oxaliplatin, a third-generation platinum analogue approved as first- and second-line therapy for metastatic colorectal cancer in Europe; the drug shows great promise combined with 5-fluorouracil/leucovorin or with irinotecan. The dose-limiting toxicity of oxaliplatin is neurologic, which can be acute or chronic; this can be prevented or reduced in some cases through patient education. Nurses play a critical role in education concerning prevention and management of oxaliplatin-related side effects.