Elderly patients with stage III colon cancer are less likely to receive optimal adjuvant treatment (treatment following surgery) than younger patients, despite having a reasonable life expectancy, according to a recent study published in the
Journal of the National Cancer Institute.
The colon is an important part of the body’s digestive system, consisting of the last few feet of the large intestine. Stage III colon cancer (Dukes C) refers to cancer that has spread from its site of origin to nearby lymph nodes, but without spread to distant sites in the body. Standard treatment options for stage III colon cancer may include surgery, chemotherapy, and/or radiation therapy.
Previous clinical trials have demonstrated that adjuvant chemotherapy consisting of 5-fluorouracil and leucovorin reduces the risk of a cancer recurrence and cancer-related deaths following surgery by up to 30%. Recent clinical trials have also specifically demonstrated that elderly patients (65 years or older) derive the same therapeutic benefit from adjuvant therapy as younger patients. However, many physicians do not offer adjuvant therapy to their elder patients due to perceived potential intolerance of therapy and/or a considered short life expectancy. It is important to note that the majority of patients who are diagnosed with colon cancer are 70 years or older.
Researches from the Memorial Sloan-Kettering Cancer Institute recently evaluated data on the treatment of over 6,200 patients aged 65 years and older with stage III colon cancer. This data demonstrated that a patient’s age at diagnosis was the strongest determinant as to whether adjuvant chemotherapy was a component of the treatment regimen. Adjuvant chemotherapy was administered to 78% of patients between the ages of 65 and 69 years, 74% of patients between 70 and 74 years, 58% of patients between 75 and 79 years, 34% of patients between 80 and 84 years, and 11% of those between 85–89 years. These results indicate that the percentage of patients receiving adjuvant therapy decreases dramatically as a patient gets older. Since patients in their 70s and even 80s have a significant life expectancy, further efforts are needed to ensure that elderly patients are aware of all their treatment options, particularly potentially curative treatments such as adjuvant chemotherapy.
Since elderly persons with colon cancer who are otherwise in good health may benefit from adjuvant chemotherapy they may wish to talk with their doctor about the risks and benefits of receiving adjuvant therapy. Two sources of information about the adjuvant treatment of colon cancer are
CancerConsultants.com and the National Cancer Institute (
Journal of the National Cancer Institute, Vol. 93, No. 11, pp 850-857, 2001)
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