Study: Doctors Less Likely to Give Chemo to Older Colon Cancer Patients

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18 March 2010


The World Health Organization (WHO) lists colon cancer among the deadliest diseases. In 2004, some 639,000 people around the world died from colon cancer. If caught in time, surgery and chemotherapy are effective treatments. But a new randomized trial finds that older cancer patients aren’t always offered another treatment option that might extend their lives.


Marty Petcoff had surgery for stage three colon cancer. Stage three means the cancer has spread beyond the middle layers of the colon and most likely into nearby lymph nodes.


He is optimistic his chemotherapy treatment will be just as successful.

"We’re in the phase of cleaning up some stuff we can’t see," he said.

Petcoff and other older patients do not always undergo chemotherapy after colon cancer surgery.

Researchers conducted a randomized study of 675 patients diagnosed with stage three colon cancer. All had undergone surgery.

Among the 202 patients over the age of 75, exactly half also received what’s called adjuvant, or supplemental, chemotherapy.

That is similar to the chemotherapy treatment given to 87 percent of younger patients in the study. Dr. Katherine Kahn and fellow researchers studied these patients from five regions of the United States.

"... amongst older patients who receive adjuvant chemotherapy, they appear to be tolerating the treatment as well as younger patients who receive the treatment," explained Dr. Katherine Kahn.

Now here are some differences:? the older patients were given adjuvant chemotherapy in weaker doses and for a shorter period of time. But it turned out the elderly patients had fewer adverse effects from the drugs than younger patients.

Previous research in 2008 surveyed doctors about their recommendations for older patients. That study asked them whether a patient’s age and other illnesses might play a role in not recommending chemotherapy after surgery.

Doctors were divided on whether chemo should be given to elderly patients, after surgery.

Dr. Kahn says this data shows that more attention should be paid to the ability of the patient to tolerate the drug, rather than his or her age.

"It informs patients and doctors that if they see an older patient with stage three colon cancer, they shouldn’t automatically, based upon their age, decide not to treat the patient," added Dr. Kahn. "They should work with the patient and family individually, to try to get a sense of how well that patient might tolerate the treatment."

Marty Petcoff is happy that he was offered those options.

"I’m doing more," he said. "I’m more relaxed and I see great value in the things that are coming my way. Now how about that for a cancer patient?"

The study appears in an issue about cancer research of the Journal of the American Medical Association.