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Adjuvant Treatment Does Not Have Negative Impact on Elderly Quality of Life

Colon and rectal cancer patients 75 years old and older who are treated with chemotherapy or radiation don’t report any poorer quality of life than older patients who don’t have such therapy.  Patients who had chemotherapy said that their physical functioning was better than that reported by those who didn’t receive chemo.

French patients who were at least 75 responded to questionnaires about their quality of life and emotional health three, six, and twelve months after their diagnoses.  Overall health and emotional functioning improved between the first questionnaire at three months and the twelve month survey for people with colon cancer.  For rectal cancer patients, scores improved between six months and twelve months.

Anne-Marie Bouvier, MD, PhD and her team at the Burgundy Digestive Cancer Registry wrote,

To the authors’ knowledge, the current study is the first to examine trends over time with regard to the influence of adjuvant treatments for colon and rectal cancers on quality of life (QoL) in a general aged population. Providing evidence that adjuvant chemotherapy for colon cancer has no negative impact on the QoL of elderly patients is of great significance in encouraging clinicians to treat this population.

SOURCE: Bouvier et al.,Cancer, Volume 113, Number 4, August 15, 2008.

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2 Comments

  1. Larry D. Howard MD said:

    I have a 95 year old mother with Stage 4 colon cancer. I am an Internist and I am not ready to give up on her. Is there any treatment that can give her a few more years. Is the chemo and Rad that bad? If we don’t do anything she will die what is wrong with trying some of the new stuff

    thanks.

  2. Kate Murphy said:

    A great deal depends on your mother’s overall health and how physically active she is.

    Chemotherapy for stage IV colon cancer does have side effects that might be difficult for a frail elderly person including diarrhea, reduced white counts and risk for infection, and nausea. Some treatments cause neuropathy with loss of balance.

    There is an oral chemotherapy Xeloda (capecitabine) that can be taken at home,reducing some need for visits to the oncologist. It is not without its own side effects, including painful rash on the hands and feet.

    If your mother is mentally alert, she should make this decision herself after talking over the risks and possible benefits of the various treatments that are available.

    If she is not strong enough to make that decision, the stress and anxiety of treatment might be very difficult for her to cope with.

    How well is she able to care for herself?

    In addition to chemotherapy itself, your mother needs to be able to manage anti-nausea medication, eat and drink well, and report difficulties with nausea and diarrhea to the doctors. Diarrhea, particularly, can lead very quickly to dehydration which, as you know, is more dangerous in the elderly.

    You also need to be realistic about what even the newest chemotherapy regimens can accomplish. While they can extend life, the median survival when stage IV patients receive all available therapy is about 2 years.

    Please don’t think in terms of “giving up on her”. Even if she is not treated with chemotherapy, she’ll need lots of support during the rest of her life. There is a lot you can do to make that time better for her.

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