Last week I had a consultation with an older gentleman who is 84 years old. Interestingly, the role of age in the treatment of colon cancer has changed. During my training in Germany in the nineteen eighties when someone came in with metastatic cancer and was older than 65, we rarely gave chemotherapy because we were afraid to make those patients sicker than cancer did.

We have a perception that when someone is old we should be much more gentle and we should adapt treatment not only using less aggressive chemotherapy cocktails but also lower doses.. These perceptions go back to the history of chemotherapy when chemotherapy drugs made most patients very sick and weak. With less toxic chemotherapeutic therapies and much better drugs against nausea and vomiting, our perception needs to be reevaluated. Read the rest of this entry »

When we go to a surgeon, we often don’t ask them how many surgery he has done for the same disease but may be we should.

For colon cancer, there is in fact a specialization fellowship to become a colorectal surgeon. A recent analysis of 17 studies from nine countries has shown that the quality of the surgeon and the surgery is associated with better outcome.

How can you evaluate the surgeon? Read the rest of this entry »

1. Facts are first. Therapies vary greatly from on cancer to another and even among the same kind of cancer. Educate yourself on the resources and information on Cancer Centers and Specialty Center in your area. Your general physician is a good first stop to obtain information about your specific disease.
2. Assign one person to coordinate contact with the primary oncologist. This will make the lines of communication run more smoothly. Although there will often be a team of experts physicians making decisions and managing your care, the primary oncologist will be the main point person for you and your family.

Read the rest of this entry »