Elderly people with colon cancer can benefit from chemotherapy after surgery as much as younger patients can, and the side effects are no worse, a study found.
The older you get, the greater the chance of colon cancer. But some doctors are reluctant to prescribe chemotherapy for patients over 65. For that matter, older patients may not want to take on six months of possible nausea, diarrhea and other side effects.
``Older people will sometimes say, `I'm not sure I'll save enough years of life to make that worth it to me,''' said Dr. Richard Goldberg, a cancer specialist at the Mayo Clinic in Rochester, Minn., and one of the authors. ``What this study says is, `If you're among the more robust sexagenarians or octogenarians, we can give you data to say that it will.'''
Doctors at Mayo and six other centers in North America and Europe pooled seven studies comparing surgery alone for colon cancer to surgery with chemotherapy afterward, the current standard treatment. Altogether, the analysis involved 3,351 patients of various ages who had cancer that had spread; some of the patients were under 50, some over 70.
Older patients generally tolerated chemotherapy as well as younger ones. Overall, chemotherapy increased the five-year survival rate from 64 percent to 71 percent, with no significant difference from age group to age group.
``A 7 percent improvement in a disease as prevalent as colorectal cancer results in the saving of thousands of lives each year,'' said Daniel J. Sargent, a Mayo statistician who led the study.
Dr. Harmon Eyre, chief medical officer for the American Cancer Association, said that perhaps one in three older patients has other ailments that rule out the use of chemotherapy.
``But doctors need to weigh that heavily and not give into the knee-jerk reaction, `Oh, they're older. Let's not give them chemotherapy,''' he said. In addition, he said, ``patients need to ask their doctors if they are not receiving it, and if not, why not.''