Adjuvant Chemotherapy Does Not Adversely Affect Quality of Life of Elderly Patients with Colorectal Cancer

Posted on March 8th, 2009 by

Adjuvant Chemotherapy Does Not Adversely Affect Quality of Life of Elderly Patients with Colorectal Cancer

Chemotherapy or radiation therapy for Stage III colon or rectal cancer, referred to as adjuvant therapy, does not significantly decrease quality of life compared with no adjuvant therapy among patients 75 years of age or older. These results were recently published in the journal Cancer.

Stage III colon or rectal cancer refers to cancer that has spread through the wall of the colon or rectum to nearby lymph nodes but is not detected elsewhere in the body. Although patients with Stage III colon or rectal cancers may have their cancers completely removed by surgery, they benefit from the addition of chemotherapy and/or radiation therapy to kill any remaining cells in the body that may go undetected (adjuvant therapy). Randomized trials have clearly demonstrated that adjuvant chemotherapy improves survival in patients with Stage III colon cancer by approximately 30%. Several studies have shown that there is no difference in effectiveness of adjuvant chemotherapy between older and younger patients. Studies have consistently shown that age is not a predictor of relapse or overall survival in patients receiving adjuvant chemotherapy for Stage II-III colon cancer.

Adjuvant chemotherapy and/or radiation therapy is also recommended for patients with Stage II-III rectal cancer. A previous U.S. study has reported that elderly patients with Stage II-III rectal cancer who complete both adjuvant radiation therapy and adjuvant chemotherapy have a lower rate of disease recurrence than patients not receiving such therapy or not receiving full courses.

Although elderly patients with colon or rectal cancer appear to benefit from adjuvant therapy, there is still concern about side effects and quality-of-life issues. These are the main reasons given for not administering adjuvant therapy to elderly patients with colorectal cancer.

Researchers from France recently conducted a clinical trial to evaluate the effects of adjuvant chemotherapy in elderly patients with Stage III colon or Stage III rectal cancers. This trial included over 1,000 patients who were 75 years of age or older.

  • At both six and 12 months, there were no differences in quality-of-life measurements between patients who received adjuvant therapy compared with those who did not receive adjuvant therapy.
  • Patients receiving adjuvant chemotherapy for colon cancer actually had better physical functioning than patients not receiving adjuvant chemotherapy.

These data appear to strongly support the concept that elderly patients with Stage III colon or rectal cancer do not experience a decrease in quality of life from adjuvant therapy. Elderly patients with colon or rectal cancer eligible for adjuvant therapy should speak with their physician regarding their individual risks and benefits of adjuvant therapy.

Reference: Bouvier AM, Jooste V, Bannalain F, et al. Adjuvant treatments do not alter the quality of life in elderly patients with colorectal cancer. Cancer. 2008;113:879-886.

Related News: Delay in Chemotherapy Associated with Worse Outcomes for Elderly with Colorectal Cancer (11/27/2006)

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