How Old Is Too Old for Colorectal Cancer Surgery?
When a reasonably healthy octogenarian gets a diagnosis of colon cancer, the issue of age is bound to come up. How old is too old for colon cancer surgery? What are the risks? What kind of recovery and quality of life can the very elderly expect afterward? Is it worth it? Johns Hopkins explores these questions and others in this Special Report.
The first line of treatment for colorectal cancer is to remove the primary tumor or tumors. If your cancer is confined to polyps or a small area, surgery is probably the only treatment that you need. For stage I or II cancers that have not spread to the lymph nodes, the expected five-year survival rate after surgery without chemotherapy is 80 to 90%.
Surgery usually involves removing the segment of the colon or rectum that has the primary cancer and a margin of healthy colon on either side of the cancer. The surgeon will also remove the tissue that holds the colon in place (mesentery) and the adjacent lymph nodes. The number of lymph nodes removed can be important in providing an accurate stage and prognosis.
It is true that the risks of colorectal cancer surgery are higher for some older people. An analysis of 28 studies found lower survival rates among the elderly who have coexisting health conditions, are diagnosed at an advanced cancer stage, and have to undergo emergency procedures. Another study found that octogenarians with early stage cancer survived 10 or more years after colorectal cancer surgery if they had no chronic illnesses.
It appears that quality of life after colorectal cancer treatment can be as good for octogenarians as it is for younger seniors -- even in the face of coexisting illness, according to a Canadian study that compared the outcomes of people over age 80 with those in their 60s. The average age of the older group was 83 years at the time of colorectal cancer surgery, while the "youngsters" ranged in age from 65-69. People in both groups underwent comparable surgical procedures and had similar coexisting health problems (such as hypertension and diabetes), although the older group had somewhat less advanced (lower-stage) cancers.
The responses to a survey on quality of life and functioning before and after colorectal cancer surgery were remarkably similar in both groups. Before surgery, both worried about pain, becoming a burden, and death. After colorectal cancer surgery, there were no major changes or differences between the groups in terms of their ability to perform daily functions or their overall health, sexual function, or quality of life.
Too Early To Draw Firm Conclusions?
The Canadian researchers emphasize that their study findings are preliminary, and some results may be biased. While the results are preliminary, the study provides further ammunition for the argument that determining which patients are candidates for colorectal cancer surgery shouldn’t be made solely on the basis of chronological age. High-functioning elderly people who undergo colorectal cancer surgery appear able to retain their ability to function and maintain a good quality of life.
Experts note that regardless of age the outcome of colorectal cancer surgery is likely to be better under these conditions:
The cancer is at an early stage. Most people in the study had stage 0, I, or II cancer; none had stage III or IV.
The person about to have treatment is functioning at a high level before surgery and in good general health, without multiple serious chronic diseases. People who have three or more chronic diseases -- such as diabetes, rheumatoid arthritis, or heart disease -- tend to have poorer outcomes.
The surgery is seen as a positive action, and the person with cancer is aware of the procedures to be performed and the potential outcomes.
Other issues that could affect outcomes at any age include a family history of longevity and a good support system of family and friends.
Posted in Colon Cancer on March 6, 2010
Tuesday, April 6, 2010
Wednesday, February 24, 2010
My sigmo exam
I learned two very interesting facts during my sigmo exam today...
Fact #1: The outside of my behind is way uglier than I ever imagined it to be. (All hairy and bumpy.)
Fact #2: The inside of my behind is way more beautiful than I ever imagined it to be. (All pink and smooth.)
You know, I can't tell you how happy I have been since watching that "scope". If they could run a camera through my whole body -- and if everything looked that pink and clean -- I would be happier yet!
Cancer-Free-Since-1991. email from a female breast cancer survivor.
Sigmoidoscopy is the minimally invasive medical examination of the large intestine from the rectum through the last part of the colon. A sigmoidoscopy is an effective screening tool. Doctors use it to look for benign and malignant polyps, as well as early signs of cancer in the descending colon and rectum.
A sigmoidoscopy is similar but not the same as a colonoscopy. A Sigmoidoscopy only examines up to the sigmoid, the most distal part of the colon, while colonoscopy examines the whole large bowel.
Fact #1: The outside of my behind is way uglier than I ever imagined it to be. (All hairy and bumpy.)
Fact #2: The inside of my behind is way more beautiful than I ever imagined it to be. (All pink and smooth.)
You know, I can't tell you how happy I have been since watching that "scope". If they could run a camera through my whole body -- and if everything looked that pink and clean -- I would be happier yet!
Cancer-Free-Since-1991. email from a female breast cancer survivor.
Sigmoidoscopy is the minimally invasive medical examination of the large intestine from the rectum through the last part of the colon. A sigmoidoscopy is an effective screening tool. Doctors use it to look for benign and malignant polyps, as well as early signs of cancer in the descending colon and rectum.
A sigmoidoscopy is similar but not the same as a colonoscopy. A Sigmoidoscopy only examines up to the sigmoid, the most distal part of the colon, while colonoscopy examines the whole large bowel.
Friday, May 29, 2009
2009 Johns Hopkins Colon Cancer White Paper
The 2009 Johns Hopkins Colon Cancer White Paper
Colon cancer patients and their families have a new resource.
The numbers are alarming: The American Cancer Society ranks colorectal cancer—a term that includes cancers of both the colon and the rectum—as the #3 cause of cancer overall in the United States (and the #2 leading cause of cancer-related deaths among men and women).
Yet it is one of the most preventable cancers, thanks to what we now know about effective colon cancer prevention. It is also one of the most curable of all cancers if you detect it and treat in its early stages.
The five-year survival rate for colon cancer when it is discovered and treated in the early stages is over 90%. In addition, early screening may reveal pre-cancerous growths (polyps) that can be removed easily, preventing you from developing colon cancer in the first place, even if you have a family history of colon cancer.
Need to contact us?
Click here: http://www.johnshopkinshealthalerts.com/contact_us/
Johns Hopkins Health Alerts
500 Fifth Avenue
19th Floor
New York, NY 10110
Attn: Web Team
Copyright © MediZine LLC. 500 Fifth Avenue, 19th Floor, New York, NY 10110. All rights reserved.
Colon cancer patients and their families have a new resource.
The numbers are alarming: The American Cancer Society ranks colorectal cancer—a term that includes cancers of both the colon and the rectum—as the #3 cause of cancer overall in the United States (and the #2 leading cause of cancer-related deaths among men and women).
Yet it is one of the most preventable cancers, thanks to what we now know about effective colon cancer prevention. It is also one of the most curable of all cancers if you detect it and treat in its early stages.
The five-year survival rate for colon cancer when it is discovered and treated in the early stages is over 90%. In addition, early screening may reveal pre-cancerous growths (polyps) that can be removed easily, preventing you from developing colon cancer in the first place, even if you have a family history of colon cancer.
Need to contact us?
Click here: http://www.johnshopkinshealthalerts.com/contact_us/
Johns Hopkins Health Alerts
500 Fifth Avenue
19th Floor
New York, NY 10110
Attn: Web Team
Copyright © MediZine LLC. 500 Fifth Avenue, 19th Floor, New York, NY 10110. All rights reserved.
Tuesday, April 14, 2009
Doc Says Doug’s Done
Doc Says Doug’s Done
March 3, 2008
Mr. Beckstein, let me take a moment to look at your chart.
Here are the results from my last Colonscopy.
OK.
Here are my CEA lab tests from 2007.
OK.
I had a CAT scan in March 2007, and there was no evidence of cancer.
I see that. No evidence of disease.
It has been five years since my colon cancer diagnosis.
Mr. Beckstein, you are done.
What.
You are done with cancer.
No more CEA tests?
Yes every six months but you will need a reading of 10 before I would be concerned.
What about CAT scans?
You really don’t have to go through that test anymore.
So I am done with cancer?
Yes. Doug you are done.
I left the doctor’s office a free man.
March 3, 2008
Mr. Beckstein, let me take a moment to look at your chart.
Here are the results from my last Colonscopy.
OK.
Here are my CEA lab tests from 2007.
OK.
I had a CAT scan in March 2007, and there was no evidence of cancer.
I see that. No evidence of disease.
It has been five years since my colon cancer diagnosis.
Mr. Beckstein, you are done.
What.
You are done with cancer.
No more CEA tests?
Yes every six months but you will need a reading of 10 before I would be concerned.
What about CAT scans?
You really don’t have to go through that test anymore.
So I am done with cancer?
Yes. Doug you are done.
I left the doctor’s office a free man.
I've Nothin' To Do
I've Nothin' To Do
by Douglas Beckstein
I opened my eyes and saw my brother, David, napping in the chair in the corner of my hospital room. This was day two after my abdominal resection.
My hair was soaked with sweat. Pain meds worked great, but I had had wild dreams last night. I had no idea what kind of day it was outside the hospital. Food did not appeal. A young doctor making his rounds entered my room. “Good morning, Mr. Beckstein," he said. "What are you reading?”
I had to look at the book open on my bed to answer his question. “Gods and Demons,” I replied, with a very dry mouth. I took a sip of water through a straw.
“Is it any good?"
"I don't know,” I said. “I can't really read on this pain killer.”
Ignoring my brother sprawled in the chair, the doctor walked over to the window and stood with his back to me. “How’s the view from here?” I asked.
"I can see the highway and the roof of this hospital,” he responded. Then he turned to face me again. “Is that an iPOD you have there?"
"Sixty gigs!" I said proudly.
"Cool. I want one," he said, inspecting the device closely.
The doctor sat on my bed, lifted the sheet covering my incision, and inspected the tubes connected to my body. I was very relaxed due to his engaging conversation. There was a nine inch incision in my body; staples held me together.
He stared at my drainage tube. “You don’t need this thing anymore,” he said. He placed one hand on my belly, grabbed the tube with his other hand, and yanked. Then he stood up, wrapped the tubing and collection pouch into a ball, tossed the mess into the hazardous medical waste garbage can, and returned to my bedside.
“You are doing very well. Healing right on schedule," he said, applying a band aid to my belly. Then he was gone.
My brother woke up. “Who was that guy?" he asked.
“I think he was a doctor.” Song lyrics entered my brain. "David, do you remember the artist who sang this song?"
Countin' flowers on the wall, that don't bother me at all
Playin' solitaire 'til dawn, with a deck of fifty-one
Smokin' cigarettes and watchin' Captain Kangaroo
Now don't tell me
I've nothin' to do.
"Statler Brothers," he replied, opening yesterday's newspaper.
by Douglas Beckstein
I opened my eyes and saw my brother, David, napping in the chair in the corner of my hospital room. This was day two after my abdominal resection.
My hair was soaked with sweat. Pain meds worked great, but I had had wild dreams last night. I had no idea what kind of day it was outside the hospital. Food did not appeal. A young doctor making his rounds entered my room. “Good morning, Mr. Beckstein," he said. "What are you reading?”
I had to look at the book open on my bed to answer his question. “Gods and Demons,” I replied, with a very dry mouth. I took a sip of water through a straw.
“Is it any good?"
"I don't know,” I said. “I can't really read on this pain killer.”
Ignoring my brother sprawled in the chair, the doctor walked over to the window and stood with his back to me. “How’s the view from here?” I asked.
"I can see the highway and the roof of this hospital,” he responded. Then he turned to face me again. “Is that an iPOD you have there?"
"Sixty gigs!" I said proudly.
"Cool. I want one," he said, inspecting the device closely.
The doctor sat on my bed, lifted the sheet covering my incision, and inspected the tubes connected to my body. I was very relaxed due to his engaging conversation. There was a nine inch incision in my body; staples held me together.
He stared at my drainage tube. “You don’t need this thing anymore,” he said. He placed one hand on my belly, grabbed the tube with his other hand, and yanked. Then he stood up, wrapped the tubing and collection pouch into a ball, tossed the mess into the hazardous medical waste garbage can, and returned to my bedside.
“You are doing very well. Healing right on schedule," he said, applying a band aid to my belly. Then he was gone.
My brother woke up. “Who was that guy?" he asked.
“I think he was a doctor.” Song lyrics entered my brain. "David, do you remember the artist who sang this song?"
Countin' flowers on the wall, that don't bother me at all
Playin' solitaire 'til dawn, with a deck of fifty-one
Smokin' cigarettes and watchin' Captain Kangaroo
Now don't tell me
I've nothin' to do.
"Statler Brothers," he replied, opening yesterday's newspaper.
Thursday, February 26, 2009
Waiting
Waiting
Waiting for an appointment
Waiting for a parking space
Waiting for an elevator
Sitting in a waiting room
Signing yet another medical form
Looking for my health insurance card
Glancing at magazines that have nothing to do with my life
Waiting to see the doctor
Waiting for the diagnosis
Wondering, is this test accurate?
Looking at numbers on a page
Wanting to understand
Lying on my back for a CAT Scan
Trying to be brave
Asking for a second opinion
Crying quietly
Wanting you to make it better
Worrying about dying
Waiting for a cure
Wanting something sweet
Waiting for a blood test
Wanting to run away
Waiting for a prescription
Cursing side effects
Looking for solutions
Wasting time
Wishing my life was different
Wondering how long will I live?
Praying to God
Talking with friends
Telling my story
Recovering
Living more
Loving deeply
Waiting for an appointment
Waiting for a parking space
Waiting for an elevator
Sitting in a waiting room
Signing yet another medical form
Looking for my health insurance card
Glancing at magazines that have nothing to do with my life
Waiting to see the doctor
Waiting for the diagnosis
Wondering, is this test accurate?
Looking at numbers on a page
Wanting to understand
Lying on my back for a CAT Scan
Trying to be brave
Asking for a second opinion
Crying quietly
Wanting you to make it better
Worrying about dying
Waiting for a cure
Wanting something sweet
Waiting for a blood test
Wanting to run away
Waiting for a prescription
Cursing side effects
Looking for solutions
Wasting time
Wishing my life was different
Wondering how long will I live?
Praying to God
Talking with friends
Telling my story
Recovering
Living more
Loving deeply
Friday, January 2, 2009
Colon Cancer
Colon cancer is the #2 cause of cancer-related death among BOTH men and women in the United States. Yet this cancer is highly treatable if detected early. I would like to introduce you to an invaluable resource in our ongoing war against colon cancer:
The numbers are alarming: The American Cancer Society ranks colorectal cancer—a term that includes cancers of both the colon and the rectum—as the #3 cause of cancer overall in the United States (and the #2 leading cause of cancer-related deaths among men and women).
Yet it is one of the most preventable cancers, thanks to what we now know about effective colon cancer prevention. It is also one of the most curable of all cancers if you detect it and treat in its early stages.
The five-year survival rate for colon cancer when it is discovered and treated in the early stages is over 90%. In addition, early screening may reveal pre-cancerous growths (polyps) that can be removed easily, preventing you from developing colon cancer in the first place, even if you have a family history of colon cancer.
The key to preventing and treating colon cancer is current, accurate, reliable knowledge.
John's Hopkins University 2008
The numbers are alarming: The American Cancer Society ranks colorectal cancer—a term that includes cancers of both the colon and the rectum—as the #3 cause of cancer overall in the United States (and the #2 leading cause of cancer-related deaths among men and women).
Yet it is one of the most preventable cancers, thanks to what we now know about effective colon cancer prevention. It is also one of the most curable of all cancers if you detect it and treat in its early stages.
The five-year survival rate for colon cancer when it is discovered and treated in the early stages is over 90%. In addition, early screening may reveal pre-cancerous growths (polyps) that can be removed easily, preventing you from developing colon cancer in the first place, even if you have a family history of colon cancer.
The key to preventing and treating colon cancer is current, accurate, reliable knowledge.
John's Hopkins University 2008
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