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SURGERY FOR COLORECTAL CANCER IN ELDERLY PATIENTS
September 14, 2000Colorectal cancer is the most common malignant disease in elderly people, with over 70% of cases occurring in those aged 65 years or older. Doctors often have to decide whether surgery will be worthwhile in terms of the patient's life expectancy and the quality of life they can expect after surgery. In fact, fewer elderly patients undergo surgery for colorectal cancer than their younger counterparts. In this week's Lancet, P D Simmonds and colleagues from Southampton, UK report that the outcome of major surgery in elderly patients could be similar to that in younger people if careful selection and attention to detail is exercised.
Life expectancy decreases with increasing age independent of the diagnosis of colorectal cancer. Elderly patients have an increased frequency of conditions, such as diabetes, hypertension, and pulmonary disease, and are more likely to present as an emergency or with advanced diseases. All these factors could contribute to the decreased long-term survival in elderly patients with colorectal cancer. However, a large proportion of patients will survive for 2 or more years after surgery. Thus elderly patients should not be denied surgery for colorectal cancer on the basis of age alone.
In an associated Commentary also in this week's Lancet, P G Alley suggests that decisions about the scope and timing of surgery of elderly patients should reside with the most senior of specialists, including an anaesthetist and a geriatrician, and the patients themselves.
Contact: Dr P D Simmonds, CRC Wessex Medical Oncology Unit and Health Care Research Unit, Southampton General Hospital, Southampton SO16 6YD. (T) 023 8079 6184; (F) 023 8078 3839;
(E) pds1@soton.ac.uk
P G Alley, Department of Surgery, North Shore Hospital, Takapuna, Auckland 10, New Zealand.
(T) 0064 9 486 8959; (F) 0064 9 488 4621; (E) ALLEYP@whl.co.nz
Lancet
Contact: Dr P D Simmonds, CRC Wessex Medical Oncology Unit and Health Care Research Unit, Southampton General Hospital, Southampton SO16 6YD. (T) 023 8079 6184; (F) 023 8078 3839;
(E) pds1@soton.ac.uk
P G Alley, Department of Surgery, North Shore Hospital, Takapuna, Auckland 10, New Zealand.
(T) 0064 9 486 8959; (F) 0064 9 488 4621; (E) ALLEYP@whl.co.nz
Lancet
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