Older patients less likely to receive chemotherapy-- study

According to researchers, chemotherapy after surgery in advanced colon cancer reduces the odds of cancer death and recurrence in all patients, but the aged are less likely to receive the treatment because of their age and the probability of developing other illnesses.

Co-author of the study, Dr. Katherine L. Kahn, an internist at the David Geffen School of Medicine at University of California, Los Angeles (UCLA) stated, "Our team found that patients, especially older patients in community settings, received care that is different in important ways from what is recommended based upon trials conducted in specialty research settings.”

Analysis of data
In order to gain some insight into the age differential and the treatment process, the researchers from the RAND Corporation and UCLA tracked 675 advance colon cancer patients from 2003 to 2005. The focus of the study was to test the treatment regimen and the side effects on 202 patients 75 and older.

The researchers noted 50 percent of the patients aged 75 and above received chemotherapy after surgery as opposed to 87 percent of the younger lot.

Chemotherapy after surgery in advanced colon cancer reduces the odds of cancer death and recurrence in all patients, but the aged are less likely to receive the treatment because of their age and the probability of developing other illnesses.

Moreover, only 14 percent of those elderly received the drug oxaliplatin, which is very effective but potentially toxic compared with 44 percent of the younger patients.

Additionally, the 40 percent of the older patients discontinued chemotherapy prematurely compared with 25 percent of younger patients while 18 percent were administered weaker doses of the drugs.

Observations by researchers
There was significant evidence of adverse effects on the whole. Approximately 24 percent of the patients experienced at least one negative side effect by the end of the study period.

In addition, though the older patients experienced negative effects in the beginning of the therapy. The side effects that manifested well into the treatment regimen were more pronounced among younger patients.

Kahn stated, "Among treated patients, older patients did not experience more adverse outcomes in the year following the cancer diagnosis than younger patients, even after accounting for the additional illnesses that older patients are more likely to have," said Kahn.

Implications of the study
The researchers are optimistic that the research would inspire more physicians to use chemotherapy as a treatment in older adults, who can usually tolerate the therapy if monitored closely and side effects are addressed promptly.

"What this does is it informs patients and doctors that if they see an older patient with stage three colon cancer they shouldn't automatically based upon their age decide not to treat the patient.

"They should work with the patient and family individually to try to get a sense of how well that patient might tolerate the treatment," said Dr. Kahn.

The study appears this week in a theme issue on cancer research in the Journal of the American Medical Association.