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Adjuvant treatment for an 82 years old stage3 colorectal cancer

Posted by maryeme @maryeme, Sep 3 4:36am

My father is 82 years old with no comorbidity except glaucoma. He got diagnosed for colorectal cancer on January 2024, after complete stenosis of the rectum. Symptoms look to be present since 5 years but bearable according to my father, till he was completely not able to go to the wc for his stools, but he lost up to 20 kg during the 5 years and he was not alarmed since it was steadily happening.
He got an urgent colostomy , a preoperative radiotherapy and a surgery for tumor resection , 8 weeks after radiotherapy. Chemotherapy was postponed because of low weight. After surgery , chemotherapy was also not advised because of low weight.
He is actually under abstinence and control by CT scan and tumor marquers.
Is it safe to cancel chemotherapy for 82 years, stage3 colorectal cancer?

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roywalton | @roywalton | Sep 3 5:20am

Hi - by your question "is it safe to cancel", I assume you are asking Will cancer progress without chemo. That's really a question for your oncologist, but really depends on other information that you have not presented. For example has circulating tumor DNA been assessed? If you are in the US you can get Signatera covered under Medicare. Recent data presented at ASCO, indicates that a negative ctDNA result 30 days following surgery, suggest adjuvant therapy does not have a better outcome then going without chemo. Please ask your doctor about this. As I'm sure you're aware the age is also a significant factor to consider. At many institutions chemo would not be considered simply because of age. I know I would be thrilled just to have 82 years under my belt

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1 reply
maryeme | @maryeme | Sep 3 7:35am
In reply to @roywalton "Hi - by your question "is it safe to cancel", I assume you are asking Will..." + (show)
@roywalton

Hi - by your question "is it safe to cancel", I assume you are asking Will cancer progress without chemo. That's really a question for your oncologist, but really depends on other information that you have not presented. For example has circulating tumor DNA been assessed? If you are in the US you can get Signatera covered under Medicare. Recent data presented at ASCO, indicates that a negative ctDNA result 30 days following surgery, suggest adjuvant therapy does not have a better outcome then going without chemo. Please ask your doctor about this. As I'm sure you're aware the age is also a significant factor to consider. At many institutions chemo would not be considered simply because of age. I know I would be thrilled just to have 82 years under my belt

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Thank you for your feedback.
The biomarkers requested by the oncologist for follow up were :
CA 19-9 and ACE.
I believe it’s not ctDNA, ACE is an antigen already, used to detect metastasis and CA 19-9 is found to be frequently associated with colon cancer according to what I understood. Both were negative right before surgery.
I will ask the oncologist about Signatera.

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isadora2021 | @isadora2021 | Sep 4 7:05pm

I’m so sorry your father is in this situation having been so fit and healthy. My father is 89 and going strong so I can understand the desire for more time to see family events.

These are tough discussions you need to have with his oncologist, including around quality of life. Assessing the potential for more time against the effects of treatment and the quality of life during that time.

It sounds as though your father’s doctors are concerned your father’s system is not well enough to handle the side effects of chemo.

Weight loss can also slide into anorexia, and chemo may exacerbate that risk.

I hope the test results help you all feel more comfortable with building up your father’s weight and health before his team is comfortable doing further treatment 🙏🙏❤️

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Moderator
Colleen Young, Connect Director | @colleenyoung | Sep 16 8:31pm
In reply to @maryeme "Thank you for your feedback. The biomarkers requested by the oncologist for follow up were :..." + (show)
@maryeme

Thank you for your feedback.
The biomarkers requested by the oncologist for follow up were :
CA 19-9 and ACE.
I believe it’s not ctDNA, ACE is an antigen already, used to detect metastasis and CA 19-9 is found to be frequently associated with colon cancer according to what I understood. Both were negative right before surgery.
I will ask the oncologist about Signatera.

Jump to this post

@maryeme, I thought I'd check to see how you and your father are doing. Has he been able to gain weight? How is he feeling? Next steps?

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