Colorectal Cancer Primer?

June 7, 2005 5:22 AM

Dad had his sigmoid colon resected to remove cancerous tissue. Since then there was a follow up visit (I wasn't there which indicated that it's stage 3 (spread to lymphatic system but not to other organs).

Any of you have insight on trends in practice for chemo or other protocols treating an 82-year-old? He still has a couple weeks of bed rest and physical therapy to go through before he's fully ambulatory and self-supporting.
The five-year survival statistics look grim. What are some well-respected (i.e., by a Sloan-Kettering oncologist) but accessible writings on geriatric courses of treatment and likely survival rates. I suspect there are some big trade-offs coming (quality of life during treatment for the higher probability of a longer survival rate). For the moment I want to leave palliative care off the table. Not in denial, I just have a pretty good understanding of that and absolutely none about viable treatments. Although comments on alternative therapies are welcome, whatever you have in the leading-edge mainstream will be greatly appreciated.

Just want to be mentally equipped for discussions with the MDs.

posted by nj_subgenius to health & fitness (8 comments total)

I can't help you with the information you're looking for, but you have my sympathies.
posted by orthogonality at 5:39 AM on June 7, 2005

It depends partially upon what the doctors perscribe for him, and how your father reacts to the therapy. The only observations I could make would concern the possible side effects, such as restlessness or fatigue.

The Cancer Forums can be helpful in terms of mental/moral support. Likewise the Association of Cancer Online Resources, the National Cancer Institute, and the CancerBlog are certainly worth bookmarking.

You shouldn't be afraid of asking the doctors too many questions - that's what they're there for. They understand peoples' lives are going to be changed by any prospect of serious illness, and often stress the importance of relatives providing support. How your family deals with the situation is just as important to your dad's health as it is to his emotional state and yours. Though prospects may seem daunting in particular cases, research is being done every day, and a variety of alternatives will certainly be considered.

The homeopathic alternatives I can think of are useful in easing discomfort, but it's important to discuss them with your doctor, as they might counteract or further aggrivate your dad's condition. Any teas, etc. will not be useful on a "bad" day, or in cases where blood cell counts are low and the patient may be succeptable to bacterial infection. Be sure to consider such matters carefully before doing anything behind the experts' backs.

Hope this helps. Good luck to you and your father!
posted by Smart Dalek at 6:05 AM on June 7, 2005

nj_subgenius - I don't have anything useful for you either, except to say that I do have first hand experience with this. Dad was in and out of the hospital for the last 8 months of his life to treat acute issues that cropped up (removal of an eye which had become cancerous, etc). In the end they chose to bring him home and let him go as gracefully as possible. We got him a hospital bed at home and he died the very next day. Mom denied that she helped him to die, but I have very serious doubts. He was, afterall in that much pain.

I wish you and your family well.
posted by FlamingBore at 6:13 AM on June 7, 2005

http://www.cancer.gov/cancertopics/pdq/treatment/colon/patient
posted by cahlers at 8:55 AM on June 7, 2005

nj_subgenius I have great empathy for your situation and wish you and your dad well. Have you talked to the surgeon? I know it's blindingly obvious but chemo/radio treatment and their successes are going to be so tied to your dad's personal story that I'm imagining it will be easy to get flawed impressions from mere reading. I'm sorry I don't have anything more tangible to offer but speaking with the Doctor is going to answer more questions for your dad's situation than any other resource I feel. (not that I'm trying to dissuade you from reading though)
posted by peacay at 9:33 AM on June 7, 2005

I agree with Peacay, except that it is your father's medical oncologist, not the surgeon, that will provide the best answers to your treatment, at least as far as chemotherapy and prognosis is concerned. The radiation oncologist is the person to address specific questions regarding radiation, and the surgeon *only* regarding recovery from surgery. It is important to understand each specialist's role and address questions to the correct person, otherwise you will not receive the best answers.

As Peacay already stated, a frank discussion about your father's particular case will be much better than whatever information can be gleaned from other sources.
posted by cahlers at 9:48 AM on June 7, 2005

Not sure if I can offer specifics for you, but I can offer up my story in hopes in sheds some insights...my dad passed away from a very aggressive colon cancer in November after battling it for years.

From what I gathered, there are (now) different types/severity of chemotheraphy offered. For my dad, towards the end, he was given a course (don't really know the terminology) of (ImClone's) Erbitux...which supposedly has less of the typical chemo effects (his oncologist stressed that this really was a breakthrough kind of treatment)...but, by this point he was so ravaged and the cancer had progressed so much that even this treatment was merely prolonging his life in terms of weeks, maybe months. The decision to stop the chemo treatment was...oppressively difficult.

But I agree with cahlers in that keeping open lines of communication with your dad's oncologist is the single best source of information. I learned (the hard way) that talking to PCPs, surgeons, nurses, orderlies, etc is a good way to understand how shockingly disorganized and uncommunicative a hospital system can be...so I focused on talking to my dad's oncologist, as she knew his case the best.

Of course, best of luck to you and your dad.
posted by tpl1212 at 1:50 PM on June 7, 2005

You might want to explore clinical trials, if the MD tells you that conventional chemotherapy doesn't normally prolong life very much, since it certainly will make living a great deal more painful. But the decision about how hard to fight, and how much pain to suffer, is, of course, your father's to make.
posted by WestCoaster at 8:11 PM on June 8, 2005