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Stage III Adenocarcinoma (Patient Case #929)

A 68-year old male has not had a colonoscopy in 13 years due to loss of his insurance. On his last colonoscopy he had multiple polyps and was advised to have follow up in 5 years. The patient was found to have an adenocarcinoma, and after full evaluation is at Stage III, has just completed his colectomy and presents for adjuvant chemo. What do you recommend?

HEALTHCASTS COMMUNITY RESPONSE

This patient case was posted to the Healthcasts peer-to-peer community in January/February 2020. 244 unique opinions were contributed. The case was reviewed and assessed in March 2020. The following is a synopsis of their aggregated recommendations and treatment plan.

Background

Colon cancer is a form of cancer that develops in the large intestine (colon), which is part of the lower digestive system. Though research shows that older adults are usually more affected by colon cancer, people of all ages can be affected. There are several factors that may increase a person’s risk of developing colon cancer, including but not limited to the aforementioned older age, history of intestinal conditions, inherited gene mutation, and lifestyle choices such as smoking and drinking.

Adjuvant Chemotherapy Options

The patient case posted to the Healthcasts community states that a colectomy followed by adjuvant chemotherapy was chosen as the best treatment option for a 68-year old male with Stage III colon cancer. The question posed, was: Which adjuvant chemotherapy option would be the best option for this patient?

I’d recommend adjuvant CAPOX or FOLFOX chemotherapy, with the duration depending on whether the stage III colon cancer was low-risk or high-risk.

There are several different treatment options available for colon cancer including surgery (colectomy), radiation therapy and chemotherapy. A colectomy is a surgical procedure in which a portion or the entire colon is removed. There are different adjuvant chemotherapy options available for a patient following this procedure. Some respondents chose one of these options, while others mentioned both and provided situations in which either would apply.

The full patient case review, available to Healthcasts members, includes explanations of the different therapy options, risks, and additional suggestions from the community.


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