Assessment and treatment of elderly patients with colorectal cancer

Roxana-Andreea Rahnea-Niță1,4, Asst. prof. Gabriela Rahnea-Niță2,4, Anda-Natalia Ciuhu3,4

1 “ Dr. Constantin Gorgos” Titan Psychiatric Hospital, Bucharest, Romania, 2University of Medicine and Pharmacy „Dr. Carol Davila”, Bucharest, Romania, Chronic Disease Hospital “Saint Luca”, Department of Oncology – Palliative Care, Bucharest, Romania3, Oncology 4

Received: 7.01.2020 • Accepted for publication: 25.03.2020

Abstract

Background: The incidence of many cancers and colorectal cancer is higher in patients aged 65 years and over. The treatment of cancer in elderly patients should be based on the assessment of the tolerance to treatment and the coexisting medical conditions.

Material and method: We conducted a retrospective study in patients with colorectal cancer admitted to “Saint Luca” Hospital of chronic diseases, Oncology-Palliative Care Department over a period of 9 months. We assessed the performance status-ECOG, 2 symptoms (pain and general status) recorded on the Edmonton Symptom Assessment Scale (ESAS) and the life environment, the stage of the disease and the treatment (palliative chemotherapy versus palliative care alone).

Results: The incidence of colorectal cancer was higher in elderly patients as compared to the patients under 65 years (63,27% elderly patients versus 36,73% patients under 65 years). The intensity of pain 51,62% of patients 65 years and over had moderate or severe pain. Regarding the general status 80,65% of elderly patients had a moderate or severe level. 12 elderly patients benefited of chemotherapy regimens and 19 patients benefited of palliative treatment.

Discussion and conclusions: As a result of achievements over the past decade, with the consequence of increasing of the survival, colorectal cancer is taking on the characteristics of a chronic disease. Age alone should not be a factor who influence the strategy of the treatment of patients. A personalized strategy for elderly patients with colorectal cancer is indicated, considering each patients comorbidities, performance status, life styles and individual preferences.

Keywords: elderly patients, colorectal cancer, palliative chemotherapy

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