It has been over a decade since the National Institutes of Health started recommending adjuvant chemotherapy for patients with stage III colon cancer, based on a major trial that found significantly better five-year-survival rates compared to surgery alone. The latest study, published in the Journal of the American Medical Association, reviewed nearly 86,000 patients who were treated at 560 different hospitals.
There was a significant increase in chemotherapy use after the NIH recommendations were introduced in 1990. The treatment is still not as widely used in blacks, females and the elderly as compared to white males, although more and more African Americans started taking chemotherapy in 2002, the last year it was measured.
Looking at the groups most likely to use aggressive therapy, Jessup's team found that five-year-survival rates jumped from 8 percent to 16 percent when chemotherapy was added to surgery.
Jessup says that some patients are reluctant to take chemotherapy because of the many unpleasant side effects, such as nausea, diarrhea and hair loss. Still, he cites a previous study that found that the elderly can benefit from aggressive treatment as much as younger patients. "Adjuvant therapy is not all that more toxic even if you're over 80," he says.
As further proof, he points to his own mother in-law. She was 78-years of age when she began chemotherapy, and although it was clearly tough on her, the whole family is happy she did.
"Five years later, she's running her grandchildren around," Jessup says.
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