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Current Oncology Reports

, 20:102 | Cite as

Treatment of Rectal Cancer in Older Adults

  • Ayesha R. SheikhEmail author
  • Hassan Yameen
  • Kevan Hartshorn
Geriatric Oncology (AR MacKenzie, Section Editor)
  • 117 Downloads
Part of the following topical collections:
  1. Topical Collection on Geriatric Oncology

Abstract

Purpose of Review

Rectal cancer is predominantly a disease of older adults but current guidelines do not incorporate the associated specific challenges leading to wide variation in the delivery of cancer care to this subset of population. Here, we will review the current data available regarding the management of rectal cancer in older adults.

Recent Findings

The greatest challenge arises in the management of stage II/III disease as it involves tri-modality treatment that can be harder to tolerate by frail older patients. Response to neoadjuvant treatment is being used as a new marker to tailor further therapy and possibly avoid surgery. Oxaliplatin can be omitted from the adjuvant treatment without compromising outcomes.

Summary

Physicians should perform geriatric assessment utilizing many validated tools available to help predict treatment tolerability and outcomes in older adults that can help personalize subsequent management. Most older adults can undergo standard therapy for stages I, II, or III rectal cancer with curative intent. Increasing evidence suggests that patients with a clinical complete response to neoadjuvant treatment may be observed closely with the possibility of avoiding surgery. Studies are evaluating alternate systemic treatments for advanced metastatic disease with the hope of maintaining quality of life without compromising cancer outcomes.

Keywords

Rectal cancer Older adults Neoadjuvant chemoradiation Watch and wait Pre-treatment risk assessment Rectal cancer surgery 

Notes

Compliance with Ethical Standards

Conflict of Interest

Ayesha R. Sheikh, Hassan Yameen, and Kevan Hartshorn declare they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Ayesha R. Sheikh
    • 1
    Email author
  • Hassan Yameen
    • 1
  • Kevan Hartshorn
    • 1
  1. 1.Section of Hematology/OncologyBoston University Medical CenterBostonUSA

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