Skip to main content
SpringerLink
Log in

Colon Cancer and Other Gastrointestinal Malignancies

  • Chapter
Geriatric Medicine

  • 236 Accesses

Abstract

In the 1983 edition of Clinical Oncology,1 the authors note, “The outlook for the patient with any alimentary tract cancer is not very favorable...) and these cancers are mainly of surgical interest.” Although cancer of the gastrointestinal tract remains of surgical interest, strides in the understanding of natural history, early diagnosis/ treatment, and pathogenesis have brought cancers of the gastrointestinal tract into a new therapeutic realm. This chapter reviews the changes that have occurred in past 10 years in the diagnosis and treatment of these cancers, with particular emphasis on the current approach to treatment of cancer of the colon and rectum in the older person. Chapter 18 discusses the major impact on treatment that has come from advances in early diagnosis.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 74.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Rubbing P. Clinical Oncology: A Multidisciplinary Approach. New York: The American Cancer Society; 1983.

    Google Scholar 

  2. Steele GD, Osteen RT, Winchester DP, Menck HR, Murphy GP. National Cancer Data Base: Annual Review of Patient Care. Atlanta: The American Cancer Society; 1994.

    Google Scholar 

  3. McGregor RA, Bacon HE. Multiple cancers in colon surgery: report of 162 cases. Surgery. 1958; 44: 828–833.

    PubMed  CAS  Google Scholar 

  4. Beahrs O, Henson D, Hutter R, et al. Manual for Staging of Cancer. 3rd ed. Philadelphia: JB Lippincott; 1988: 75–78.

    Google Scholar 

  5. McDermott FT, Hughes ESR, Paihl E, et al. Prognosis in relation to symptom duration in colon cancer. Br J Surg. 1981; 68: 846–849.

    Article  PubMed  CAS  Google Scholar 

  6. Goldman L. Cardiac risks and complications of noncardiac surgery. Ann Intern Med. 1983; 98: 504–513.

    PubMed  CAS  Google Scholar 

  7. Griffith RS. Preoperative evaluation: medical obstacles to surgery. Cancer. 1992; 70: 1333–1341.

    Article  PubMed  CAS  Google Scholar 

  8. Freeny PC, Marks WM, Ryan JA, et al. Colorectal carcinoma evaluation with CT: preoperative staging and detection of postoperative recurrence. Radiology. 1986; 158: 347–353.

    PubMed  CAS  Google Scholar 

  9. Collier BD, Abdel-Nabi H, Doerr RJ. Immunoscintigraphy performed with IN-111-labeled CYT-103 in the management of colorectal cancer. Comparison with CT. Radiology. 1992; 185: 179–186.

    PubMed  CAS  Google Scholar 

  10. DeVita VT, Hellman S, Rosenberg SA. Cancer: Principles and Practice of Oncology. 3rd ed. Philadelphia: JB Lippincott; 1989.

    Google Scholar 

  11. Ozoux JP, deCalan L, Perrier M, et al. Surgery for carcinoma of the colon in people aged 75 years and older. Int J Colorect Dis. 1990; 5: 25–30.

    Article  CAS  Google Scholar 

  12. Zieren HU, Muller JM, Zieren J. Resection of colorectal liver metastases in old patients. Hepatogastroenterology. 1994; 41: 34–37.

    PubMed  CAS  Google Scholar 

  13. Gastrointestinal Tumor Study Group. Prolongation of the disease-free interval in surgically treated rectal carcinoma. N Engl J Med. 1985; 312: 1465–1472.

    Google Scholar 

  14. Fisher B, Wolmark N, Rockette H, et al. Postoperative adjuvant chemotherapy of radiation therapy for rectal cancer: results form NSABP protocol R-01. J Natl Cancer Inst. 1988; 80: 21–29.

    Article  PubMed  CAS  Google Scholar 

  15. Krook JE, Moertel CG, Gunderson LL, et al. Effective surgical adjuvant therapy for high risk rectal carcinoma. N Engl J Med. 1991; 324: 709–715.

    Article  PubMed  CAS  Google Scholar 

  16. Steele G. Combined-modality therapy for rectal carcinoma -the time has come. N Engl J Med. 1991; 324: 764–766.

    Article  PubMed  Google Scholar 

  17. Glimelius B, Pahlman L. The value of adjuvant therapy after radical surgery for colorectal cancer. Ann Med. 1992; 24: 9–14.

    Article  PubMed  CAS  Google Scholar 

  18. Stockholm Rectal Cancer Study Group. Preoperative short term radiation in operable rectal carcinoma. A prospective randomized trial. Cancer. 1990; 66: 49–55.

    Google Scholar 

  19. Schilsky RL, Brachman DG. Adjuvant chemotherapy and radiation therapy in colorectal cancer. PPO Updates. 1992; 6: 1–12.

    Google Scholar 

  20. Wolmark N, Rockette H, Fisher B, et al. Leukovorinmodulated 5-FU(LV-FU) as adjuvant therapy for primary colon cancer: NSABP C-03. Proc Am Soc Clin Oncol. 1993; 12: 578.

    Google Scholar 

  21. Hoover HC, et al. Five year follow up of a controlled trial of active specific immunotherapy in colorectal cancer. Proc Am Soc Clin Oncol. 1990; 9: 106.

    Google Scholar 

  22. Moertel CG, et al. Levamisole and fluorouracil for adjuvant therapy of resected colon carcinoma. N Engl J Med. 1990; 322: 352–358.

    Article  PubMed  CAS  Google Scholar 

  23. Adjuvant therapy for patients with colon and rectum cancer. Clin Courier 1990, November; 8(10).

    Google Scholar 

  24. Brower M, Asbury R, Kramer Z, et al. Adjuvant chemotherapy for colorectal cancer in the elderly: population based experience. ASCO Proc. 1993; 12: 195.

    Google Scholar 

  25. Witzig TE, et al. DNA ploidy and cell kinetic measurements as predictors of recurrence and survival in stages B2 and C colorectal adenocarcinoma. Cancer. 1991; 68: 879–888.

    Article  PubMed  CAS  Google Scholar 

  26. Patt YZ. Regional hepatic arterial chemotherapy for colorectal cancer metastatic to the liver: the controversy continues. J Clin Oncol. 1993; 11: 815–819.

    PubMed  CAS  Google Scholar 

  27. Kohne-Wompner CH, Schmoll HJ, Harstrick A, Rusturn YM. Chemotherapeutic strategies in metastatic colorectal cancer: an overview of current clinical trials. Semin Oncol. 1992; 19: 105–125.

    PubMed  CAS  Google Scholar 

  28. Vaughn DJ, Haller DG. Nonsurgical management of recurrent colorectal cancer. Cancer. 1993; 71: 4278–4293.

    Article  PubMed  CAS  Google Scholar 

  29. Manton KG, Stallard E. Cross-sectional estimates of active life expectancy for the U.S. elderly and oldest-old populations. J Gerontol. 1991; 46 (suppl): 170–182.

    Google Scholar 

  30. Scheithauer W, Rosen H, Kornek GV, Sebesta C, Depisch D. Randomized comparison of combination chemotherapy plus supportive care with supportive care alone in patients with metastatic colorectal cancer. Br Med J. 1993; 306: 752–755.

    Article  CAS  Google Scholar 

  31. Meyers WC, Damaino RJ, Postlethwait RW, et al. Adenocarcinoma of the stomach: changing patterns over et al. Serum testosterone: dihydrotestosterone ratio and the last four decades Ann Surg. 1987;205:1–8

    Google Scholar 

  32. Weiman TJ, Max MH, Volges CR, et al. Diversion of duodenal contents: its effect on the production of experi- gastric cancer. Arch Surg. 1980; 115: 959–961.

    Article  Google Scholar 

  33. Hitchock CR, Schneider SL. Early diagnosis of gastric cancer. Surg Gynecol Obstet. 1961; 113: 655.

    Google Scholar 

  34. Gobbi PG, Diongi P, Barbieri F, Corbella F, et al. The role of surgery in the multimodal treatment of primary gastric non-Hodgkin’s lymphoma. Cancer. 1990; 65: 2528–2536.

    Google Scholar 

  35. Higgins GA, Serlin O, Amadeo JH, et al. Gastric cancer factors in survival. Surg Gastrointest. 1976; 10: 393.

    Google Scholar 

  36. Beahrs GS, Henson DE, Hutter RVP, et al. Manual for canStaging of Cancer. Philadelphia: WB Saunders; 1993: 63–71

    Google Scholar 

  37. Smith JW, Brennan MF, et al. Preoperative endoscopic ultrasound can predict the risk of recurrence after opera cancer of the esophagus. Cancer. 1961; 14: 389–413.

    Article  Google Scholar 

  38. Cook AO, Levine BA, Sirinek KR, et al. Evaluation of gastric adenocarcinoma: abdominal computer tomography does not replace celiotomy. Arch Surg. 1986; 121: 603–606.

    Google Scholar 

  39. Kaneko K, Nakamura T, Umeda N, et al. Outcome of gastric carcinoma detected by gastric survey. Gut 1977;18:626–630.

    Google Scholar 

  40. Dalton RR, Eisenberg BL. Rationale for the current sur gical management of gastric adenocarcinoma. Oncology. 1994; 8: 99–104.

    PubMed  CAS  Google Scholar 

  41. Gouzi JL, Huguier M, Faginiez PL, et al. Total versus subtotal gastrectomy for adenocarcinoma of the gastric an trum: a French prospective controlled trial. 1989; 209: 162–166.

    CAS  Google Scholar 

  42. Fujimoto S, Takahashi M, Ohkubo H, et al. Comparative clinicopathologic features of early gastric cancer in and older patients. Surgery. 1994; 115: 516–520.

    PubMed  CAS  Google Scholar 

  43. Cullinan SA, Moertel CG, Fleming TR, et al. A comparison of 3 chemotherapeutic regimens in the treatment of advanced pancreatic and gastric carcinoma: vs fluorouracil, doxorubicinand mitomycin. JAMA. 1985; 253: 2061–2067.

    Article  PubMed  CAS  Google Scholar 

  44. Wilke H, Preusser P, Fink U, et al. High dose folinic acid/ etoposide/5-fluorouracil in advanced gastric cancer-a phase II study in elderly patients or patients with cardiacr isk. Invest New Drugs. 1990; 8: 65–70.

    Article  PubMed  CAS  Google Scholar 

  45. The Gastrointestinal Study Group. The concept of locally advanced gastric cancer: effect of treatment on outcome. Cancer 1990; 66: 2322–2330.

    Google Scholar 

  46. Moertel C, Childs DS, O’Fallon JR, et al. 5-fluorouracil and radiation therapy as a surgical adjuvant for poor prognosis gastric cancer. J Clin Oncol 1984;2:

    Google Scholar 

  47. Ghadirian P, Simard A, Baillargeon J. Tobacco, alcohol and coffee and cancer of pancreas. Cancer. 1991; 67: 2664 2670.

    Google Scholar 

  48. Farrow DC, Davis S. Diet and the risk of pancreatic in men. Am J Epidemiol. 1990; 132: 422–431

    Google Scholar 

  49. Offerhaus GJA, Tersmette AC, Tersmette KWF, et al. Gastric, pancreatic, and colorectal carcinogenesis following remote peptic ulcer surgery. Mod Pathol 1988; 1: 352–356.

    PubMed  CAS  Google Scholar 

  50. Moertel CG. An odyssey in the land of small tumors. J Clin. Oncol 1987; 5: 1503–1522.

    Google Scholar 

  51. Robles-Diaz G, Diaz-Sanchez V, Fernandez-delCastillo C, CA 19–9 in the diagnosis of pancreatic cancer. Am J Gastroenterol. 1991; 86: 591–594.

    PubMed  CAS  Google Scholar 

  52. Balthazar EJ, Chako AC. Computed tomography of panmental creatic masses. Am J Castroenterol. 1990; 85: 343–349.

    CAS  Google Scholar 

  53. Whipple AO, Parsons WB, Mullins CR. Treatment of carcinoma of the ampulla of Vater Ann Surg1935;102

    Google Scholar 

  54. Saltzberg D, Foley K. Management of pain in pancreatic cancer. Surg Clin North Am. 1989; 69: 629–649.

    Google Scholar 

  55. Ilson DH, Kelson DP. Adjuvant postoperative therapy of gastrointestinal malignancies. Oncology. 1994; 8: 75–95.

    PubMed  CAS  Google Scholar 

  56. Kelson D. Neoadjuvant therapy for gastrointestinal. cers. Oncology. 1993; 7: 25–32.

    Google Scholar 

  57. Wynder AR, Bross LJ. A study of the etiologic factors in tion for gastric carcinoma. J Clin Oncol. 1993; 11: 2380–2385.

    Google Scholar 

  58. Blot WJ, Devesa SS, Kneller RW, et al. Rising incidence of adenocarcinoma of the esophagus. DAMA. 1991; 265: 1287–1289.

    Google Scholar 

  59. Cameron AJ, Ott BJ, Payne WS. Incidence of adenocarcinoma in columnar-lined (Barrett’s) esophagus. N Engl J Med. 1985; 313: 857–859.

    Article  PubMed  CAS  Google Scholar 

  60. Earlem R. An MRC prospective randomized trial of radiotherapy versus surgery for operable squamous cell carcinoma of the esophagus.Ann R Coll Surg Engl 1991; 73: 8–12.

    Google Scholar 

  61. Caspers RJ, Welvaart K, Verkes RJ, et al. The effect of radiotherapy on dysphagia and survival in patients with esophageal cancer. Radiother Oncol. 1988; 12: 15–23.

    Article  PubMed  CAS  Google Scholar 

  62. Pakisch B, Kohek P, Poier E, et al. Iridium-192 high dose brachytherapy combined with external beam irradiation younger in non-resectable oesophageal cancer. Clin Oncol. 1993; 5: 154–158.

    Article  CAS  Google Scholar 

  63. Anderson LL, Lad TE. Autopsy findings in squamous-cell carcinoma of the esophagus. Cancer. 1982; 50: 1587–1590.

    Article  PubMed  CAS  Google Scholar 

  64. Philip PA, Ajani JA. Has combination modality therapy improved the outlook in carcinoma of the esophagus? Oncology. 1994; 8: 37–44.

    PubMed  CAS  Google Scholar 

  65. Leichman L, Berry BT. Experience with cisplatin in treat-ment regimens for esophageal cancer. Semin Oncol. 1991; 18: 64–72.

    PubMed  CAS  Google Scholar 

  66. Thyss A, Saudes JO, Creisson MH, et al. Renal tolerance of cisplatin in patients more than 80 years old. J Clin Oncol. 1994; 12: 2121–2125.

    PubMed  CAS  Google Scholar 

  67. Ajani JA, Roth JA, Ryan MB, et al. Intensive preoperative Combined chemotherapy with colony-stimulating factor for resectable adenocarcinoma of the esophagus or gastroesophageal junction. J Clin Oncol. 1993; 11: 22–28.

    PubMed  CAS  Google Scholar 

  68. Doyle D, Hanks WC, MacDonald N. In: The Oxford Text-, book of Palliative Medicine. Oxford: Oxford University.Press; 1993.

    Google Scholar 

  69. Sharfman W, Walsh D. Has the analgesic efficacy of cancer neurolytic celiac plexus block been demonstrated in pan creatic cancer? Pain. 1990; 41: 267–271.

    Article  PubMed  CAS  Google Scholar 

  70. Management of Cancer Pain. AHCPR Pub. ©94–0592. Rockville, MD: U.S. Dept. of Health and Human Services; March, 1994.

    Google Scholar 

  71. Mercadante S. The role of octreotide in palliative care J Pain Symptom Manage. 1994; 9: 406–411.

    Article  PubMed  CAS  Google Scholar 

  72. Ashby MA, Game PA, Britten-Jones R, et al. Percutane- Canous gastrostomy as a venting procedure in palliative care. cer. Pallias Med. 1991; 5: 147–150.

    Google Scholar 

  73. Doberneck R, Berndt G. Delayed gastric emptying after palliative gastrojejunostomy for carcinoma of the pancreas Arch Surg. 1987; 122: 827–829.

    Article  PubMed  CAS  Google Scholar 

  74. Van den Bosch RP, van den Schelling GP, Klinbenbilj JHG, et al. Guidelines for the application of surgery and endoprosthesis in the palliation of obstructive jaundice in advanced cancer of the pancreas. Ann Surg. 1994; 219: 18–24.

    Article  PubMed  Google Scholar 

  75. Twycross RG, Lack SA. In: Therapeutics in Terminal London: Churchill -Livingstone; 1990.

    Google Scholar 

  76. Alexander HR, Norton JA. Pathophysiology of cancer cachexia. In: Doyle D, Hanks WC, MacDonald N, eds. The.Oxford Textbook of Palliative Medicine. Oxford: Oxford University Press; 1993: 316–329.

    Google Scholar 

  77. Breura E, Fainsinger R. Clinical management of cachexia and anorexia. In: Doyle D, Hanks WC, MacDonald N, eds. The Oxford Textbook of Palliative Medicine. Oxford: Oxford University Press; 1993: 330–337.

    Google Scholar 

Download references

Authors
  1. Walter B. Forman
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. The Henry L. Schwartz Department of Geriatrics and Adult Development, The Mount Sinai Medical Center, 10029-6574, New York, NY, USA

    Christine K. Cassel M.D. (Professor and Chairman) & Diane E. Meier M.D. (Associate Professor) (Professor and Chairman) &  (Associate Professor)

  2. Center for Study of Aging and Geriatric Research Education and Clinical Center, Duke University Medical Center, 27710, Durham, NC, USA

    Harvey J. Cohen M.D. (Director) (Director)

  3. University of Washington Medical Center, 98195, Seattle, WA, USA

    Eric B. Larson M.D., M.P.H. (Medical Director) (Medical Director)

  4. Gerontology Division, Harvard Medical School, Brigham and Women’s Hospital, 02115, Boston, MA, USA

    Neil M. Resnick M.D. (Chief) (Chief)

  5. Geriatric Research Education and Clinical Center, Sepulveda VA Medical Center, 91343, Sepulveda, CA, USA

    Laurence Z. Rubenstein M.D., M.P.H. (Director) (Director)

  6. Department of Medicine, University of Chicago, 60637, Chicago, IL, USA

    Leif B. Sorensen M.D. (Professor and Vice Chairman) (Professor and Vice Chairman)

Rights and permissions

Reprints and permissions

Copyright information

© 1997 Springer Science+Business Media New York

About this chapter

Cite this chapter

Forman, W.B. (1997). Colon Cancer and Other Gastrointestinal Malignancies. In: Cassel, C.K., et al. Geriatric Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-2705-0_21

Download citation

  • DOI: https://doi.org/10.1007/978-1-4757-2705-0_21

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4757-2707-4

  • Online ISBN: 978-1-4757-2705-0

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation