Dear OncoLink "Ask The Experts,"
My mother was just diagnosed with signet ring cell colon cancer. She had a right colectomy. She has one lymph node involved. I'm wondering what her prognosis and treatment options are?
Julia Draznin Maltzman, MD, Attending Physician at the University of Pennsylvania School of Medicine, responds:
The most important prognostic factor in colon cancer is the stage of the disease. Provided she has no distant metastasis, given the lymph node involvement, she may be classified as stage III. The treatment options for adjuvant colon cancer therapy are many. Most of them include a drug called 5-Fluouracil or 5-FU, and its partner Leucovorin (LV). Up until 2-3 years ago this was the standard of care. Now, a more aggressive regimen may include a combination of 5-FU/LV with either Oxaliplatin or Irinotican. Either is an option. Some physicians also may chose to give the "oral equivalent of 5-FU" called Xeloda. It is best you discuss the pros and cons of each treatment regimen with your doctor. The decision will take into account your mothers age, medical history, disease extend, and side effect profile.
Taking all comers with stage III disease with only 1-3 positive lymph nodes from an adequate sample (at least 10-15 were sampled), then the average five year survival tends to be about 65-70%. Your mother’s chances are favorable and there are many new options in colon cancer that are available now that did not exist only 2-3 years ago.
Jul 28, 2014 - In patients with synchronous stage IV colorectal cancer who receive up-front modern combination chemotherapy, immediate colon surgery to remove the primary tumor is seldom necessary, according to research presented at the annual meeting of the American Society of Clinical Oncology, held from May 29 to June 2 in Orlando, Fla. These findings accompanied several other studies presented at the conference focusing on treatment of gastrointestinal cancers.
Jul 28, 2014