Colon Cancer in the Elderly

Colon cancer, also known as colorectal cancer, is a type of cancer that starts in the colon (large intestine) or rectum. Most colon cancers begin as small, non-cancerous clumps of cells called polyps that form on the inner lining of the colon. Over time, some of these polyps can become cancerous. But how do you navigate colorectal cancer in the elderly? How long can an 80-year-old live with colon cancer? How do you treat colon cancer in seniors? In this post, we’ll take a look at what you need to know about colon cancer in the elderly, including the causes, symptoms, and treatment for this type of bowel cancer in old age.

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Causes of Colon Cancer in the Elderly

When it comes to this type of bowel cancer in the elderly, the causes include:

• Genetic changes in colon cells. Colon cancer occurs when cells in the colon develop changes in their DNA, which contains the instructions for cell function.
• Abnormal cell growth. These DNA changes cause cells to multiply uncontrollably and continue living when healthy cells would normally die, leading to an accumulation of abnormal cells.
• Tumor formation and metastasis. The excess cells can form a tumor, invade surrounding tissues, and potentially spread to other parts of the body, a process known as metastatic cancer.

Symptoms of Colon Cancer in the Elderly

The symptoms of colon cancer in older men and women include:

• Changes in bowel movements, such as increased frequency of diarrhea or constipation
• Blood in the stool or rectal bleeding
• Ongoing discomfort in the belly area, such as cramps, gas, or pain
• A feeling that the bowel doesn’t empty completely during a bowel movement
• Weakness or fatigue
• Unexplained weight loss

Life Expectancy of Colon Cancer in the Elderly

As life expectancy rises, more cases of colon cancer after 80 are being diagnosed, prompting questions about whether surgery is suitable for this vulnerable population. A study presented at the American College of Surgeons Clinical Congress 2019 examined short-term outcomes of colon cancer surgery (colectomy) in 3,779 patients aged 85+ with Stage II or III colon cancer, with results suggesting that surgery can be effective. The findings showed that 89% of patients, including those 80 and older, were alive 30 days post-surgery, and 83% at 90 days.

However, untreated colon cancer in the elderly, particularly for colon cancer in 80-year-olds, is often associated with worse survival outcomes, reinforcing the importance of timely intervention. In the study, factors linked to better survival included having elective rather than emergency surgery, avoiding open procedures when possible, and addressing pre-operative complications. Discharge to a skilled nursing facility and treatment by high-volume surgeons were also associated with improved survival rates. These findings highlight the need for early detection and tailored approaches in managing colon cancer in the elderly, balancing potential benefits with patient health and quality of life.

Treating Colon Cancer in the Elderly

Some treatment options for colon cancer in older adults include:

• Ablation or embolization. These are treatments for metastatic or recurrent colorectal cancer with small tumors (less than 4 cm) in the liver or lungs. Ablation uses techniques like radio frequencies, microwaves, or alcohol to destroy cancer cells, while embolization blocks blood flow to the cancer cells in the liver to limit their growth.
• Chemotherapy. This is used when cancer has spread too far for surgery and often combined with targeted therapies to help control cancer progression.
• Hepatic artery infusion. A regional chemotherapy method that delivers drugs directly to the liver, helping destroy cancer cells without harming healthy tissue.
• Palliative care. Focuses on symptom management and improving quality of life when surgery or curative treatments are no longer effective.
• Radiation therapy. Recommended for late-stage colon cancer to relieve symptoms, though it typically doesn’t cure the disease.
• Surgery. Surgery may be an option for limited cancer spread, involving removal of part of the colon, lymph nodes, or affected tissues, sometimes followed by chemotherapy. Minimally invasive options like stents or a diverting colostomy may also be used for obstruction.

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