Metastatic CRC with Marwan G. Fakih, MD and Tanios Bekaii-Saab, MD: Case 2 - Episode 3
Would comorbidity conditions in this patient influence your treatment decisions?
Dr. Bekaii-Saab think that this patient is more likely than not to be able to tolerate these types of treatments. Again, very few comorbidities, if any, and then a good performance status. Age itself is only a minor determinant. Of course a patient above 80, you really need to think hard about being too aggressive. But under 80, and in some would cut the mark at 75, still you should be equally aggressive across these patients unless significant comorbidities coexist, or a poor performance status.
CASE 2: Metastatic Colorectal Cancer (CRC)
Beverly C. is a 73-year-old retired nurse originally from Albany, New York. She and her husband enjoy golf and traveling.
In 2010, routine colonoscopy revealed a large adenomatous polyp that was subsequently removed endoscopically.
In January of 2014, she presented to her PCP with symptoms of irregular bowel movements, fatigue, and unexplained weight loss.
CT scan revealed a large mass in the sigmoid colon and multiple hepatic lesions
Patient was eventually diagnosed with stage IV colorectal cancer with metastasis to the liver
She underwent resection of the sigmoid mass followed by FOLFOX for metastatic disease
After 6 months she developed stage 3 sensory neuropathy and oxaliplatin was discontinued; at that time, hepatic lesions were stable
She is now continuing treatment with 5-FU and leucovorin until disease progression