Tech Helps Elderly Cancer Patients Live Longer

Bladder and colorectal cancer in older patients have stronger treatment options

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Cancer can be one of the most difficult things to live with, and for those fighting it at 80, treatments can be even more trying.

Two new operations may help improve recovery and extend the lives of older patients with bladder and colorectal cancer, as presented in two new studies at a recent conference.

"Talk to your doctor about surgery options."

The studies looked at operations done with the help of robots and operations involving very little cutting into the body.

Surgeries done with robots and computerized systems to assist the procedure can access the body more easily through small incisions than a surgeon can.

Though they can also be more pricey and limited to more simple procedures, the robots can be more accurate and precise in what it's performing.

In the first study, researchers led by Vikrant Uberoi, MD, a urology resident, in the School of Medicine at Boston University looked at the records of 17 patients who had their bladders removed.

The participants in the study were between 80- and 88-years-old who may not otherwise have an operation to remove the cancer.

Each patient underwent a cystectomy operation, meaning the bladder is removed, with the help of a robot.

Though the results are new and still need to be reviewed, the researchers found that bladder procedures done with the help of robots may be a viable option in certain patients.

"The standard of care for muscle-invasive bladder cancer is to undergo cystectomy," Dr. Uberoi said.

"However, what we were seeing was that patients over age 80 were not being offered cystectomy; they were more likely to be treated with alternatives such as chemotherapy and radiation instead because of their age and comorbidities."

Patients stayed in the hospital about seven days on average after the operation. The time spent in the hospital remains shorter than with open surgery.

Only three complications were reported within the first 90 days, and none of the patients died from the surgery.

RARC can be performed in select patients over the age of 80. And complication rates appear to be lower than reported for this age group.

Robotic-assisted operations are not appropriate for everyone with bladder cancers, particularly those with severe coronary artery disease or chronic occlusive pulmonary disease, according to Dr. Uberoi.

"These patients have to be able to undergo anesthesia for four to six hours, tolerate fluid shifts, and possible large blood loss," he said.

The second study, led by Therese Kerwel, MD, a colon and rectal surgeon, focused on laparoscopic operations, which involve very little cutting and probing into the body, on colorectal cancer patients.

Laparoscopy blunts the stress response from surgery and helps recovery in the short-term, according to the authors.

Researchers looked at patients over a six and a half year period and whether they were disease-free after undergoing this procedure compared to other, more open procedures.

They looked at records for 216 patients starting in mid-2004 and ending in July 2010.

Half the patients had a laparoscopic operation for Stage I-III colorectal cancer, and the other half had open operations.

"The laparoscopic group was also much more likely to undergo chemotherapy in stage III disease," Dr. Kerwel said.

"Given that the average age in our study was 81.5 years, the laparoscopic approach for colorectal cancer patients revealed a significant survival benefit."

Researchers said that many patients older than 75 years old are often too frail after an open operation to remove the tumor to start the next step with chemotherapy right away.

They found that there were no differences between the the laparoscopic and open surgery groups as far as the age of the patient, gender, the stage of cancer, and elective surgery is concerned.

Further, 63 percent of the laparoscopic group went on to chemotherapy.

And only 29 percent in the open surgery group did so, which may explain why they're able to live longer in the former group, according to Dr. Kerwel.

Among the laparoscopic and open surgery groups, almost 60 percent and 40 percent of them respectively were disease-free and alive five years after the operation.

The researchers notes that their study aimed to see how long elderly patients lived with colorectal cancer.

Other studies have already found that laparoscopic procedures have fewer short-term problems, faster recoveries and shorter hospital stays compared to open surgeries. 

The studies were presented at the 2012 Annual Clinical Congress of the American College of Surgeons September 30 through October 4.  

Reviewed by: 
Review Date: 
October 7, 2012
Last Updated:
October 10, 2012