Doctors often have to decide whether surgery will be worthwhile in terms of the patient's life expectancy and the quality of life they can expect after surgery. In fact, fewer elderly patients undergo surgery for colorectal cancer than their younger counterparts.
Life expectancy decreases with increasing age independent of the diagnosis of colorectal cancer.
Elderly patients have an increased frequency of conditions, such as diabetes, hypertension, and pulmonary disease, and are more likely to present as an emergency or with advanced diseases. All these factors could contribute to the decreased long-term survival in elderly patients with colorectal cancer. However, a large proportion of patients will survive for two or more years after surgery. Thus elderly patients should not be denied surgery for colorectal cancer on the basis of age alone, argue Simmonds et al. In an editorial, P.G. Alley, North Shore Hospital, Auckland, New Zealand, suggests that decisions about the scope and timing of surgery of elderly patients should reside with the most senior of specialists, including an anesthetist and a geriatrician, and the patients themselves.