(Standard 1.12 Public Reporting of Outcomes)
Colorectal cancer is the fourth most common malignancy in the U.S and is the second leading cause of cancer deaths. In 2014, there will be approximately 136,830 new cases, of which 96,830 will be cancers of the colon.
The incidence of cancers of the colon and rectum has been declining over the past two decades because of the use of screening colonoscopy and lifestyle and dietary changes. From 2006 through 2010 the incidence declined at a rate of 3.7% per year for individuals over 50 years of age.
The death rate from colon cancer has been declining in recent decades. From 2006 to 2010 the death rate declined by 2.5% from men and 3.0% for women. Although some of the improvement in the death rate has resulted from increased screening with colonoscopy, better treatment of stage 3 colon cancer has also significantly contributed to the declining death rate.
Clinical trials conducted prior to the year 2000 demonstrated a distinct survival advantage for stage 3 colon cancers treated with surgery and a chemotherapy regimen of 5 FU and leucovorin. For patients with stage 3 colon cancer the five year survival rate increased from 49% to 61% when this chemotherapy regimen was added to their treatment plan.
A new drug called Oxaloplatin has been added to this treatment regimen and subsequent clinical trials have demonstrated that this three drug combination can provide stage 3 colon cancer cases with a 72% 5 year survival rate.
These clinical trials have clearly demonstrated the importance of including adjuvant chemotherapy into the treatment plan for stage 3 colon cancer patients in order to achieve the best possible outcome.
The cancer program at Fremont Health Medical Center has treated six patients with stage 3 colon cancer from 2009 – 2011. The nationally recognized guideline of care for stage 3 colon cancer states that adjuvant chemotherapy should be considered or administered within 120 days of diagnosis to patients 80 years old or less. The timely administration is important for obtaining the best results of therapy.
Results from the National Cancer Data Base quality measuring tool indicates that adjuvant chemotherapy was incorporated into the treatment plan for each of these patients for whom it was appropriate based on their age, stage of disease and general medical condition. These results compare very favorably with other cancer programs in Nebraska and the U.S.
Colon cancer patients with stage 3 disease can be assured that they will receive care at Fremont Health Medical Center that is consistent with nationally recognized standards.
Submitted: August 26, 2014
Stephen J Dreyer, MD
Cancer Liaison Physician
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