Adjuvant Chemotherapy (G8927) for AJCC Stage III Colon Cancer

Name of the Procedure:

Common Name(s): Adjuvant Chemotherapy
Technical/Medical Term(s): Adjuvant Systemic Therapy, Chemotherapy for Colon Cancer (G8927)

Summary

Adjuvant chemotherapy involves the use of cancer-fighting drugs after surgery to eliminate any remaining cancer cells and reduce the risk of colorectal cancer coming back for patients with stage III colon cancer.

Purpose

Adjuvant chemotherapy is administered for patients:

• With stage III colon cancer.
• To target and kill any remaining cancer cells post-surgery.
• Aiming to reduce the risk of cancer recurrence and prolong overall survival.

Indications

• Symptoms/Conditions Warranting Procedure: Diagnosed with stage III colon cancer.
• Patient Criteria/Factors: Patients who have undergone surgical resection of the tumor and have been determined to be in stage III according to the American Joint Committee on Cancer (AJCC) staging guidelines.

Preparation

• Pre-Procedure Instructions:
  • No specific fasting or dietary restrictions generally needed.
  • Adjustments to any current medication routine may be necessary; follow physician's guidance.
  • Blood tests and scans may be required to assess overall health and kidney function.
• Diagnostic Tests: Blood test, liver function test, kidney function test, and imaging scans if necessary.

Procedure Description

1. Administer Drugs: Chemotherapy drugs are usually administered through intravenous (IV) infusions. This can occur in cycles, with breaks in between for the body to recover.
2. Monitoring: Vital signs and patient response are closely monitored during each session.
3. Support Medications: Anti-nausea medications and other supportive drugs may be provided to manage side effects.
   • Tools/Equipment: IV infusion pumps, chemotherapy drugs, supportive care medications.
   • Anesthesia/Sedation: Local anesthesia may be applied at the infusion site; sedation is generally not required.

Duration

Each chemotherapy session can last between 1 to 4 hours, depending on the specific regimen. The entire course usually spans several months, often 6 months.

Setting

Chemotherapy is administered in an outpatient setting, such as a hospital's chemotherapy unit, outpatient clinic, or specialized cancer treatment center.

Personnel

• Healthcare Professionals Involved: Medical oncologists, oncology nurses, pharmacists, and support staff.

Risks and Complications

• Common Risks: Fatigue, nausea, vomiting, diarrhea, hair loss, increased susceptibility to infection.
• Rare Risks: Allergic reactions, organ damage, and secondary cancers.
• Complication Management: Regular monitoring, supportive medications, dose adjustments, and emergency care as needed.

Benefits

• Expected Benefits: Reduction in cancer recurrence, improved survival rates.
• Time to Realize Benefits: Full physical benefits may become apparent after the completion of the treatment course, and ongoing follow-up tests confirm no recurrence.

Recovery

• Post-Procedure Care: Follow a balanced diet, manage side effects with prescribed medications, maintain hydration, and avoid contact with infectious agents.
• Expected Recovery Time: Recovery times vary; most side effects subside gradually after the completion of chemotherapy.
• Follow-Up Appointments: Regular follow-up appointments with the oncology team for monitoring and health assessments.

Alternatives

• Other Treatment Options: Surveillance without chemotherapy, participation in clinical trials, alternative drug regimens, immunotherapy (in select cases).
• Pros and Cons: Alternatives may have fewer side effects but might be less effective in preventing recurrence as compared to standard adjuvant chemotherapy.

Patient Experience

• During Procedure: Some discomfort from IV insertion, potential side effects from drugs (nausea, fatigue).
• After Procedure: Possible fatigue, digestive issues, pain management, avoiding infections, and dealing with emotional and psychological impacts with support from healthcare providers.

By using adjuvant chemotherapy for stage III colon cancer, patients have a better chance at reducing the likelihood of cancer recurrence, thereby increasing their long-term survival and quality of life after the initial surgical treatment.