In a Clinical Crossroads article published in May 2007,1 Gerald Smetana, MD, weighed the pulmonary risks of colon cancer surgery for Mr A, a 68-year-old man with severe chronic obstructive pulmonary disease, peripheral vascular disease, high cholesterol, high blood pressure, and extensive tobacco use. In December 2005, Mr A had a colonoscopy revealing a malignant-appearing, friable infiltrative sigmoid mass. Mr A subsequently consulted 2 general surgeons; both recommended that the tumor be resected.
Mattson-DiCecca AA, Reynolds E. Update: A 68-Year-Old Man With COPD Contemplating Colon Cancer Surgery. JAMA. 2009;302(6):678. doi:10.1001/jama.2009.1148