Citing Cancer, Chief Resigns at McDonald’s

“The Australian-born Mr. Bell, the youngest chief executive and the first non-American to lead the company, was given his diagnosis a month after being named chief executive. He has been treated with surgery and chemotherapy.”

The diagnosis is colorectal cancer, which is the second leading cause of cancer death. Approximately one-third of people who develop it die of the disease.

It had been noted in the story that Mr. Bell was treated with surgery and chemotherapy. Regardless of the extent of the cancer, surgery has the most important role in treatment. However, the role of chemotherapy is more complicated.

Adjuvent (i.e. “additional”) chemotherapy is usually given when it is suspected that residual cancer remains after surgical removal of the tumor. This is most likely in those with stage III disease (i.e. when the cancer spreads to the lymph node). In these cases, chemotherapy reduces the mortality risk by about 30%.

The recommendation of chemotherapy is a little more difficult in those without lymph node involvement (i.e. stage II disease). Studies show as little as a 2 percent benefit, and the American Society of Clinical Oncology recommends against chemotherapy in resected stage II disease. However, in selected stage II cases (i.e. where the tumor has obstructed or perforated the colon wall), chemotherapy can then be considered.

Thus, one can surmise that Mr. Bell’s cancer is either stage II or more likely, stage III. 5-year survival rates for stage II disease ranges from 63-78 percent, and for stage III disease ranges from 37-66 percent (depending on amount of lymph node involvement).

Colon cancer is tragic at any age, but especially in one so young. I wish Mr. Bell all the best.

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