DEAR DR. ROACH: My daughter, who’s 44 years old, was recently diagnosed with rectal cancer. It’s stage III and contained. She has no cancer in her liver, lymph nodes, rectum or colon. Her doctor is going to start her on a more aggressive chemo than he first thought of, then radiation. Since the cancer’s contained, once it’s removed, would her survival rate be better than someone whose cancer had spread to other organs? Would there be recurrences? — N.F.B.

ANSWER: I’m sorry to hear of your daughter being diagnosed with colorectal cancer at such a young age. Normally, screening begins at age 45, so she was diagnosed before screening usually begins. More young people are being diagnosed recently. The reason isn’t exactly clear, but a less-healthy diet, a lack of exercise, and increasing rates of obesity may be increasing the risk at the population level, even if your daughter had none of these.

The stage is a big determining factor in the survival rates for colon cancer, and stage III is much better than stage IV (when cancer has spread to other organs). Your daughter’s undergoing the standard of care, which is chemotherapy and radiation prior to surgery. The goal is to shrink the cancer so that it can all be removed during surgery.

After the cancer is removed, her doctor will perform a restaging based on the pathology of the tumor, the molecular characteristics of the cancer, the presence or absence of lymph nodes, and how much of a response the cancer had to the presurgical treatment. With this information, your daughter will have a much better idea of whether she can be considered “cured.”

I can’t answer whether the cancer will recur, but all the efforts right now are to control the tumor so that it doesn’t spread or recur. The best treatment now can cure most people who are in stage III.

DEAR DR. ROACH: Why aren’t more doctors advising a WATCHMAN instead of anticoagulation like Eliquis for seniors with atrial fibrillation (AFib)? I experienced major bleeding on Eliquis, and I asked for a WATCHMAN. It was a blessing, a relief, and a financial benefit. — B.J.

ANSWER: The best data right now shows that a left atrial appendage closure device, like the WATCHMAN, isn’t worse than anticoagulation with apixaban (Eliquis) in older people who have AFib.

Although there were slightly fewer deaths in the anticoagulation group (4.8% versus 5.7% among those who received the WATCHMAN FLX device), this difference wasn’t considered statistically significant, meaning that it could’ve happened by chance if the therapies were equivalent. However, the decreased bleeding among the WATCHMAN group (19% versus 11%) was statistically significant.

Even though the WATCHMAN device has a greater upfront cost, the device is cost-saving (to the system) after about five years, due to lower medication costs. The actual out-of-pocket costs to an individual patient depend entirely on their insurance coverage. I can’t say that the WATCHMAN device will be less expensive for everyone, but it’s likely that not having to pay for Eliquis or a similar medication will make a WATCHMAN device less expensive over a lifetime.

A left atrial occlusion device (Amulet is another brand) is a good option in people who are at an increased risk from anticoagulation. Why don’t more physicians recommend the WATCHMAN among those at average risk? The data are new, and some physicians are concerned that the increased stroke and death rates in the WATCHMAN group, although not statistically significant, are still concerning. Personally, I think people with AFib should be aware of their options.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. (c) 2026 North America Syndicate Inc.

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