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1. One in five Americans will be at least age 65 or older by the year 2030, and the incidence of cancer is 11-fold higher in persons over age 65.
2. About 3.5% of the American population are cancer survivors - meaning many people suffer the consequences of cancer and its treatment.
3. There is now proven efficacy for aggressive chemotherapy in elderly patients with cancer. Thus, chronological age is no longer a factor that would limit aggressive treatment.
4. About 400 thousand new patients a year develop bone metastases, requiring therapeutic options, either via surgery, chemotherapy, radiation therapy, or the use of bisphosphonates. Zometa (Zoledronic acid) has been shown to reduce the progression of metastases with a 30-40% risk reduction.1
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The colorectal cancer incidence is over 50 times as high among people aged 60-79 than those younger than 40.
It has been noted that elderly colorectal cancer patients often receive less adequate lymph node sampling and are therefore often under-diagnosed, which could leave to a less favorable survival. Often, patients over 70 are less likely to receive chemotherapy.
Thus, those with a reasonable life expectancy should receive the same type of therapy given to younger patients. Comorbid conditions with age should be taken into account for treatment decisions, depending on what the comorbidity is and its severity in relation to prognosis.
Thus, treatment, in part, depends on one's physical function, clinical condition, comorbidities and ability to tolerate some of the many side effects of therapy. Part of the problem is physicians‚ reluctance to treat despite the evidence and benefits. It could be a wise move to offer some of the full and wide range of treatments available in hopes of obtaining a remission, cure and prolonged longevity.
- 1. A lot depends on age related comorbidities, psychological, spiritual, and physical aspects of the patient.
2. Improved ways of patient follow up to prevent and/or treat late recurrences and long-term side effects related to the cancer and/or its treatment.
3. Ways of improving education provided for patients and caregivers in respect to survivorship.
Further results are being awaited.
1 Gammon, M. D., et al., J Natl Cancer Inst, 1998; 90: 100-117.
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