One of the risk factors of cancer growth and progression is aging.
With increasing age, the body becomes vulnerable to developing cancer because of susceptibility towards environmental carcinogens, prolonged exposure to environmental carcinogens, and bodily changes that trigger carcinogenesis. Aging also influences the biology of cancer like some types of cancer to become more aggressive with aging like ovarian cancer.
Increasing age limits stress tolerance and reduce the cancer survival rate.
Elderly populations usually have renal physiological issues like reduced glomerular filtration rate along with cardiac, muscular, neurological, metabolic disorders.
Therefore, cancer management in elderly patients requires additional consideration in terms of selection treatment modality, a dose of cancer therapy, etc.
Based on renal functioning, hemoglobin level, and other physiological factors.
However, age is not a contradictory factor to cancer treatment.
Cytotoxic chemotherapy is prescribed to treat elderly cancer patients to the same extent as pediatric patients.
Decision making
Before starting the cancer treatment, doctors consider the decision of elderly patients as they have the right to take the decision.
However, it is always kept in mind that cancer treatment helps patients of any age.
Elderly patients need to make the decision based on physical comfort, financial security, ability to take care of themselves means ability do usual regular activities, live independently, have a meaningful life, ideas of peaceful death, etc.
However, doctors are considered the following points before decision making a treatment plan for elderly cancer patients:
The type and stage of cancer
- Analysis of benefit-risk ratio of available treatment options
- Presence of other medical conditions
- Individual patient’s physical health, emotional health, and lifestyle
Difference of cancer management for elderly patients
Cancer management is relatively more challenging and complicated for elderly patients.
For instance, the chance of side effects from prescribed cancer treatment is higher in elderly patients.
Therefore, a collaborative decision between doctor and patient and family members is important to decide the best possible treatment for individual patients.
This process is termed shared decision-making. Some of the following common cancer treatments can affect older adults:
Medication
Administration of cancer medication through the IV route is termed systemic therapy.
These types of treatment can affect the whole body. Chemotherapy, immunotherapy, hormonal therapy, and targeted therapy are some examples of systemic therapy.
The risk of side effects of systemic therapy is higher in elderly and pediatric patients.
The management of side effects for elderly patients is more difficult. Often medications for co-morbidity interact with cancer medication and developmental toxicity.
Therefore, before prescribing systemic therapy to elderly cancer patients, the healthcare team always checks the medications list that patient regularly take to minimize the risk of drug-drug interaction.
Surgery
Surgery and anesthesia often increase the risk of every individual. However, the scope of complication during and post-surgical intervention is often higher in elderly patients.
Sometimes anesthetic medication and surgical intervention affect the heart, kidney, lung, liver functioning.
Elderly patients usually have a slow recovery rate after surgical intervention and require additional care.
Therefore, doctors are critical analyze the risk-benefit ratio of surgical intervention before starting the treatment.
Radiation therapy
Radiation therapy is usually recommended to avoid cancer recurrence.
Moreover, radiation therapy is also recommended in conjunction with chemotherapy and surgery for better treatment outcomes.
Combination therapy also reduces the risk of reoccurring cancer.
However, radiation therapy is prescribed by considering the part of the body that is treated, depending upon patients’ overall health.
Doctors usually prefer to use less intense radiation for a shorter period to treat elderly cancer patients to avoid side effects.
Bone marrow transplantation
Bone marrow transplant or stem cell transplant is an effective treatment for certain types of cancer like blood cancers that often affect the elderly population.
But elderly population also faces a higher risk of side effects of such treatment.
