It was not so long ago that an elderly person suffering from cancer would have received limited treatment and been sent home to die.
“The common thoughts used to be that it wasn’t worth treating cancer in older patients; that they’d lived their lives; they might be dying anyway; they couldn’t tolerate the treatment; the treatment might adversely affect their quality of life; or that they didn’t want to live with the side effects of treatment,” said Gary Shapiro, MD, chairman of the department of oncology at Johns Hopkins Bayview and co-founder of its Geriatric Oncology program.
That would not have been particularly good news to people like Charlotte, an 83-year-old local woman who five years ago was diagnosed with breast cancer. Today, after surgery and chemotherapy, Charlotte remains in remission and lives an active live that includes traveling, taking adult education classes, gardening and spending quality time with her children and grandchildren.
Nor, would it have been good news to a Prostate Protocol neighbor of Charlotte’s, 91-year-old Gordon, who was diagnosed with prostate cancer when he was 85. In the past, the philosophy was that with a slow growing tumor like this, there would be no reason to intervene. Gordon’s physician, however, convinced the tumor was aggressive, suggested an intensive protocol of radiation. Six years later, he is still driving, playing an occasional round of golf and competing in bridge tournaments.
When Charlotte was first diagnosed with cancer, her children’s first thought was that they didn’t want to put their mother through any rigorous regimen that would affect her quality of life. Only after the oncologist, who had considerable experience in working with geriatric patients, assured them that he thought Charlotte was healthy enough to cope with the treatment and had a good prognosis, did they feel comfortable with having her undergo treatment. Gordon’s children were equally concerned about their dad having radiation. He tolerated the treatments well and has not looked back since.
A Disease of Aging
Cancer can strike anyone at any age, but it is considered a disease of aging. The average age of those diagnosed with all types of cancer is 70. Certain cancers, such as breast, colon, prostate, pancreatic, lung, bladder and stomach cancer, are linked to aging. For lung cancer, for example, the average age of onset is 72; for colon cancer it’s 71; breast cancer is 68. These statistics notwithstanding, relatively little is known about how cancers develop and progress in older patients or how best to treat them.
What is known is that recent research has shown that many older cancer patients can tolerate more aggressive treatment than they have typically received. Yet, this group of cancer patients has not been studied in proportion to its size so there is still a dearth of information in understanding the functional, physical, mental, pharma-therapeutic and socio-economic factors that affect the course of disease and outcome of treatment decisions.
In many cases, older people with cancer present with other medical conditions as well. They may have heart disease or diabetes, for example, and the cancer may impact those problems, and conversely.