Cancer and Aging
The risk of developing cancer increases with age and is 11 times higher in people over 65 years of age. More than half of diagnoses occur in people >65 years of age, while the average age of diagnosis of several cancers is >60 years (breast, prostate, colon, myeloma, kidney).
Many prejudices still exist today, such as that cancer progresses more slowly in the elderly, that the elderly do not live long, and that they do not tolerate curative surgeries, chemotherapy, or radiotherapy.
The consequences of prejudices are many: the elderly do not participate in screening programs, are not often referred to an oncologist, are not adequately investigated, and are not offered all the indicated treatments.
Epidemiological studies show that elderly cancer patients live shorter lives due to delayed recognition of symptoms, delayed diagnosis, and undertreatment.
We undertreat elderly cancer patients mainly because the proposed treatments are based on the chronological rather than the biological age of the patient, we have no data on the benefit and effects of treatments due to the non-participation of elderly patients in clinical trials, while coexisting diseases, socio-economic problems, and lack of adequate care make their overall treatment difficult.
There is no evidence-based data for their treatment because most studies in Oncology do not include people >65 or 70 years old, almost all of them exclude the participation of patients with concomitant diseases and furthermore there is no reliable assessment of their quality of life which is of decisive importance for the choice of treatment.
The therapeutic approach should be individualized taking into account factors related to the specific patient (biological age, fitness status, comorbidities, life expectancy) and the specific cancer.
The goal of the treatment must be clearly defined (symptom relief, improvement of quality of life, prolongation of survival, disease remission, cure). Informing the patient, his environment and collaboration with Gerontologists are of decisive importance.
Taking into account the demographics of the aging population, it is necessary to organize support and care structures for the elderly, train oncologists and other personnel in the management of elderly cancer patients, collaborate with gerontologists and participate in patients in appropriately designed studies.
NEVER TOO OLD TO FIGHT CANCER
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