Issues in treatment

Article Abstract:

In March of 1991, the American Cancer Society hosted the Workshop on Cancer Control and the Older Person. Advancing age is the greatest risk factor for cancer, and the Workshop participants discussed various aspects of prevention, treatment, support services, research, and public advocacy for the older cancer patient. The Committee on Treatment acknowledged that there is little scientific evidence on which to base advice about the treatment of cancer in the elderly. In lieu of presenting recommendations, the Committee on Treatment outlined several areas that might be the focus of future research. One problem underlying the acquisition of data is the lack of any indicator of age beyond mere chronological age. Studies on cancer treatment are likely to consider patients in age groups which might, for example, include patients between 65 and 74 years. However, within this group there is likely to be a wide variety of individuals, some healthy and vital, some weak and depressed, some with 5 years of life before them and others with 15. Lumping these patients together may well obscure important relations between age and the treatment of cancer. Chemotherapeutic agents may not be metabolized the same way in older patients, and studies are needed to clarify the relations between age and effective chemotherapy dosages. Similarly, the likelihood of adverse side effects is likely to be affected by age and deserves further exploration. New methods of radiation therapy may prove to be more effective against some cancers, but their use in older patients needs careful evaluation. Unfortunately, the surgical treatment of many cancers can be disfiguring for many older patients, as well as a source of disability and social impairment. Methods might be investigated for improving both the cosmetic and the functional effects of cancer surgery in the elderly. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Therapeutics, Surgery, Cancer treatment, Radiotherapy, Chemotherapy

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Targeting health advocacy efforts toward the older population

Article Abstract:

About 13 percent of Americans are presently over the age of 65. This fraction is expected to increase to about 22 percent by the year 2030. As the fraction of older people in our society increases, so will the health problems most common in this age group. The American Association of Retired Persons (AARP) has taken a position of advocacy for health problems among older citizens. One significant problem addressed by the Association is the utilization of breast cancer screening programs among elderly women. The program attempts to educate older women about the risks of breast cancer and the opportunities for successful detection and treatment. Some women believe that if no family member has had breast cancer, their risk is low. In fact, 80 percent of all breast cancers occur in women with no family history of the disease. Some elderly women also believe that if they have not developed breast cancer yet, they probably never will. Women are also afraid of the bad news that might result from mammographic screening. However, they must be reminded of the excellent treatment results for early-stage breast cancer; these favorable outcomes are sacrificed by those not taking advantage of screening programs. Many women do not seek to have a mammogram because it has not been suggested by their physicians. Women must be encouraged to take an active role in their own health care; if a mammogram is not suggested, they should request one. The AARP is also involved in establishing training programs in which older adults teach their peers how to become more sophisticated consumers of health care. The Association has also developed a program to influence older citizens who believe that since they have smoked for so long, there is little point in giving up the cigarette habit. The AARP emphasizes that it is never too late to quit smoking. (Consumer Summary produced by Reliance Medical Information, Inc.)

Planning, AARP

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Cancer in the aged: an epidemiologic perspective on treatment issues

Article Abstract:

People over 65 years account for 55 percent of all cancers and about 67 percent of all cancer deaths. The author outlines the basic statistics for the major cancers among the elderly in the United States. Among women, breast cancers are not only more likely to occur in older women, they are more likely to be in an advanced stage when discovered. Among women under 45 years, 4.5 percent of breast cancers have disseminated to distant parts of the body at the time of diagnosis. The rate of metastatic breast cancer rises to over 8 percent after age 55. The death rate from breast cancer increases with age; similar effects may be observed for prostate cancer among men. Among men 65 to 69 years, the death rate from prostate cancer is less than 100 deaths per 100,000 population. Over 85, the death rate from this cancer exceeds 600 deaths per 100,000 population. Similar age-related trends in cancer mortality may be seen for colorectal cancer, lymphomas, pancreatic cancer, stomach cancer, and cancer of the urinary bladder. The death rate from lung cancer rises until age 85, after which it decreases slightly. Today, about 13 percent of the US population is 65 years or older. It is estimated that this fraction will increase to about 20 percent by the year 2030, which is when the so-called baby boom children will reach their twilight years. If significant breakthroughs in cancer prevention and treatment are not achieved over the next few decades, the number of people whose lives will be affected by cancer will probably double. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diseases

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