WAUKEGAN, Illinois (Waukegan News Sun), October 29, 2007:
Over the last several months, I have seen several elderly patients who have been diagnosed with cancer when they were over 80 years old. Since this group is somewhat diverse in terms of their type of cancer, I will not be describing a single patient, but will rather discuss the issue of age, cancer diagnosis and choices of cancer treatment.
For years, old age has deterred physicians from embarking on aggressive treatments for cancer. This historically has been due to the fact that chemotherapy has several potential complications which can sometimes be more lethal than the cancer itself. Hence, doctors weigh the risks and benefits of treatment versus no treatment in this group of elderly cancer patients.
While chemotherapy continues to have several complications, medical oncologists have become more adept at managing the side effects of chemotherapy. The field of supportive care has become an integral part of cancer management. We support patients with growth factor injections for red blood cells (Procrit, Aranesp) and white blood cells (Neupogen, Neulasta), antibiotics, intravenous fluids, as well as better education of patients and their families. Dr. Nilesh Mehta
By 2030, one in five Americans will be around 65 years old. Cancer diagnosis is more common in elderly patients, particularly colon cancer.
Fifteen years ago, during my training as a medical oncologist, I recommended supportive care to patients with metastatic colon cancer. These patients did not receive any chemotherapy at that time because they were thought to be "old."
How times have changed. Recently, I have prescribed chemotherapy to an otherwise healthy 80-year-old woman with widespread colon cancer and she responded favorably.
Oncologists may not be able to cure metastatic colon cancers, but even elderly patients are experiencing meaningful impact on the quality of their lives.
Through clinical trials, we have established the benefits of aggressive chemotherapy for elderly patients with different cancers. It was found that the toxicities in the elderly group were nearly identical to the younger group of patients with cancer. If an older patient has good health otherwise with reasonable kidney, liver and heart function, medical oncologists will now strongly consider chemotherapy and discuss that option with the patients and their families.
Doctors use a term called "performance status," which judges the level of activity of cancer patients. Oncologists should offer elderly patients the full range of therapeutic options which their life expectancy deserves. This is also being studied in well-designed clinical trials.
Chemotherapy in colorectal cancer patients has had tremendous success over the last decade or so. Life expectancy of even elderly patients is being positively affected with the use of chemotherapy.
Finally, to quote George Burns, "If you live to be one hundred, you've got it made. Very few people die past that age." This might have been written differently today -- by George.
By Nilesh Mehta M.D.
drnileshdmehta@gmail.com
© Copyright 2007 Digital Chicago, Inc.
