Cancer treatment for the elderly: It’s about more than age

Former President Jimmy Carter

Former President Jimmy Carter’s cancer diagnosis and his decision to battle the disease at age 90 raises questions about an older person’s ability to physically, emotionally and mentally withstand the demands and discomforts of treatment. Could it be worse than the cancer itself?

Despite the prevalence of cancer in the elderly, with most cancers diagnosed in patients over age 50, treatment studies rarely include people older than 70. This has made finding the optimal treatment strategy for these patients challenging.

Chronological age isn’t everything

Chronological age alone is just one of many factors to consider. The physician must assess the patient’s overall health, including medications or chronic health problems unrelated to cancer, such as high blood pressure or diabetes, which could inhibit the patient’s response to cancer treatment.

What is more revealing is the patient’s “physiologic age.” How well an individual functions in every day life and can tolerate the stresses of cancer treatment, whether younger or older, becomes more important than the year they were born.

New therapies enhance treatment options

New cancer therapies, such as targeted immune-therapies, may be better tolerated in the elderly than traditional chemotherapy. President Carter, for example, is taking the relatively new drug Keytruda (pembrolizumab), an immune-system-boosting therapy for his metastatic melanoma. Compared to similar drugs, it has relatively few side effects and has made tumors disappear in some patients.

The key with every patient, regardless of age, is the importance of ongoing discussions between the patient and their physician.

Ask your doctor the following questions:

  • What are the goals of cancer treatment?
  • What are the risks and benefits?
  • What is the life expectancy?
  • What other medical problems affect eligibility for treatment?

It is important for the patient and family to have this honest discussion with their physician about treatment options based on the patient’s needs and goals, as well as their expectations for a quality of life. The Cancer Care Team at the Ann B. Barshinger Cancer Institute works closely with physicians to provide patients and their families with the comprehensive support they need before, during and after treatment.

author name

Shanthi Sivendran, MD

Shanthi Sivendran, MD, is a physician with Lancaster General Health Physicians Hematology & Medical Oncology. Dr. Sivendran’s areas of expertise include melanoma, urinary system cancers (kidney, prostate, bladder and testicles) and breast cancer.

Education: Medical School—University College, Dublin; Residency—Pennsylvania State University College of Medicine; Fellowship—Mount Sinai School of Medicine.

Call: 717-544-9400

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