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Cancer Treatment in Old Age - Page 2

© David Olle

Certain tissues can be particularly susceptible to chemotherapy. The hematopoietic (blood cell formation) system could be disrupted, leading to increased infections and anemia. The mucosa can be affected by chemotherapy as well as by radiation. Anthracyanines can cause congestive heart failure, and cisplatin and paclitaxel can damage the central nervous system, leading to weakness. Modifications in treatments can correct these problems.

Sociological factors in treatment decisions

There are several unique factors related to the older patient that weighs in on treatment decisions. The older patient may have other serious health problems that may be potentially more lethal than the cancer. The patient may not live long enough to experience complications from the cancer. Will the cancer treatment affect the patient's quality of life such that he or she will lose independence and would require institutionalization?

Prior to deciding on a cancer management program, a series of assessments should be performed: 1 1. An evaluation of other health problems 2. Nutritional status 3. Presence of geriatric syndromes, such as memory dysfunction, depression, and osteoporosis 4. Social resources to help the patient 5. Ability to perform certain activities that predict the risk of mortality and functional dependence 6. Laboratory tests for immune function

References

1. Balducci L, Ershler W. Cancer and ageing: a nexus at several levels. Nutrition Reviews Cancer. 2005 Aug; 5 (8): 655-662.

2. Ershler W. Cancer: a disease of the elderly. Supportive Oncology. 2003 Nov/Dec; 1 (Suppl 2): 5-10.

3. Singh K. Mitochondrial dysfunction is a common phenotype in ageing and cancer. NY Acad Sci. 2004; 1019: 260-264.

4. Turner N, et. al. Cancer in old age - is it inadequately investigated and treated? Brit Med J. 1999 July 31; 319: 309-312.

5. Vorobtsova I, et. al. An investigation of the age-dependency of chromosome abnormalities in human populations exposed to low-dose ionizing radiation. Mech Ageing. 2001 Sep 15; 122 (13): 1373-82.

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