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Tuesday, April 14, 2015

Challenges with Cancer

Complications faced in older patients

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Getting older certainly may have its challenges, but adding cancer into the mix may present some complications when receiving treatment. As with many types of cancer, the risk of developing cancer increases with age. According to the American Society of Clinical Oncology, 60 percent of cancers in the United States occur in people ages 65 and older. The challenges older patients may face when dealing with cancer are multifaceted, but treatment options are available and often just as effective as with younger adults.

In addition to dealing with a cancer diagnosis, older patients may be faced with the addition of other conditions and illnesses as well, such as heart disease, high blood pressure and arthritis. This is all also impacted by other limitations some older people experience, such as being dependent on others for transportation or managing the emotions that come along with the recovery or treatment of cancer, according to the ASCO.

When it comes to cancer treatment, Dr. Christopher Snead, hematologist and oncologist for CHRISTUS Cancer Treatment Center, said there are a number of difficulties that may arise in older patients.

“In general, older patients will be less tolerant to more aggressive treatment regimens. It may take longer for them to recover from side effects of treatment and may be more susceptible to infection compared with younger patients,” Snead said.

According to the ASCO, when a patient has a co-existing or co-morbid disease, which presents challenges for anyone, it can limit and affect the type of treatment as well as the severity of the side effects of treatment. The importance of working closely and compliantly with a doctor or health care team during the course of a treatment plan is stressed.

“The treatment of some cancers in older patients may utilize the same chemotherapy regimens used in younger patients or may be used in a dose-reduced fashion,” Snead said. “Adjustments to chemotherapy regimens are sometimes necessary to ensure tolerability of the treatment.”

While the length, intensity and dosage of some cancer treatments may be altered or adjusted, the options tend to be relatively the same for patients of a younger age.

“Older patients are eligible to receive the same cancer-fighting modalities, including chemotherapy, radiation and surgery,” Snead said.

The ASCO emphasizes while a significant portion of cancer patients are 65 and older, they can sometimes be undertreated even though studies have proven that cancer treatment is often effective for older patients. The goals of a cancer treatment plan can include getting rid of the cancer, enabling a person to live longer, reducing the symptoms of the cancer or maintaining the physical and emotional abilities that enhance the quality of life.

When it comes to the outcome of treatment options, there are a number of factors which contribute to the prognosis. This is something to always discuss with your doctor in order to be more aware of the treatment plan.

“The main factors which determine a patient’s prognosis is the type of cancer, the stage of cancer, a patient’s level of functioning or performance status and the responsiveness of the cancer to treatment,” Snead said.

It’s important to have a sense of control over one’s treatment, and the ASCO encourages each person to be informed and prepared for their doctor visit by having a set of questions to ask. Some of those questions include what all of the available options are and their potential recovery times, the goals of each treatment option, which options are recommended and on what basis, how will the treatment plan affect daily life and what supportive services are available.

The quality of life is a significant concern when treating older patients with cancer. Part of the worry or concern of these issues may be alleviated by having an open and honest discussion with your doctor. It’s important to be aware of the impact cancer treatment may have on relationships, daily activities, emotional regulation, nutrition, financial security and personal independence.

Snead encourages taking proactive measures to promote healthy living.

“The most important thing is to get regular check-ups in an attempt to diagnose cancer in its earliest stage,” he said. “This may include mammograms, colonoscopies, gynecological exams, skin exams, laboratory testing and X-rays. Certain cancers may run in families and it is important to let your health care provider know about any family history of cancer.”

Being aware of all available options and asking the right questions, while continuing precautionary measures of screening for cancer, may help ease many concerns some older patients may have regarding cancer. A significant factor in being an informed patient is simply seeking support and having an open conversation with health care professionals.

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