BACKGROUND: In 1971, there were 3 million cancer survivors. In 2007, that number jumped to 11.7 million. Of the 11.7 million people living with cancer in 2007, about 7 million were 65 years of age or older. Most of the survivors (54 percent) are women, with breast cancer survivors making up the largest group (22 percent). Then comes men with prostate cancer (10 percent) and colon cancer survivors (10 percent).
(SOURCE: HealthDay News, CDC)
SENIOR SURVIVORS: While more and more seniors are surviving cancer, there are no clear-cut guidelines to help doctors make treatment decisions. “Older patients are much more complex than younger patients,” Heidi Klepin, M.D., M.S., a geriatric oncologist from Wake Forest Baptist Medical Center, told Ivanhoe. “They are more likely to present with chronic medical conditions such as heart disease, diabetes, chronic lung disease. All of these increase the risk of complications with cancer therapy.” Dr. Klepin says another problem is that clinical trials for cancer therapies typically do not include older individuals. “There’s a lack of clinical trial data to say here’s an effective therapy for a patient in this age group with this cancer. There are very few tools that an oncologist can use to assess a given patient,” she said. Most treatment recommendations are based on chronological age.
(SOURCE: Ivanhoe interview with Dr. Klepin)
ASSESSMENT TOOL: Researchers from Wake Forest Baptist Medical Center used a simple assessment tool to determine how well older adults diagnosed with acute myelogenous leukemia (AML) can handle treatment. A study published in the Journal of the American Geriatrics Society looked at the bedside geriatric assessment (GA) to evaluate cognitive function, psychological state, physical function and co-morbid disease to identify patients who were most vulnerable to side effects of chemotherapy. The study involved 61 patients, and the mean age was 70.8. The researchers found, as a group, these patients presented with depressive symptoms, distress and physical function impairments and had more difficulty with mobility. “We found a significant percentage of patients who were going to start aggressive chemotherapy had limitations in physical function and cognitive function such as memory impairments,” Dr. Klepin said. “We were picking up a lot of impairments that would not have been picked up by standard evaluation.” Preliminary data also showed having impairments in these areas prior to starting treatment for AML was associated with shorter survival.
(SOURCES: Wake Forest Baptist Medical Center press release and Ivanhoe interview with Dr. Klepin)