Selecting Appropriate Cancer Treatment Modality for the Elderly
Cancer has become one of the world’s top diseases affecting many people and posing a great financial burden. Scientists have made several advancements in the management of different types of cancer but there are still several gaps in cancer management. Cancer among the elderly poses special challenges to the healthcare team given that the risk of developing cancer increases with age (Wildiers et al, 2014). Minimal research has been done on the management of cancer among the elderly, which makes it hard for the practitioners to employ evidence-based practice, and the elderly are managed based on assumptions from the younger populations.
Aging is complex and highly individualized and is affected by various factors, which in turn affect exposure to diseases and response to treatment. Old age is associated with decreased rate of drug absorption rates, which interfere with the absorption of chemotherapy in the elderly. Renal mass decreases with old age affecting clearance of drugs for cancer treatment coupled with polypharmacy among the elderly (Caillet et al, 2014). Changes in pharmacodynamics and pharmacokinetics also impair with treatment modalities among the elderly.
Various physiological changes that occur in old age affect the ability of the elderly to tolerate cancer treatment. The aging cells of the elderly cannot tolerate chemotherapy, radiology and surgery as the younger generation. The elderly are mostly hemodynamically unstable and may not tolerate surgery to remove various tumors from their body. Their haemoglobin levels are likely to be lower than other ages and they may not tolerate anaesthesia. The body’s immunity weakens with aging and it is worsened by cancer and this makes prognosis of the elderly post-surgery poor (Kunkler et al, 2014). The elderly therefore face numerous challenges with different cancer treatment modalities, which interfere with their effective treatment. A lot of research should be done on the efficacy of different modalities of cancer treatment among the elderly.
References
Caillet, P., Laurent, M., Bastuji-Garin, S., Liuu, E., Culine, S., Lagrange, J. L., Canoui-Poitrine, F., & Paillaud, E. (2014). Optimal management of elderly cancer patients: usefulness of the Comprehensive Geriatric Assessment. Clinical interventions in aging, 9, 1645.
Kunkler, I. H., Audisio, R., Belkacemi, Y., Betz, M., Gore, E., Hoffe, S., Kirova, Y., Koper, P., Lagrange, J. L., Markouizou, A.,& Pfeffer, R. (2014). Review of current best practice and priorities for research in radiation oncology for elderly patients with cancer: the International Society of Geriatric Oncology (SIOG) task force. Annals of oncology, 25(11), 2134-2146.
Wildiers, H., Heeren, P., Puts, M., Topinkova, E., Janssen-Heijnen, M. L., Extermann, M., Falandry, C., Artz, A., Brain, E., Colloca, G., & Flamaing, J. (2014). International Society of Geriatric Oncology consensus on geriatric assessment in older patients with cancer. Journal of clinical oncology, 32(24), 2595-2603.
