How to treat cancer in older adults: Comorbidities and medical disorders add to the complications

Cancer treatment: Disorders such as diabetes, arthritis, or heart disease can make healing more difficult or lower one's tolerance to some treatments

An increasing number of older persons are receiving cancer diagnoses as their life expectancy rises. People who are 65 years of age and beyond account for 70 percent of cancer-related fatalities and about 60 percent of new cancer diagnoses. Personalised care is emphasised in modern healthcare, even though age-related considerations may make cancer treatment options seem complicated for older persons. This implies that deciding whether to pursue cancer treatment should not be based only on age.

Challenges of cancer treatment in older adults

Because of comorbidities, or other medical disorders, and the natural ageing processes, treating cancer in older persons poses special hurdles, says Dr Raman Narang, Senior Consultant, Medical Oncologist, Andromeda Cancer Hospital, Sonipat.

The body's capacity to withstand harsh therapies like radiation, chemotherapy, or surgery may be impacted by these variables, says Dr Narang and lists down typical worries.

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Decreased organ function: As we age, our bodies' ability to process and eliminate drugs may be impacted by the liver and kidneys, two organs that may not perform as well.

Weakened immune system: Older persons may have a more difficult time recovering from infections or related problems if their immune systems are weaker.

Comorbidities: Disorders such as diabetes, arthritis, or heart disease can make healing more difficult or lower one's tolerance to some treatments.

Frailty: Because physical weakness and frailty reduce the potential for intensive treatments, it's critical to consider the dangers.

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Assessment before treatment

A comprehensive evaluation known as a geriatric assessment prior to initiating treatment is very important as this procedure assesses a patient's health in a number of ways, such as:

Mental health and cognitive performance

State of nutrition

Physical independence and mobility

Networks of social support

Conditions that coexist

By determining which treatments will be safe and successful, these evaluations assist oncologists in making sure that the treatment plan takes the patient's preferences and general health into account.

Treatment options for alder adults

The kind and stage of the illness, general health, and individual goals all influence the many effective cancer therapy options available to older persons, says Dr Narang.

Surgery: Especially when done early in the disease, surgery can be very beneficial for many types of cancer. Certain elderly patients have a good tolerance for surgery, particularly for minimally invasive techniques like robotic or laparoscopic surgery, which have lower risks and quicker recovery periods.

Chemotherapy: Because of its negative effects, older persons may find it more difficult to handle chemotherapy. Oncologists might, however, change the dosage or choose targeted treatments, which have less adverse effects. Oral chemotherapy presents a convenient option for people who find it difficult to attend the hospital frequently.

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Radiation therapy: Thanks to technological advancements, radiation therapy is now more accurate and causes less damage to healthy tissues. For localised malignancies, it may be a less invasive choice. It is especially helpful for managing symptoms, like pain alleviation.

Targeted therapy: Drugs used in targeted therapies target particular chemicals that promote the growth of cancer. For older persons who are unable to tolerate severe therapies, these medicines are a useful option because they typically have less adverse effects than standard chemotherapy.

Immunotherapy: To combat cancer, immunotherapy strengthens the body's immune system. Although individual responses can vary, it has showed promise in older persons and frequently has fewer side effects than chemotherapy.

Hormone therapy: Hormone therapy is a viable treatment option for tumors that are hormone-sensitive, such as certain forms of prostate and breast cancer. Older people often tolerate this technique well and experience fewer adverse effects.

Palliative care: Palliative care aims to improve quality of life by managing symptoms for patients who might not benefit from vigorous therapy. For elderly people who value comfort above all else, this alternative is great.