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Treating cancer: How old is too old?
Bob Riter
bob@ibca.net
The older you are, the more likely it is that you’ll be diagnosed with
cancer.
Once diagnosed, there are decisions that need to be made regarding the types
of treatment (e.g., surgery, radiation, chemotherapy) and the intensity of that
treatment. Those making these decisions sometimes debate the extent to which
a patient’s age should be considered.
I’ll begin with my conclusion: age should be a factor in making
treatment decisions, but age should never be the deciding factor.
First, chronological age is less important than a person’s overall health
status. I know some 80 year olds that are healthier and more vibrant (and have
a longer life expectancy) than some 60 year olds.
Second, don’t assume that personal preferences necessarily differ with
age. At one time, some doctors didn’t offer breast-conserving surgery
to older women because they assumed that older women wouldn’t mind losing
a breast. (A word of advice I freely share with my readers: never, ever make
assumptions about anyone else’s body parts).
Third, even if aggressive treatment is not in a person’s best interests,
don’t blindly say “no more treatment” when you mean to say,
“no more life-extending treatment.” Radiation therapy is
often given to reduce pain. Even some surgical procedures are designed not to
extend life, but to provide comfort.
Age is an important consideration because it may influence the response to treatment,
predict the patient’s side effects, and provide clues into the underlying
biology of the cancer itself. For example, prostate cancer in older men is often
less aggressive than prostate cancer in younger men. The same is true for breast
cancer in women.
Age is part of the equation and should be factored into treatment decisions
for cancer. But basing any decision strictly on chronological age does a disservice
to the patient and reflects poorly on the decision-maker.
From the Ithaca Journal, November 1, 2007
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