Older female cancer survivors have added health issues compared to their counterparts
As cancer survivors live longer, questions arise about what kind of care long-term survivors require.
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Since: Dec 05
#1 Feb 6, 2010
As a result of chemo and radiation, infections are the curse of the rest of their lives.
A tough issue indeed. Complications of cytotoxic chemotherapy (even targeted therapy) are more common in older patients (65 years of age and older) with cancer than in younger patients, and the occurrence of myelosuppression, mucositis, cardiodepression, peripheral neuropathy and central neurotoxicity can complicate matters.
Comorbidities increase the risk of toxicity through their effects on the body. Futhermore, the drugs used to treat comorbidities may interact with chemotherapeutic drugs, potentially increasing toxicity in elderly patients.
The survival benefit obtained with adjuvant chemotherapy can vanish or decrease in the elderly because of higher toxic death rate. In fact, many elderly patients tolerate this treatment modality poorly because of comorbidity and organ failure. The prevalence of these comorbid conditions is about twice as high as in the general population.
The effects of aging on bodily functions and physiology cannot be ignored when making treatment decisions. Pharmacokinetic processes such as the absorption, metabolism and excretion of drugs appear to be different in older patients, and a person's physiologic tolerance or reserve diminishes with increasing age.
Older people are generally closer to some edge beyond which they would tip into a more clinically important organ dysfunction. That doesn't mean you can set the same goals for treating and controlling their disease as younger patients.
What is being left out of this report is the fact that a chemo-induced gene mutation can happen when the original chemo received does not work. The cancer comes back. When it does this, the cancer comes back more aggressively. The mutagenic effects (changes in form) of chemotherapy on a genetically-unstable tumor, drives the tumor into a state of more aggressive behavior.
By analyzing non-cancer deaths among cancer patients, it becomes clear that orthodox therapies often do more harm than good. For example, cancer treatment can damage the heart and cause deaths from heart failure. This means fewer deaths from cancer.
Analysis of the records of 1.2 million cancer cases in the Surveilance, Evaluatlion and End Results (SEER) database showed that non-cancer deaths accounted for 21-37 percent of all deaths. The authors attributed this effect to the damage caused by cancer treatment (mainly radiotherapy and chemotherapy).
Until recently, we did not have access to SEER data in MDS (Myelodysplastic Syndromes). This data is now starting to be developed and is confirming that MDS differentially affects older patients. As the current generation's age and life expectation lengthens, MDS may become a significant health issue world wide. This emphasizes the need to develop therapies for old patients not candidates for intensive chemotherapy.
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