977 Cancer in the elderly

Abstract

Although cancer is not an inevitable consequence of aging, malignant diseases, especially solid tumors, occur disproportionately in the subset of the population aged 65 years and older. Thus, because the older population are rapidly expanding in most industrial nations, there is a high potential in these countries for many more persons to have cancer. Although two thirds of all cancer deaths occur in the 65-and-olderage segment of the population, there have been so far only a few descriptive, cross-sectional retrospective and prospective studies on cancer in the elderly. More interest and activity in research on aging and cancer has however been evidenced in the 1990s. Directions for the future could be as follows: 1.Establish multidisciplinary clinical trial design teams to address the challenging issues of old age and cancer therapy in a prospective study methodology. 2.Focus on the pharmacokinetics and drug sensitivity of elderly cancer patients to assess and deal with differences in drug metabolism. 3.Introduce in clinical oncology “multidimensional geriatric assessment” methods for pretreatment and follow-up evaluation of elderly cancer patients. 4.Develop special “patterns of care” studies of the major tumors to characterize the treatment of older cancer patients who, because of an excess of comorbid conditions, are not eligible for placement on clinical trials. 5.Increase the cooperation of geriatricians with clinical oncologists since cancer is one of the more prevalent chronic diseases of their older patients. Although cancer is not an inevitable consequence of aging, malignant diseases, especially solid tumors, occur disproportionately in the subset of the population aged 65 years and older. Thus, because the older population are rapidly expanding in most industrial nations, there is a high potential in these countries for many more persons to have cancer. Although two thirds of all cancer deaths occur in the 65-and-olderage segment of the population, there have been so far only a few descriptive, cross-sectional retrospective and prospective studies on cancer in the elderly. More interest and activity in research on aging and cancer has however been evidenced in the 1990s. Directions for the future could be as follows: 1.Establish multidisciplinary clinical trial design teams to address the challenging issues of old age and cancer therapy in a prospective study methodology. 2.Focus on the pharmacokinetics and drug sensitivity of elderly cancer patients to assess and deal with differences in drug metabolism. 3.Introduce in clinical oncology “multidimensional geriatric assessment” methods for pretreatment and follow-up evaluation of elderly cancer patients. 4.Develop special “patterns of care” studies of the major tumors to characterize the treatment of older cancer patients who, because of an excess of comorbid conditions, are not eligible for placement on clinical trials. 5.Increase the cooperation of geriatricians with clinical oncologists since cancer is one of the more prevalent chronic diseases of their older patients.