Abstract
The mortality due to cancers of older patients, in age above 65 years of life, in comparison to younger is higher in majority of these diseases. It has been also reported that seniors are frequently denied the treatment according to current standards of therapy, thus suffer from undertreatment. There is solid evidence from controlled trials that older patients may tolerate pharmacological therapies in some cancers as well as young, providing they are under good supportive care. At the same time aggressive multimodal treatment may cause immediate or delayed side effects and exhaustion of reserves of the vital organs in elderly. This may cause a general deterioration, a decompensation of comorbidities, an evolution of geriatric syndromes and premature death, not directly caused by cancer. Such situation in aged cancer patients should be called the overtreatment. In diseases with better prognosis, with effective screening methods and large choice of treatment options like breast cancer, survival is getting better, although not in the eldest. The worse prognosis in old breast cancer patients may be caused to some extent by undertreatment. More fatal tumors like NSCLC await further optimization of cancer therapy towards better toxicity profile to avoid overtreatment.
Highlights
Cancer incidence culminates in younger age groups deaths rise linearly in association with age in Poland
EGFR-mutant non-small-cell lung cancer (NSCLC) [hazard ratio (HR) 0.60, 95% confidence interval (CI) 0.42-0.87; p = 0.0054] (27)
Treatment with chemoradiation was associated with improved OS versus that with radiation [hazard ratio (HR) = 0.66, 95% confidence interval (CI): 0.64-0.68, p
Summary
W przypadku chorób o lepszym rokowaniu, w przypadku których istnieją efektywne metody badań przesiewowych i duży wybór metod leczniczych, przeżycie całkowite poprawia się, aczkolwiek nie u najstarszych pacjentek. The increase in MIR in older age groups results from the rising mortality (Fig. 3) (2) It is frustrating after the decade of development in standards of treatment of central nervous system tumors and fund rising in national healthcare system. Mammography detects early invasive cancer, raising the incidence and increasing the chance for cure, so decreasing mortality It is not the case in older age groups. There is still little data on treatment results in elderly This may lead to hesitation and neglect in use of some more aggressive, toxic or expensive therapies in aged patients due to the fact that may be frail and have usually several concomitant diseases.
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