Aging & Health A to Z
Care & Treatment
The recommendations that your oncologist will give you are based on the desire to let you live as long as you can, with a good quality of life, and with as few symptoms as possible. He or she will recommend treatments that take into consideration your type of cancer, its stage and severity, and your overall health.
Discuss your treatment plans carefully with your oncologist and make sure you understand what to expect from the treatments and procedures. Also, make sure that your healthcare team answer your questions and explains the treatment clearly.
The choice of treatment is a joint decision based on your wishes and your oncologist’s advice. Tell him or her what your priorities are, and feel free to get a second opinion if that would make you feel more sure of your treatment decision.
Cancer treatments may take any of the following forms, or be a combination of more than one approach:
- hormone therapy
- biological (immune) therapy.
Age-related diseases and conditions can affect your healthcare provider’s decisions about treatment and possible side effects. For example, many drugs used in cancer chemotherapy are given at lower dosages in older adults because of reduced liver and kidney function that often come with age.
If your cancer is at an early stage and has not spread, your oncologist may recommend surgery. For many people, this approach will cure the cancer, especially in cases of skin cancer, and often with lung, breast, kidney, and colon cancer. If the cancer has spread, but only to nearby lymph nodes, these may also be removed. Sometimes, another type of therapy such as chemotherapy may be prescribed first in order to shrink the tumor, after which surgery is used to remove it.
Advances in anesthesia and surgical techniques have made surgery much safer in older adults and lowered the risk of complications. Sometimes, surgery can be avoided by using endoscopy procedures (for example, colonoscopy and laparoscopy) instead. In this technique, a flexible tube is inserted into the body for examination or biopsy, avoiding traditional surgery. Surgery is often followed by another therapy such as radiation or chemotherapy.
Radiation or radiotherapy uses high-energy beams of radiation to kill rapidly dividing cancer cells. It is a painless procedure that is generally safe and effective in older adults. It is scheduled on a regular basis, often every weekday, and usually takes only a few minutes per session. The skin above the tumor may become sensitive or irritated and some soothing products are available. You may also become tired from the treatment, so make sure to get plenty of rest and eat a balanced diet. Side effects are usually temporary.
For some cancers, such as prostate cancer or thyroid cancer, radioactive particles or chemicals can be placed directly in the area of the cancer.
Chemotherapy is a drug treatment for cancer, and new anti-cancer drugs are constantly being developed and tested. Many are as safe and effective in older adults as they are in younger people. But because older people tend to break down toxins more slowly, you may be given a lower dose than a younger person with the same disease. Also, older people may have more permanent organ damage than younger people.
The choice of chemotherapy drug or drug combination depends on the cancer, its stage, and the person’s overall health. They are taken by mouth or given intravenously.
These toxic chemicals are designed to kill rapidly-growing cancer cells. Unfortunately, they often affect healthy cells to a lesser extent—especially cells in the bone marrow, the lining of the gastrointestinal tract, and the hair follicles. Some can cause temporary side effects that can usually be controlled, such as:
- low blood cell counts
- hair loss.
Chemotherapy drugs often weaken your immune system, so it is very important to eat a healthy diet, get plenty of rest, wash your hands frequently, and avoid contact with anyone who has an infection that can spread, such as a cold or flu.
Hormone-like drugs, usually taken as a daily pill, are effective against certain cancers, including cancers of the breast, prostate, and lining of the uterus (endometrium). They can be used as initial therapy, but are usually administered to reduce the risk of cancer returning after surgery, or to slow down cancer growth after it has come back or spread, as an addition to other therapies.
Immune Therapies (immunotherapy or biological therapy)
Immune therapy is a form of cancer treatment that uses your own immune system to fight your cancer. Immune therapies are usually used along with, or after, other treatments. The immune defenses in older adults are often weaker than in younger people. For this reason, certain immune therapies are a particularly attractive treatment option for older adults.
Prognosis: Long-term Expectations
Some cancers can be cured. Other cancers that are not curable can still be treated effectively. Many patients with cancer live for many years with an excellent quality of life. But some cancers become life-threatening very quickly and don’t respond to treatment. Your long-term outlook depends on many things:
- your type of cancer
- the stage of the cancer (how much it has spread)
- the treatment choices
- your cancer’s susceptibility to available treatments
- your physical condition at diagnosis
- your age.
Updated: March 2012
Posted: March 2012