Discuss your cancer diagnosis and treatment plans carefully with your oncologist. Make sure you understand what to expect from the treatments and procedures. Do not hesitate to ask questions.

Cancer treatments may include one or more of the following:

• surgery
• radiation
• chemotherapy
• hormone therapy
• biological (immune) therapy

Your healthcare provider will consider possible side effects and your physical condition when recommending treatment options. For example, older adults are often given chemotherapy drugs at lower dosages. This is because older people are more likely to have reduced liver and kidney function.

Surgery

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. This is especially in cases of skin cancer, and often with lung, breast, kidney, and colon cancer.  Sometimes cancer spreads to the lymph nodes only. If that is the case, the lymph nodes may also be removed. Sometimes, you may first be prescribed another type of treatment such as chemotherapy, in order to shrink the tumor. Then surgery is used to remove it.  

Age itself is not a risk factor for cancer surgery. However, the older you are, the more likely it is that hospital stays are longer and more time is needed for full recovery. Advances in anesthesia (medicine used to reduce or block pain) and surgical techniques have made surgery much safer in older adults and lowered the risk of complications. However, surgery can sometimes be avoided by using endoscopy procedures instead (for example, colonoscopy and laparoscopy). 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

Radiation or radiotherapy uses high-energy beams of radiation to kill cancer cells that grow rapidly. It is a painless procedure that is generally safe and effective for older adults. It is scheduled on a regular basis, often every weekday, and usually takes only a few minutes per session. There may be side effects such as the skin above the tumor becoming sensitive or irritated. (There are soothing products available to treat this.) 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

Chemotherapy is a drug treatment for cancer, and new anti-cancer drugs are constantly being developed and tested. Many are as safe and effective for older adults as they are for younger people. But older people tend to break down toxins more slowly. So you may be given a lower dose than a younger person with the same disease. Also, older people may be more likely to have 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 also 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:

• nausea
• vomiting
• diarrhea
• 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 Therapy

Hormone-like drugs are usually taken as a daily pill. They are effective against certain cancers, including cancers of the breast, prostate, and lining of the uterus (endometrium). They can be used as an initial therapy, but they are usually given as an addition to other therapies. Hormone treatment is often used to reduce the risk of cancer returning after surgery, or to slow down cancer growth after it has come back or spread. 

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 or treated effectively, allowing many patients with cancers to live for many years with an excellent quality of life. But some cancers are aggressive and may not respond to treatments. This causes them to become life-threatening very quickly.

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
• the likelihood that your cancer will respond to available treatments
• your physical condition at diagnosis
• your age

It can be challenging to consider your long-term outlook after a cancer diagnosis. However, it can also a good time to think about your goals for your treatment. You may want to talk to your healthcare provider and family members about what your wishes are for your care.  

Last Updated June 2020