The incidence of tumors on the rise among the over 70s, the challenge to guarantee them effective treatments despite the danger of chemotherapy. The risk is also the interaction with drugs for other diseases, but assessments must be made on a case-by-case basis
The elderly who face a cancer there are many, and they will always be more. Estimates presented at Healthy Aging Week 2021 indicate that in 20 years the over 70s with an oncological disease will have grown by 40 percent, the over 80s almost doubled. Also in this case, prevention should have a life-long approach, as explained by the epidemiologist of the University of Turin Lorenzo Richiardi: Thinking about it from an early age is necessary, especially for tumors that tend to appear later in the years such as lung cancer. Today, for the real challenge, guaranteeing the elderly a proper treatment: in oncology their survival is higher, but generally they are treated less.
Surgical interventions
An under-treatment is not always justified by the danger of oncological drugs in those who are later in life, as Matti Aapro, president of the European Cancer Organization specifies: The elderly are different and more delicate, they often have other pathologies and take other drugs that could give interactions, but we can and must evaluate each one to understand what he wants and what he can tolerate: it is necessary to intervene not taking into account the age but the overall state of health. Breast cancer, for example, is often more resistant to treatment in women over 80 and older surgeons they do not want to operate on them: well, those over eighty who receive the most appropriate treatment for their condition have a survival of 90 percent at 5 years, in those under-treated it drops to 46 percent. In short, it should not be age that acts as a compass, but the type of tumor and general health, combined with an assessment of the patient’s expectations. As Aapro warns, what can impact the quality of life of a young adult may have less weight for an elderly person or vice versa, therefore an individual assessment is required. To decide how to intervene, the G-8 score, an eight-question test that can be answered in a few minutes and which measures the person’s overall health, can be of great help.
Immune response
Age alone is not a contraindication to treatment, as confirmed by the pharmacologist of the University of Turin Massimo Collino: Of course, those who are older often take many drugs and it must be taken into account that the relationship between adverse events and the number of drugs taken is not linear but exponential; also in the elderly there is ainflammation low grade which accelerates the senescence of the immune system and can change the response to some treatments, for example immunotherapy; it should also be considered that the metabolism of drugs is different and at the same dose the effects are greater than in a young person. However, these are not sufficient reasons for not treating properly, just choose the right drugs and therapeutic dosages: in the elderly it is necessary to start with low doses and proceed slowly, an approach that is often successful, not only in oncology.
March 10, 2022 (change March 10, 2022 | 20:06)
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