Chemotherapy for Seniors
Most experts agree that aging is highly individualized. Doctors that treat the elderly will note that no two 75-year-olds are the same. One may be more akin to a 60-year- old while the other's physical age may be closer to 85 or 90. So, when it comes to cancer treatments for senior citizens with diseases like mesothelioma, the fact remains that every case is different.
Statistically, the chance of a person over 65 dying from cancer is 12 times greater than that of a younger patient. This is due to a number of different reasons. However, doctors do generally agree that - when it comes to chemotherapy - there is a greater risk of chemo-related toxicity in senior patients. This is due to several factors that come about with age including a decreased ability to repair cell damage, accumulation of body fat, and a decline in organ function. In addition, co-morbidity issues - the fact that elderly people often have multiple medical problems - increase toxicity, often because the chemotherapeutic drugs will negatively interact with the drugs used to treat issues like heart disease, diabetes, and hypertension.
All of these issues seem to slow a senior's recovery after chemotherapy or simply make the therapy too hard for the older person to handle, prompting them to cease the treatment. Common side effects seem to be amplified because, for example, certain changes in the body may decrease drug absorption. Other problems, like decreased kidney function, make it difficult to excrete the drug, causing even more concern. All of these issues put the elderly individual at high risk for serious chemo-related reactions or even death.
Oncologists also note that they are frequently "in the dark" when it comes to the effects chemotherapy may have on their senior patients, largely due to the fact that seniors are hardly ever recruited for clinical trials. Therefore, treatment of elderly patients with certain chemotherapy drugs tends to be hit-or-miss simply because the pairing of the two hasn't been studied.
This concern over toxicity means that caregivers need to watch their senior charges carefully for signs of serious side effects and should never hesitate to call the patient's doctor or take them to an emergency room should an alarming situation arise. In most cases, the better-safe-than-sorry approach is best applied.
Journal of Supportive Oncology
National Institute of Health