It often takes aggressive chemotherapy to knock out cancer. But physicians know that side effects from too much chemotherapy can jeopardize patients’ health as much as the disease can, particularly among older patients.
A new tool may help physicians be tough on cancer while being gentle on the seniors diagnosed with it.
|Arti Hurria is a national leader in geriatric oncology. (Photo by p.cunningham)|
No one can precisely predict how much chemotherapy a particular patient can tolerate before its side effects limit treatment. But physicians know that older cancer patients tend to be more vulnerable to side effects. A geriatric assessment tool uses risk factors related to a senior patient’s age to better determine chemotherapy’s risks to that patient.
“Cancer is still primarily a disease of age, and with our graying population there is a growing, critical need for assessment tools to weigh the risks and benefits of chemotherapy,” said Arti Hurria, M.D., associate professor in City of Hope’s Department of Medical Oncology & Therapeutics Research.
Hurria, who directs City of Hope’s Cancer and Aging Research Program, helped guide a study used to develop the new tool.
“These data will provide the basis for future intervention studies aimed at decreasing the side effects from chemotherapy so that older patients can receive chemotherapy treatment and maintain their function and health,” she said.
People older than 65 accounted for 60 percent of the more than 1.5 million new cancer cases diagnosed in the U.S. last year, according to the American Cancer Society — and the number of older adults nationwide will mushroom within the next two decades.
With the coming growth in cancer cases among seniors, Hurria and her colleagues are searching for tools to make the best chemotherapy choices for older patients.
Research suggests that older adults derive similar benefits from chemotherapy as younger adults. But older patients are less likely to be offered chemotherapy because of concerns regarding their ability to tolerate the treatment, according to Hurria.
In the current study, the researchers wanted to develop a model that could predict when treatment toxicity would be severe or life-threatening. This would help physicians and older patients discuss treatment options and make decisions about care.
The study, conducted across seven institutions, included 500 cancer patients between the ages of 65 and 91 with lung, gastrointestinal, gynecologic, breast or genitourinary cancers. And it included dozens of pieces of information about each patient ranging from tumor characteristics to social support.
In the end, the new system had a greater ability to predict risk of chemotherapy toxicity in older patients than the standard tool, said Hurria.
The research group plans to continue their investigations and refine their model among patients with specific tumor types who are receiving specific treatment regimens.
Cancer and America’s aging population
America’s senior population — those age 65 and older — grew by 15 percent over the last decade, according to the U.S. Census, and it’s expected to double by 2030. About 60 percent of all cancers and 70 percent of cancer deaths occur in people in this age group.
With the population graying, physicians and cancer advocates are throwing a public light on the needs of elderly cancer patients. Seniors can find helpful tips on dealing with cancer and its treatment through the American Society of Clinical Oncology. The National Institute on Aging also has easy-to-understand guidelines on cancer screening for older adults.