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Cancer In Older Adults: Should I Consider Cancer Treatment? Would I Be Able to Take It?
Cancer In Older Adults: Should I Consider Cancer Treatment? Would I Be Able to Take It?

Cancer in older adults, occurring in individuals aged 65 years or older, presents unique considerations. The risk of cancers increases with age, yet the suitability of cancer treatments e.g. chemotherapy, surgery or radiation therapy must be carefully evaluated based on older adults’ health, fitness and psychosocial circumstances. In this blog, we delve into cancer in older adults and cancer treatment options, addressing concerns and offering insights for informed decisions.

Cancer In Older Adults: Unique Considerations

Older adults with cancer have unique needs and considerations, differing from younger adults. Age-related factors can significantly influence treatment decisions. Older adults may have reduced tolerance for certain cancer treatments such as chemotherapy and diminished reserves to respond to disease and treatment related complications. They are more likely to have multiple medical problems, functional limitations, and variable access to transportation, social support, and financial resources. Balancing one’s quality of life and life expectancy becomes a crucial consideration for both older adults and their caregivers. Older adults are 11 times more likely to develop cancer in comparison to younger people and approximately 60% of all cancer patients are being 65 and older, it’s essential to learn more about how we can rationalise the use of the different types of cancer treatment in older adults, especially chemotherapy.

Understanding Chemotherapy And Its Role In Cancer Treatment For Older Adults

Chemotherapy is a common cancer treatment that uses drugs to eliminate cancer cells. It can be given orally or through the veins, targeting cancer cells throughout the body. Depending on the stage and type of cancer, chemotherapy may be used alone or in combination with surgery or radiation therapy. In older adults with cancer, the decision to undergo chemotherapy takes into account the patient’s overall health, functional status, and specific cancer characteristics.

Evaluating Chemotherapy In Cancer For Older Adults: Factors To Consider

Older adults are more likely to have other factors which may contribute to their overall health status. When assessing an older adult’s suitability for chemotherapy, several unique factors should be carefully considered such as:

  • Treatment duration: Chemotherapy often involves multiple sessions spread over weeks or months, which pose challenges for older adults with other medical appointments or limited transportation options.
  • Pre-existing Medical Conditions : Chemotherapy may be associated with certain side effects such as neuropathy (nerve damage), renal impairment or liver dysfunction. Extra care should be taken in prescribing chemotherapy to older adults who already have multiple pre-existing medical conditions.
  • Nutritional Status : Older adults may have swallowing difficulties, poor dentition contributing to a suboptimal nutritional status. When coupled with cancer related cachexia, it can be challenging for the patients to tolerate chemotherapy.
  • Functional Status and Fall Risk : Some older adults may functional limitations and be at risk of frequent falls. It is important to take this into consideration and prudent to ensure that these older adults are always accompanied by their caregivers when receiving chemotherapy.
  • Polypharmacy : For older adults who are currently on multiple prescription medications, care should be taken to avoid drug interactions with their chemotherapy and to ensure medication compliance.

Barriers To Cancer Treatment in Older Adults

Older adults may face a range of psychosocial challenges when making cancer related treatment decisions.

  • Societal norms: Many older adults and their loved ones may perceive their advanced age as a deterrent to them receiving cancer treatment and feel that they are unlikely to benefit from it because of their age.
  • Family support: In our Asian setting, family members play an important role in making treatment decisions and caregivers for older adults during their cancer journey.
  • Financial Constraints : As many older adults are retirees, they may be concerned about the costs of their cancer treatment and the affordability.

These diverse factors highlight the complex interplay between psychosocial factors that can influence geriatric patients’ decisions regarding cancer treatment and their willingness to pursue it.

Trends On People Living Longer And Getting Cancer

A notable trend in recent years is the increase in life extpectancy, due to advancements in healthcare, improved living conditions, and better access to medical care. While this is undoubtedly positive news, it also brings to light the challenges associated with an ageing population, including a higher incidence of cancer.

As individuals age, their risk of developing cancer increases due to various factors, such as cumulative exposure to environmental toxins, genetic predisposition, and age-related changes in the body’s cells. This trend poses significant implications for healthcare systems and cancer care, as it necessitates a greater focus on geriatric oncology and tailoring treatment approaches to meet the specific needs and considerations of older individuals.

There is increased awareness about the need to develop age-appropriate screening protocols, refine treatment strategies, and improve supportive care for older adults with cancer. These efforts would provide holistics cancer care to ensure optimal treatment outcomes, while maintaining the quality of life in older adults.

Benefits Of Cancer Treatment In Older Adults

Appropriate cancer treatment is crucial for preventing the spread of cancer, slowing tumour growth, and targeting cancer cells that have metastasized in older adults.

It’s important to recognise that cancer treatment can be beneficial for patients of any age. Additionally, advancements in cancer treatments, including chemotherapy, have demonstrated substantial benefits for older adults.

Studies have shown that targeted therapies, such as immunotherapy and molecularly targeted agents, can improve survival rates and quality of life for older adults with cancer. These treatments are designed to specifically target cancer cells while minimising damage to healthy tissues, thereby reducing the side effects commonly associated with traditional chemotherapy. These are more improved therapeutic options for older adults with cancer, offering them a better quality of life and improved overall outcomes.

It is still important to acknowledge the potential risks and side effects of cancer treatment, particularly in older adults with reduced physiologic reserves. Factors such as coexisting medical conditions, multiple medications, bone marrow changes, and other physical alterations can influence how cancer treatment affects older adults. Additionally, cognitive problems, including difficulties with thinking and memory, may impact treatment decisions. The decision to pursue cancer treatment should be a collaborative process, considering the potential benefits, weighing them against the risks, and taking into account the individual’s state of health, goals and preferences.

Consultation With A Cancer Specialist In Singapore

When it comes to cancer in older adults, consulting doctors in Singapore experienced with treating cancer in older adults, such as OncoCare, is crucial. Our oncology consultants have extensive knowledge in managing cancer in older individuals and can provide personalised evaluation and guidance. If you or your loved one is facing the possibility of chemotherapy, it’s important to consider the unique circumstances that come with cancer in older adults. Consulting with a cancer specialist will help you better understand the specific benefits and risks associated with chemotherapy in older adults. By involving healthcare providers and support networks, you can ensure that your decisions are personalised and well-informed.

At OncoCare, we embrace the opportunity to provide personalised cancer care that empowers older adults to thrive during their golden years. Our dedicated team is committed to ensuring that you receive the best possible treatment while preserving your quality of life. Don’t hesitate to reach out to us for compassionate and tailored assistance from our expert cancer specialists. Together, we can navigate the path to a brighter and healthier future.

“Expert knowledge means better care for cancer”

Written by:

Dr Angela Pang

MBBS (Singapore)

Grad Dip (GRM)


M Med (Internal Med)