Skip to main content

Cancer in the Older Population

  • Chapter
Oncology

Abstract

Advancing age comes bundled with increased cancer incidence and mortality. Indeed, the median age at diagnosis of all cancers combined is 69 years for men and 67 for women.3 Age-adjusted cancer incidence is 10 times higher in the 65+ population compared to their younger counterparts (2,151.2 versus 208.8/100,000 persons).2 Similarly, age-adjusted cancer mortality is 15-fold higher in the 65+ population (1,068.2 versus 67.3/100,000 persons). Figure 97.1 illustrates the proportions of the commonest cancers incidence and mortality in the 65+ population. As a result, although the total U.S. population is expected to grow by 9% between 1990 and 2010, the incidence of cancer is expected to increase by a disproportionate 32% in the same time frame. These trends are mirrored in countries across the globe.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Smith D. Changing causes of death of elderly people in the United States, 1950–1990. Gerontology 1998;44:331–335.

    Article  PubMed  CAS  Google Scholar 

  2. Ries L, Kosary C, Hankey B. SEER Cancer Statistics Review, 1973–1996. Bethesda, MD: National Cancer Institute, 1999.

    Google Scholar 

  3. Miller B, Ries L, Hankey B, et al. Cancer Statistics Review 1973–1989. Bethesda, MD: National Cancer Institute, 1992.

    Google Scholar 

  4. Ries L, Eisner M, Kosary C, et al. Surveillance, Epidemiology and End Results (SEER) Cancer Statistics Review 1975–2000. Bethesda, MD: National Cancer Institute, 2003. Available from: URL: http://seer.cancer.gov/csr/1975_2000

    Google Scholar 

  5. Kennedy B, Bushhouse S, Benber A. Minnesota population cancer risks. Cancer (Phila) 1994;73:724–729.

    Article  PubMed  CAS  Google Scholar 

  6. Mettlin C. New evidence of progress in the National Cancer Program. Cancer (Phila) 1996;78:2043–2044.

    Article  PubMed  CAS  Google Scholar 

  7. Levi F, Vecchia CL, Lucchini F, et al. Worldwide trends in cancer mortality in the elderly, 1955-1992. Eur J Cancer 1996;32A:652–672.

    Article  PubMed  CAS  Google Scholar 

  8. Vecchia CL, Levi F, Lucchini F, et al. International perspectives of cancer and aging. In: Ershler WB (ed) Comprehensive Geriatric Oncology. Amsterdam: Harwood, 1998:19–93.

    Google Scholar 

  9. Sargent D, Goldberg R, Jacobson S, et al. A pooled analysis of adjuvant chemotherapy for resected colon cancer in elderly patients. N Engl J Med 2001;345:1091–1097.

    Article  PubMed  CAS  Google Scholar 

  10. Schild S, Stella P, Geyer S, et al. The outcome of combined-modality therapy for stage III non-small cell lung cancer in the elderly. J Clin Oncol 2003;21:3201–3206.

    Article  PubMed  CAS  Google Scholar 

  11. Silliman RA. What constitutes optimal care for older women with breast cancer? J Clin Oncol 2003;21:3554–3556.

    Article  PubMed  Google Scholar 

  12. Bouchardy C, Rapiti E, Fioretta G, et al. Undertreatment strongly decreases prognosis of breast cancer in elderly women. J Clin Oncol 2003;21:3580–3587.

    Article  PubMed  Google Scholar 

  13. Yee K, Pater J, Pho L, et al. Enrollment of older patients in cancer treatment trials in Canada: why is age a barrier? J Clin Oncol 2003;21:1618–1623.

    Article  PubMed  Google Scholar 

  14. Hutchins L, Unger J, Crowley J, et al. Underrepresentation of patients 65 years of age or older in cancer-treatment trials. N Eng J Med 1999;341:2061–2067.

    Article  CAS  Google Scholar 

  15. Monfardini S, Sorio R, Boes G, et al. Entry and evaluation of elderly patients in European Organization for Research and Treatment of Cancer (EORTC) new drug development studies. Cancer (Phila) 1995;76:333–338.

    Article  PubMed  CAS  Google Scholar 

  16. Lewis JH, Kilgore ML, Goldman DP, et al. Participation of patients 65 years of age or older in cancer clinical trials. J Clin Oncol 2003;21:1383–1389.

    Article  PubMed  Google Scholar 

  17. United States life tables, 2000. Natl Vital Stat Rep 2002;51:1–38.

    Google Scholar 

  18. Record high life expectancy. Stat Bull Metrop Insur Co 1993;74:28–35.

    Google Scholar 

  19. Moroff S, Pauker S. What to do when the patient outlives the literature, or DEALE-ing with a full deck. Med Decision Making 1983;3:313–338.

    Article  CAS  Google Scholar 

  20. Fried L, Wallace R. The complexity of chronic illness in the elderly: from clinic to community. In: Wallace R, Woolson R (eds) The Epidemiologic Study of the Elderly. New York: Oxford University Press, 1992:10–19.

    Google Scholar 

  21. Yancik R, Wesley M, Ries L. Comorbidity and age as predictors of risk for early mortality in male and female colon cancer patients: a population-based study. Cancer (Phila) 1998;82:2123–2134.

    Article  PubMed  CAS  Google Scholar 

  22. Satariano W, Ragland D. The effect of comorbidity on 3-year survival of women with primary breast cancer. Ann Intern Med 1994;120:104–110.

    PubMed  CAS  Google Scholar 

  23. Satariano W. Comorbidities and cancer. In: Muss HB (ed) Cancer in the Elderly. New York: Dekker, 2000:477–499.

    Google Scholar 

  24. Mandeblatt J, Bierman A, Gold K, et al. Constructs of burden of illness in older patients with breast cancer: a comparison of measurement methods. Health Serv Res 2001;36:1085–1107.

    Google Scholar 

  25. Charlson M, Pompei P, Ales K, et al. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987;40:373–383.

    Article  PubMed  CAS  Google Scholar 

  26. Wang P, Walker A, Tsuang M, et al. Strategies for improving comorbidity measures based on Medicare and Medicaid claims data. J Clin Epidemiol 2000;53:571–578.

    Article  PubMed  CAS  Google Scholar 

  27. Monfardini S, Ferrucci L, Fratino L, et al. Validation of a multidimensional evaluation scale for use in elderly cancer patients. Cancer (Phila) 1996;77:395–401.

    Article  PubMed  CAS  Google Scholar 

  28. Reuben D. Principles of geriatric assessment. In: Tinetti M (ed) Principles of Geriatric Medicine and Gerontology. New York: McGraw-Hill, 2003:99–110.

    Google Scholar 

  29. Balducci L, Yates J. General guidelines for the management of older patients with cancer. Oncology (Huntingt) 2000;14:221–227.

    PubMed  CAS  Google Scholar 

  30. Moore AA, Siu AL. Screening for common problems in ambulatory elderly: clinical confirmation of a screening instrument [see comment]. Am J Med 1996;100:438–443.

    Article  PubMed  CAS  Google Scholar 

  31. Chen H, Cantor A, Meyer J, et al. Can older cancer patients tolerate chemotherapy? A prospective pilot study. Cancer (Phila) 2003;97:1107–1114.

    Article  PubMed  Google Scholar 

  32. Greenblatt D, Sellers E, Shader R. Drug therapy: drug disposition in old age. New Engl J Med 1982;306:1018–1028.

    Article  Google Scholar 

  33. Shaw P. Common pitfalls in geriatric drug prescribing. Drugs 1982;23:324–328.

    Article  PubMed  CAS  Google Scholar 

  34. Beers M, Ouslander J. Risk factors in geriatric drug prescribing: a practical guide to avoid problems. Drugs 1989;37:105–112.

    PubMed  CAS  Google Scholar 

  35. West D, Satariano W, Ragland D. Comorbidity and breast cancer survival: a comparison between black and white women. Ann Intern Med 1996:413–419.

    Google Scholar 

  36. Fleming S, Rastogi A, Dmitrienko A, Johnson KD. A comprehensive prognostic index to predict survival based on multiple comorbidities: a focus on breast cancer. Med Care 1999;37(6):601–614.

    Article  PubMed  CAS  Google Scholar 

  37. Yancik R, Wesley M, Ries M, et al. Effect of age and comorbidity in postmenopausal breast cancer patients aged 55 years and older. JAMA 2001;285:885–892.

    Article  PubMed  CAS  Google Scholar 

  38. Schneeweiss S, Maclure M. Use of comorbidity scores for the control of confounding in studies using administrative databases. Int J Epidemiol 2000;29:891–898.

    Article  PubMed  CAS  Google Scholar 

  39. Small GW. Recognizing and treating anxiety in the elderly. J Clin Psychiatry 1997;58:41–47.

    PubMed  Google Scholar 

  40. Osborn DP, Fletcher AE, Smeeth L, et al. Factors associated with depression in a representative sample of 14 217 people aged 75 and over in the United Kingdom: results from the MRC trial of assessment and management of older people in the community. Int J Geriatr Psychiatry 2003;18:623–630.

    Article  PubMed  Google Scholar 

  41. Feinstein A. The pre-therapeutic classification of comorbidity in chronic diseases. J Chronic Dis 1970;23:455–469.

    Article  Google Scholar 

  42. Lash T, Thwin S, Horton N, et al. Multiple informants: a new method to assess comorbidity in breast cancer patients. Am J Epidemiol 2003;157:249–257.

    Article  PubMed  Google Scholar 

  43. Kaplan M, Feinstein A. The importance of classifying initial comorbidity in evaluating the outcome of diabetes mellitus. J Chronic Dis 1974;27:387–404.

    Article  PubMed  CAS  Google Scholar 

  44. Greenfield S, Blanco D, Elashoff R, et al. Patterns of care related to age of breast cancer patients. JAMA 1987;257:2766–2770.

    Article  PubMed  CAS  Google Scholar 

  45. Bennett C, Greenfield S, Aronow H, et al. Patterns of care related to age of men with prostate cancer. Cancer (Phila) 1991;67:2633–2441.

    Article  PubMed  CAS  Google Scholar 

  46. Ienozzi L, Ash A, Coffman G, et al. Predicting in-hospital mortality: a comparison of severity measurement approaches. Med Care 1992;30:347–359.

    Article  Google Scholar 

  47. Ienozzi L, Moskowitz M. A clinical assessment of Medis-Groups. JAMA 1988;260:3159–3163.

    Article  Google Scholar 

  48. Lyman G. Decision analysis: a way of thinking about health care in the elderly. In: Ershler WB (ed) Geriatric Oncology. Philadelphia: Lippincott, 1992:5–14.

    Google Scholar 

  49. Carney P, Miglioretti D, Yankaskas B, et al. Individual and combined effects of age, breast density, and hormone replacement therapy use on the accuracy of screening mammography. Ann Intern Med 2003;138:168–175.

    PubMed  Google Scholar 

  50. Diab S, Elledge R, Clark G. Tumor characteristics and clinical outcome of elderly women with breast cancer. J Natl Cancer Inst 2000;92:550–556.

    Article  PubMed  CAS  Google Scholar 

  51. Walter L, Covinsky K. Cancer screening in the elderly patients. A framework for individualized decision making. JAMA 2001;285:2750–2756.

    Article  PubMed  CAS  Google Scholar 

  52. Law M. Screening without evidence of efficacy [see comment]. BMJ 2004;328:301–302.

    Article  PubMed  Google Scholar 

  53. Nystrom L, Rutqvist L, Wall S, et al. Breast cancer screening with mammography: overview of Swedish randomized trials. Lancet 1993;341:973–978.

    Article  PubMed  CAS  Google Scholar 

  54. Olsen O, Gotzsche P. Cochrane review on screening for breast cancer with mammography. Lancet 2001;358:1340–1342.

    Article  PubMed  CAS  Google Scholar 

  55. Duffy S, Tabar L, Chen H-H, et al. The impact of organized mammography service screening on breast carcinoma mortality in seven Swedish counties: a collaborative evaluation. Cancer (Phila) 2002;95:458–469.

    Article  PubMed  Google Scholar 

  56. Kerlikowske K, Grady D, Rubin S, et al. Efficacy of screening mammography: a meta-analysis. JAMA 1995;273:149–154.

    Article  PubMed  CAS  Google Scholar 

  57. van Dijck J, Holland R, Verbeek A, et al. Efficacy of mammographic screening of the elderly: a case-referent study in the Nijmegen program in The Netherlands. J Natl Cancer Inst 1994;86:934–938.

    Article  PubMed  Google Scholar 

  58. McCarthy E, Burns R, Freund K, et al. Mammography use, breast cancer stage at diagnosis and survival among older women. J Am Geriatr Soc 2000;48:1226–1233.

    PubMed  CAS  Google Scholar 

  59. Randolph W, Goodwin J, Mahnken J, et al. Regular mammography use is associated with elimination of age-related disparities in size and stage of breast cancer at diagnosis. Ann Intern Med 2002;137:783–790.

    PubMed  Google Scholar 

  60. Mandelblatt J, Saha S, Teutsch S, et al. The cost-effectiveness of screening mammography beyond age 65 years: a systematic review for the U.S. Preventive Service Task Force. Ann Intern Med 2003;139:835–842.

    PubMed  Google Scholar 

  61. Zappa M, Visioli C, Ciatto S. Mammography screening in elderly women: efficacy and cost-effectiveness. Crit Rev Oncol Hematol 2002;46:235–239.

    Article  Google Scholar 

  62. Mandel J, Bond J, Church T. Reducing mortality from colorectal cancer by screening for fecal occult blood. N Engl J Med 1993;328:1365–1371.

    Article  PubMed  CAS  Google Scholar 

  63. Hardcastle J, Chamberlain J, Robinson M, et al. Randomised controlled trial of faecal-occult-blood screening for colorectal cancer. Lancet 1996;348:1472–1477.

    Article  PubMed  CAS  Google Scholar 

  64. Kronborg O, Fenger C, Olsen J, et al. Randomized study of screening for colorectal cancer with faecal-occult-blood test. Lancet 1996;348:1467–1471.

    Article  PubMed  CAS  Google Scholar 

  65. Mandel J, Church T, Ederer F, et al. Colorectal cancer mortality: effectiveness of biennial screening for fecal occult blood. J Natl Cancer Inst 1999;91:434–437.

    Article  PubMed  CAS  Google Scholar 

  66. Mandel JS, Church TR, Bond JH, et al. The effect of fecal occultblood screening on the incidence of colorectal cancer. N Engl J Med 2000;343:1603–1607.

    Article  PubMed  CAS  Google Scholar 

  67. Lieberman DA, Harford WV, Ahnen DJ, et al. One-time screening for colorectal cancer with combined fecal occult-blood testing and examination of the distal colon. N Engl J Med 2001;345:555–560.

    Article  PubMed  CAS  Google Scholar 

  68. Winawer S, Fletcher R, Miller L, et al. Colorectal cancer screening: clinical guidelines and rationale. Gastroenterology 1997;112:594–642.

    Article  PubMed  CAS  Google Scholar 

  69. Ransohoff DF, Sandler RS. Screening for colorectal cancer. N Engl J Med 2002;346:40–44.

    Article  PubMed  Google Scholar 

  70. Selby J, Friedman G, Queensburry C, et al. A case-controlled study of screening sigmoidoscopy and mortality from colorectal cancer. N Engl J Med 1992;326:653–657.

    Article  PubMed  CAS  Google Scholar 

  71. Muller A, Sonnenberg A. Protection by endoscopy against death from colorectal cancer: a case-control study among veterans. Arch Intern Med 1995;155:1741–1748.

    Article  PubMed  CAS  Google Scholar 

  72. Lieberman DA, Weiss DG, Bond JH, et al. Use of colonoscopy to screen asymptomatic adults for colorectal cancer. N Engl J Med 2000;343:162–168.

    Article  PubMed  CAS  Google Scholar 

  73. Sonnenberg A, Delco F, Inadomi J, et al. Cost-effectiveness of colonoscopy screening for colorectal cancer. Ann Intern Med 2000;133:573–584.

    PubMed  CAS  Google Scholar 

  74. Crawford E, Leewansangtong S, Goktas S, et al. Efficiency of prostate specific antigen and digital rectal examination in screening using 4.0ng/ml and age-specific reference range as cut-off for abnormal values. Prostate 1999;38:296–302.

    Article  PubMed  CAS  Google Scholar 

  75. Schroder F, Maas P, Beemsterboer P, et al. Evaluation of the digital rectal examination as a screening test for prostate cancer: Rotterdam section of the European Randomized Study of Screening for Prostate Cancer. J Natl Cancer Inst 1998;1998:1817–1823.

    Google Scholar 

  76. Labrie F, Candas B, Dupont A, et al. Screening decreases prostate cancer death: first analysis of the Quebec randomized controlled trial. Prostate 1999;38:83–91.

    Article  PubMed  CAS  Google Scholar 

  77. Horninger W, Reisigl A, Rogatsch H, et al. Prostate cancer screening in Tyrol, Austria: experience and results. Eur J Cancer 2000;2000:1322–1335.

    Google Scholar 

  78. Punglia RS, D’Amico AV, Catalona WJ, et al. Effect of verification bias on screening for prostate cancer by measurement of prostate-specific antigen. N Engl J Med 2003;349:335–342.

    Article  PubMed  Google Scholar 

  79. Catalona W, Partin A, Slawin K, et al. Use of percentage of free prostate-specific antigen to enhance differentiation of prostate cancer from benign prostatic disease: A prospective multicenter clinical trial. JAMA 1998;279:1542–1547.

    Article  PubMed  CAS  Google Scholar 

  80. In: Katlic MR (ed) Principles and Practice of Geriatric Surgery. New York: Springer-Verlag, 2001:1098.

    Google Scholar 

  81. Pofahl WE, Pories WJ. Current status and future directions of geriatric general surgery. J Am Geriatr Soc 2003;51:S351–S354.

    Article  PubMed  Google Scholar 

  82. Devereaux E, Kemeny M. Surgery in the elderly oncology patient. In: Muss HB (ed) Cancer in the Elderly. New York: Dekker, 2000:153–186.

    Google Scholar 

  83. Evans B, Townsend C, Thompson J. Organ physiology of aging. Surg Clin N Am 1994;74:23–29.

    Google Scholar 

  84. Wynne H, Cope L, Mutch E, et al. The effect of aging upon liver volume and apparent liver blood flow in healthy men. Hepatology 1989;1989:297–301.

    Google Scholar 

  85. Mooney H, Roberts R, Cooksley W, et al. Alterations in the liver with ageing. Clin Gastroenterol 1985;14:757–771.

    PubMed  CAS  Google Scholar 

  86. Rocca R. Psychosocial aspects of surgical care in the elderly patient. Surg Clin N Am 1994;74:223–243.

    Google Scholar 

  87. Fleisher L, Eagle K. Lowering cardiac risk in non-cardiac surgery. N Engl J Med 2001;345:1677–1682.

    Article  PubMed  CAS  Google Scholar 

  88. Marcello P, Roberts P. “Routine” preoperative studies: which studies in which patients? Surg Clin N Am 1996;76:11–23.

    Article  PubMed  CAS  Google Scholar 

  89. Velanovich V. Preoperative laboratory evaluation. J Am Coll Surg 1996;183:79–87.

    PubMed  CAS  Google Scholar 

  90. Kaplan E, Sheiner L, Boeckmann A, et al. The usefulness of preoperative laboratory screening. JAMA 1985;253:3576–3581.

    Article  PubMed  CAS  Google Scholar 

  91. Roizen M, Kaplan E, Schreider B, et al. The relative roles of the history and physical examination, and laboratory testing in preoperative evaluation for outpatient surgery: the “Starling” curve of preoperative laboratory testing. Anesthesiol Clin N Am 1987;5:15.

    Google Scholar 

  92. Goldman L, Caldera D, Nussbaum S. Multifactorial index of cardiac risk in noncardiac surgical procedures. N Engl J Med 1977;297:845–850.

    Article  PubMed  CAS  Google Scholar 

  93. Goldman L. Cardiac risks and complications of noncardiac surgery. Ann Intern Med 1983;98:504–513.

    PubMed  CAS  Google Scholar 

  94. Owens W, Felts J Jr. ASA physical status classifications: a study of consistency of ratings. Anesthesiology 1978;49:239–243.

    Article  PubMed  CAS  Google Scholar 

  95. Evans T. Hemodynamic and metabolic therapy in critically ill patients. N Engl J Med 2001;345:1417–1418.

    Article  PubMed  CAS  Google Scholar 

  96. Cooper A, Doig G, Sibbald W. Pulmonary artery catheters in the critically ill: an overview using the methodology of evidence-based medicine. Crit Care Clin 1996;12:777–794.

    Article  PubMed  CAS  Google Scholar 

  97. Sandman J, Hull R, Brant R, et al. A randomized, controlled trial of the use of pulmonary-artery catheters in high-risk surgical patients. N Engl J Med 2003;348:5–14.

    Article  Google Scholar 

  98. Tobias J. Clinical practice of radiotherapy. Lancet 1992;339:159–163.

    Article  PubMed  CAS  Google Scholar 

  99. Sargent E, Burns F. Repair of radiation-induced DNA damage in rat epidermis as function of age. Radiat Res 1985;102:176–181.

    Article  PubMed  CAS  Google Scholar 

  100. Scalliet P, Pignon T. Radiotherapy in the elderly. In: Ershler WB (ed) Comprehensive Geriatric Oncology. Amsterdam: Harwood, 2000:421–427.

    Google Scholar 

  101. Mundt A. Radiation therapy and the elderly. In: Muss HB (ed) Cancer in the Elderly. New York: Dekker, 2000:187–216.

    Google Scholar 

  102. Isenring E, Bauer J, Capra S. The scored Patient-generated Subjective Global Assessment (PG-SGA) and its association with quality of life in ambulatory patients receiving radiotherapy. Eur J Clin Nutr 2003;57:305–309.

    Article  PubMed  CAS  Google Scholar 

  103. Nag S, Ellis RJ, Merrick GS, et al. American Brachytherapy Society recommendations for reporting morbidity after prostate brachytherapy. Int J Radiat Oncol Biol Phys 2002;54:462–470.

    Article  PubMed  Google Scholar 

  104. Janda M, Johnson D, Woelfl H, et al. Measurement of quality of life in head and neck cancer patients utilizing the quality of life radiation therapy questionnaire. Strahlenther Onkol 2002;178:153–158.

    Article  PubMed  Google Scholar 

  105. Berg C, Carbone P. Clinical trials and drug toxicity in the elderly: the experience of the Eastern Cooperative Oncology Group. Cancer (Phila) 1983;52:1986–1992.

    Article  Google Scholar 

  106. Christman K, Muss H, Case L, et al. Chemotherapy of metastatic breast cancer in the elderly: the Piedmont Oncology Association experience. JAMA 1992;268:57–62.

    Article  PubMed  CAS  Google Scholar 

  107. Lichtman S, Skirvin J, Vemulapalli S. Pharmacology of antineoplastic agents in older cancer patients. Clin Rev Oncol Hematol 2003;46:101–114.

    Article  Google Scholar 

  108. Yuen G. Altered pharmacokinetics in the elderly. Clin Geriatr Med 1990;6:257–267.

    PubMed  CAS  Google Scholar 

  109. Wallace S, Whiting B. Factors affecting drug binding in plasma of elderly patients. Br J Clin Pharmacol 1976;3:327–330.

    PubMed  CAS  Google Scholar 

  110. Woodhouse K, Wynne H. Age-related changes in liver size and hepatic blood flow: the influence on drug metabolism in the elderly. Clin Pharmacokinet 1998;15:287–294.

    Article  Google Scholar 

  111. Soteniemi E, Arranto A, Pelkonen O, et al. Age and cytochrome P450-linked drug metabolism in humans: an analysis of 226 subjects with equal histopathologic conditions. Clin Pharmacol Ther 1997;61:331–339.

    Article  Google Scholar 

  112. Vestal R. Aging and pharmacology. Cancer (Phila) 1997;80:1302–1310.

    Article  PubMed  CAS  Google Scholar 

  113. Lindeman R, Tobin J, Shock N, et al. Longitudinal studies on the rate of decline in renal function with age. J Am Geriatr Soc 1985;33:278–285.

    PubMed  CAS  Google Scholar 

  114. Cockroft D, Gault M. Prediction of creatinine clearance from serum creatinine. Nephron 1976;16:31–42.

    Article  Google Scholar 

  115. Lipschitz D. Age-related declines in hematopoietic reserve capacity. Semin Oncol 1995;22(suppl):3–5.

    PubMed  CAS  Google Scholar 

  116. Ibrahim N, Frye D, Buzdar A, et al. Doxorubicin-based chemotherapy in elderly patients with metastatic breast cancer: tolerance and outcome. Arch Intern Med 1996;156:882–888.

    Article  PubMed  CAS  Google Scholar 

  117. Fisher R, Graynor E, Dahlberg S, et al. Comparison of a standard regimen (CHOP) with three intensive chemotherapy regimens for advanced non-Hodgkin’s lymphoma. N Engl J Med 1993;328:1002–1006.

    Article  PubMed  CAS  Google Scholar 

  118. Lyman G, Kuderer D, Djulbegovic B. Prophylactic granulocyte colony-stimulating factors in patients receiving dose-intensive cancer chemotherapy: a meta-analysis. Am J Med 2002;112:406–411.

    Article  PubMed  CAS  Google Scholar 

  119. Balducci L, Lyman G. Patients aged ≥70 are at high risk for neutropenic infection and should receive hematopoietic growth factors when treated with moderately toxic chemotherapy. J Clin Oncol 2001;19:1583–1585.

    PubMed  CAS  Google Scholar 

  120. Ozer H, Armitage J, Bennett C, et al. 2000 Update of recommendations for the use of hematopoietic colony-stimulating factors: evidence-based, clinical practice guidelines. J Clin Oncol 2000;18:3558–3585.

    PubMed  CAS  Google Scholar 

  121. Chavez P, Volpato S, Fried L. Challenging the World Health Organization criteria for anemia in older women. J Am Geriatr Soc 2001;49(suppl 3):10.

    Google Scholar 

  122. Izaks G, Westendorp R, Knoot D. The definition of anemia in older persons. JAMA 1999;281:1714–1717.

    Article  PubMed  CAS  Google Scholar 

  123. Kikuchi M, Inagaki T, Shinagawa N. Five-year survival of older people with anemia: variation with hemoglobin concentration. J Am Geriatr Soc 2001;49:1226–1228.

    Article  PubMed  CAS  Google Scholar 

  124. Gutstein H. The biologic basis of fatigue. Cancer (Phila) 2001;92(suppl):1678–1683.

    Article  PubMed  CAS  Google Scholar 

  125. Nissenson A. Epoetin and cognitive function. Am J Kidney Dis 1992;20(suppl):21–24.

    PubMed  CAS  Google Scholar 

  126. Shrijvers D, Highley M, Bruyn ED, et al. Role of red blood cells in pharmacokinetics of chemotherapeutic agents. Anticancer Drugs 1999;10:147–153.

    Google Scholar 

  127. Rizzo J, Lichtin A, Woolf S, et al. Use of epoetin in patients with cancer: evidence-based clinical practice guidelines of the American Society of Clinical Oncology and the American Society of Hematology. J Clin Oncol 2002;19:4083–4107.

    Article  Google Scholar 

  128. Hellstrom-Lindberg E, Ahlgren T, Begguin Y, et al. Treatment of the anemia of myelodysplastic syndromes with G-CSF plus erythoropoietin: results of a randomized phase II study and longterm follow-up of 71 patients. Blood 1998;92:68–75.

    PubMed  CAS  Google Scholar 

  129. Popescu R, Norman A, Ross P, et al. Adjuvant or palliative chemotherapy for colorectal cancer in patients 70 years or older. J Clin Oncol 1999;17:2412–2418.

    PubMed  CAS  Google Scholar 

  130. Sargent D, Goldberg R, MacDonald J, et al. Adjuvant chemotherapy for colon cancer (CC) is beneficial without significant incrased toxicity in elderly patients: results from 3351 Pt meta-analysis. Proc Am Soc Clin Oncol 2000;19:241a (abstract 933).

    Google Scholar 

  131. Derogatis L. The prevalence of psychiatric disorders among patients with cancer. JAMA 1983;249:751–757.

    Article  PubMed  CAS  Google Scholar 

  132. Sanson-Fisher R, Girgis A, Boyes A, et al. Supportive Care Review Group. The unmet supportive care needs of patients with cancer. Cancer (Phila) 2000;88:225–236.

    Article  Google Scholar 

  133. Mor V, Allen S, Malin M. The psychological impact of cancer on older versus younger patients. Cancer (Phila) 1994;74:2118–2127.

    Article  PubMed  CAS  Google Scholar 

  134. Lyness J, Cox C, Curry J, et al. Older age and the underreporting of depressive symptoms. J Am Geriatr Soc 1995;43:216–221.

    PubMed  CAS  Google Scholar 

  135. Cassileth B, Lusk E, Strouse T, et al. Psychological status in chronic illness: a comparative analysis of six diagnostic groups. N Engl J Med 1984;311:506–511.

    Article  PubMed  CAS  Google Scholar 

  136. Willey C, Silliman R. The impact of disease on social support experiences of patients with cancer. J Psychol Oncol 1990;8:79–95.

    Article  Google Scholar 

  137. Goodwin J, Hunt W, Samet J. A population-based study of functional status and social support networks of elderly patients newly diagnosed with cancer. Arch Intern Med 1991;151:366–370.

    Article  PubMed  CAS  Google Scholar 

  138. Kurtz M, Kurtz J, Stommel M, et al. The influence of symptoms, age, comorbidity and cancer site on physical functioning and mental health in geriatric women patients. Women Health 1999;29:1–12.

    PubMed  CAS  Google Scholar 

  139. Stafford R, Cyr P. The impact of cancer on the physical function of the elderly and their utilization of health care. Cancer (Phila) 1980;80:1973–1980.

    Article  Google Scholar 

  140. Dalaker J. People 65 years and over by ratio of income to poverty and state: 1999–2001 averages. U.S. Government Printing Office, 2003. Available from: URL: http://www.census.gov/hhes/poverty/65+inctopov.html

    Google Scholar 

  141. Berkman L, Syme S. Social networks, host resistance and mortality: a nine-year follow-up study of Alameda County residents. Am J Epidemiol 1979;109:186–204.

    PubMed  CAS  Google Scholar 

  142. Beck A, Ward C, Mendelson M. An inventory for measuring depression. Arch Gen Psychiatry 1961;4:561–571.

    PubMed  CAS  Google Scholar 

  143. Hamilton M. The development of a rating scale for primary depressive illness. Br J Soc Clin Psychol 1967;6:278–296.

    PubMed  CAS  Google Scholar 

  144. Rush A, Giles D, Schlesser M. The Inventory for Depressive Symptomatology (IDS): preliminary findings. Psychiatry Res 1986;18:65–87.

    Article  PubMed  CAS  Google Scholar 

  145. Sheikh J, Yesavage J. Geriatric Depression Scale [GDS]: recent evidence and development of a shorter version. In: Brink TL (ed) Clinical Gerontology: A Guide to Assessment and Intervention. New York: Haworth Press, 1986:165.

    Google Scholar 

  146. Folstein M, Folstein S, McHugh P. “Mini-mental state.” A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1875;12:189–198.

    Article  Google Scholar 

  147. Crum R, Anthony J, Bassett S, et al. Population-based norms for the Mini-Mental State Examination by age and educational level. JAMA 1993;269:2386–2391.

    Article  PubMed  CAS  Google Scholar 

  148. Crooks V, Waller S, Smith T, et al. The use of the Karnofsky Performance Scale in determining outcomes and risks in geriatric outpatients. J Gerontol 1991;46:M139–M144.

    PubMed  CAS  Google Scholar 

  149. Optimizing cancer care: the importance of symptom management. In: von Gunten CF (ed) ASCO Curriculum, vol I. Dubuque, IA: Kendall/Hunt, 2003.

    Google Scholar 

  150. Roberts C, Cox C, Reintgen D, et al. Influence of physician communication on newly diagnosed breast cancer patients’ psychological adjustment and decision making. Cancer (Phila) 1994;74:157–164.

    Article  Google Scholar 

  151. Eide H, Graugaard P, Holgersen K, et al. Physician communication in different phases of a consultation at an oncology outpatient clinic related to patient satisfaction. Patient Educ Counsel 2003;51:259–266.

    Article  Google Scholar 

  152. Hann D, Oxman T, Ahles T, et al. Social support adequacy and depression in older patients with metastatic cancer. Psycho-Oncology 1995;4:213–221.

    Article  Google Scholar 

  153. Northouse L. Social support in patients’ and husbands’ adjustment to breast cancer. Nurs Res 1988;37:91–95.

    Article  PubMed  CAS  Google Scholar 

  154. Spiegel D, Bloom J, Krawmer H, et al. Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet 1989;2:888–891.

    Article  PubMed  CAS  Google Scholar 

  155. Callahan C, McHorney C, Mulrow C, et al. Determinants of successful aging: Developing an integrated research agenda for the 21st century. Ann Intern Med 2003;139(suppl):389–462.

    PubMed  Google Scholar 

  156. Exploring the role of cancer centers for integrating aging and cancer research. Workshop report. Bethesda, MD: National Institute on Aging and National Cancer Institute, June 13–15, 2001:36–40.

    Google Scholar 

  157. Yancik R, Ganz P, Varricchio C, et al. Perspectives on comorbidity and cancer in older patients: approaches to expand the knowledge base. J Clin Oncol 2001;19:1147–1115.

    PubMed  CAS  Google Scholar 

  158. Busch E, Kemeny M, Fremgen A, et al. Patterns of breast cancer care in the elderly. Cancer (Phila) 1996;78:101–111.

    Article  PubMed  CAS  Google Scholar 

  159. Hesterberg R, Schmidt W, Ohmann C, et al. Risk of elective surgery in colorectal carcinoma in the elderly. Dig Surg 1991;8:2–27.

    Google Scholar 

  160. Arnaud J, Schloegel M, Ollier J. Colorectal cancer in patients over 80 years of age. Dis Colon Rectum 1991;34:896–898.

    Article  PubMed  CAS  Google Scholar 

  161. Mulcahy H, Patchett S, Daly L, et al. Prognosis of patients with large bowel cancer. Br J Surg 1994;81:736–738.

    Article  PubMed  CAS  Google Scholar 

  162. Bonenkamp J, Songun I, Hermans J, et al. Randomized comparison of morbidity after D1 and D2 dissection for gastric cancer in 996 Dutch patients. Lancet 1995;345:745–748.

    Article  PubMed  CAS  Google Scholar 

  163. Viste A, Haugstvedt T, Eide G, et al. Postoperative complications and mortality after surgery for gastric cancer. Ann Surg 1998;207:7–13.

    Article  Google Scholar 

  164. Tsujitani S, Katano K, Oka A, et al. Limited operation for gastric cancer in the elderly. Br J Surg 1996;83:836–839.

    Article  PubMed  CAS  Google Scholar 

  165. Fong Y, Blumgart L, Fortner J, et al. Pancreatic or liver resection is safe and effective in the elderly. Ann Surg 1995;222:426–434.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2006 Springer Science+Business Media, Inc.

About this chapter

Cite this chapter

Malek, K.S., Silliman, R.A. (2006). Cancer in the Older Population. In: Chang, A.E., et al. Oncology. Springer, New York, NY. https://doi.org/10.1007/0-387-31056-8_97

Download citation

  • DOI: https://doi.org/10.1007/0-387-31056-8_97

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-24291-0

  • Online ISBN: 978-0-387-31056-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics