Content area
Full Text
The number of people with cancer diagnosed at age 85 years or older - so-called super-elders - is increasing sharply, posing challenges for radiation oncology planning. Geriatric oncology evaluations and careful communication to identify patients' goals and priorities for care will play important roles in personalizing treatment plans.
As the US population ages, radiation oncology will see increasing numbers of elderly and super-elder (older than 85 years) patients whose potential benefits, information needs, comorbidities, radiation dose regimens, and treatment toxicity vulnerabilities can differ importantly from those ofyounger patients, according to a collection of papers published in the International Journal of Radiation Oncology Biology Physics (known as "the Red Journal").1-7
The US Census Bureau predicts that by 2050 there will be as many super-elders as there are young children (younger than 5 years), and that by 2030, older adults will represent onefifth of the US population and 70% of patients with newly diagnosed cancer.1,3
"The elderly, and particularly those older than 85 [years], are the fastestgrowing age demographic in most of the developed world," noted Anthony L. Zietman, MD, FASTRO, the editorin-chief of the Red Journal and a radiation oncologist at the Harvard Medical School and Massachusetts General Hospital Cancer Center, in Boston.
Super-elders are a "new and rapidly growing demographic, never previously encountered in our evolutionary past," Dr Zietman noted.2
UNIQUE CHARACTERISTICS
These patients tend to be frail. Their capacity to repair tissue damage and to recover from stressful events is not what it once was.2 Both cancer and its treatment can take a heavier toll on these patients than on younger populations. Treatment toxicity can "undermine dignity, independence, and the will to live," Dr Zietman wrote.2 "Elders with neuropathy may be unable to dress themselves; muscle loss may render them bedbound; and those who become incontinent, or deaf, or...