Most elderly patients assume the end of life is near when they are diagnosed with cancer. But with advanced age, the risks of dying from other diseases also increase.
“Many older persons also die of stroke, heart disease, dementia and other conditions. The older person is, of course, more likely to be at the end of their lives, compared to younger persons.
“Therefore doctors who care for them are more likely to encounter death and dying, ” says Universiti Malaya Medical Centre’s consultant geriatrician Prof Dr Tan Maw Pin.
Most people associate cancer with pain, but for the older person, pain may not necessarily be the problem, explains Prof Tan.
“We still don’t know enough about cancer in older persons. For the older person, they may have no symptoms at all from the cancer, or they may experience other symptoms such as weakness, loss of appetite, shortness of breath and tiredness from the cancer rather than pain.”
What is the risk of cancer for the aged?
Prof Tan: Cancer is a disease of older persons. Of every 100 persons who is diagnosed with cancer, one will be aged 24 or below, 10 will be between the ages of 25 and 49, while the other 89 will be over 50 years. The peak age to be diagnosed with cancer is between 85 and 90.
What are signs of cancer in the elderly?
Doctors advocate a rectal examination for older men for prostate cancer, colonoscopy for bowel cancer every 10 years, breast mammography for older women every two years up to 74 years of age.
In addition, women are advised to examine their own breasts regularly. Patients are advised to report symptoms of coughing up blood, passing blood in their urine or change of bowel habit.
Will the presence of other diseases affect cancer treatment?
Nowadays, there are many types of cancer medications that do not cause serious side effects.
The main issue is that some of the newer drugs can be expensive.
Doctors regularly prescribe many cancer treatment drugs together with drugs for medical issues like blood pressure and diabetes. It includes hormonal treatments drugs for breast and prostate cancer which are usually safe to be given with other drugs.
Doctors need to balance out the risk of treatment with the potential benefits.
Do elderly cancer patients seek palliative care?
Many older persons with cancer die without ever seeing a geriatrician or palliative care doctor. However, geriatricians do selectively refer patients to hospices if there is a need for supported discharge and continued symptom management.
Many of our older persons do not “suffer” in their last days like many people envisage. They are often calm, peaceful and sleep away their final hours or days.
How do we help elderly patients with depression?
Depression is commonly linked to any chronic medical conditions and cancer is one of them. It is important that people are aware of it, pre-empt it and treat it as soon as possible.
Often, patients fear cancer treatment due to the stigma attached, and this causes unnecessary anxiety for patients and family members.
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