October 17, 2013

By Diane Walker, RN, MS, CSA

Cancer – just the word itself can send chills through a person. An actual diagnosis can cause the patient and their family to go into a tailspin. Modern medicine and technology has come a long way, however, in the diagnosis and treatment of cancer. It is not always the death sentence it once was. Early detection and recognizing certain warning signs are important factors one needs to be aware of when caring for the older adult.

For adults in general, some of the most common cancers diagnosed at any age are the following:

  •     Lung Cancer
  •     Bladder Cancer
  •     Breast Cancer
  •     Pancreatic Cancer
  •     Kidney Cancer
  •     Leukemia
  •     Colon Cancer

It is important to keep in mind that more than one-third of cancers occur in people over the age of seventy-five. Unfortunately, older adults can be under-treated. Age should not be a factor in cancer treatment. instead, the older adult’s overall health should determine the course of care. It’s not just the risk of undertreatment that poses a concern for older adults. Despite the fact that they account for the largest demographic among cancer cases in the U.S., adults over the age of 65 are under-represented in clinical trials. For adults over the age of sixty-five, the most common cancers are:

  •     Prostate Cancer – half of all cases are in men over the age of seventy-five
  •     Bladder Cancer – 70% of all cases are in men between the ages of fifty and eighty
  •     Pancreatic Cancer – most cases are in adults over the age of sixty-five
  •     Lung Cancer – 81% of all cases are in adults over the age of sixty

The warning signs of cancer in older adults include:

  •     Bladder Cancer – Elderly patients will see warning signs that include frequent urination, blood in urine, a distended bladder and a burning sensation when urinating.
  •     Lung Cancer – Elderly patients will see warning signs including chest pain caused by coughing, intense or ongoing coughing, breathing difficulty, chronic pneumonia, and coughing up blood.
  •     Bone Cancer – Elderly patients will find that the most common warning sign is pain. Swelling near a bone is also a symptom that needs to be checked out by a doctor.
  •     Colon Cancer – Elderly patients may find that there are no warning signs during the early stages. Later they may see blood in their stool, a change in bowel habits, vomiting, and stomach pain.

The Emotional Impact of Treatment

Treatment of cancer in older adults brings with it concerns that are not present in younger patients. Often, an older adult has other health issues such as high blood pressure or diabetes. These conditions can affect treatment options and the severity of negative side effects of the treatment. An additional concern is that some older adults do not have the same independence as their younger counterparts. Their limited mobility, their ability to care for themselves, and possible financial issues stemming from medical costs can all impact the outcome of their treatment. They may have a smaller support system, as well which leads to feelings of isolation and an increased sense of mortality if they have known someone who has died from cancer or watched another loved one suffer from the disease.

While a diagnosis of cancer is frightening, studies have shown it is important to become involved with support groups and cancer survivors. The emotional impact of cancer on patients and family members can be devastating. Support groups provide an outlet for both to deal with the emotional aspects of the disease. Also, knowing you are not alone and that others have gone through what you are dealing with and have survived also helps.

Good News: Survival Rates Are Rising

The good news is that survival rates of cancer victims in on the upswing. In 1976, the survival rate – five years – for all types of cancers was 50%. Today, that rate is 74% for bladder cancer, 75% breast cancer, 69% for prostate and 51% for colorectal (colon) cancer. In addition, today’s treatments are not what they used to be. A vaccine was approved in 2010 by the FDA for prostate cancer. Currently, vaccines are being tested for ovarian cancer, lung cancer, pancreatic cancer, and melanoma. Radiation therapy has also changed. They are now using 3-dimensional conformal radiation therapy which sends high doses of radiation to the actual tumors while at the same time avoiding healthy tissue.

When an older adult in your life receives a diagnosis of cancer, it is important to be a true advocate for their healthcare. Don’t let their age become a factor in treatment, and be sure to reach out to support groups for emotional support when needed. It is a difficult diagnosis, but no one has to go through it alone.