As Americas’ Greatest Generation continue to age studies are revealing that with the increase in the age of the population comes an increase in cancer risk. The nexus of age and cancer is supported by National Cancer Institute (NCI) research. The convergence of an overall aging population and a peak cancer incidence among those aged 65 to 74 will result in a significant rise in the number of people diagnosed with cancer. In addition, as people age the types of treatments and the eligibility and ability for older patients to participate in clinical trials diminishes.
According to the most recent statistical data from NCI’s Surveillance, Epidemiology, and End Results program, the median age of a cancer diagnosis is 66 years. The median age at diagnosis is 61 years for breast cancer, 68 years for colorectal cancer, 70 years for lung cancer, and 66 years for prostate cancer.
Healthcare professionals treating older cancer patients often discover other health conditions that may limit the use of specific therapies. Unless there is sufficient evidence that older patients can benefit from standard dosage of some therapies, clinicians can be reluctant to give older patients potentially beneficial treatments. This practice of less intensive therapy in aging patients is historically understandable; however, a growing field of geriatric oncologists now consider chronological age insufficient evidence for denying aggressive cancer therapy.
The solution to this aging dilemma, like the disease, is complex and we need to better understand how the biological underpinnings of aging affect the onset and trajectory of cancer. Reasons for this increase of cancer with aging can be contributed to the fact that living longer increases our exposure to things that have been shown to be contributing factors in determining cancer risk, such as exposure to sunlight, radiation, environmental toxins and noxious by-products of metabolism that increase with age. “Most aging cells develop genomic changes that make them more susceptible to the carcinogens in the environment,” says oncologist Lodovico Balducci, who studies and treats cancer in the elderly at the Moffitt Cancer Center in Tampa, Fla. In addition, the various immune defenses that keep our tissues healthy begin to break down with age.
Some of the more serious health conditions that are more common in adults over 65 that may impact the response to a cancer diagnosis include; high blood pressure, heart disease, lung disease, diabetes, kidney disease and arthritis. These co-existing conditions must be taken into account when designing cancer treatment protocols for older patients. For those older patients with cancer, knowing how treatments will be affected by these contributing factors is important to understanding how to respond to the process of therapy.
But progress towards better understanding is underway. A joint collaborative effort with the National Institute on Aging (NIA) and the Samuel Waxman Cancer Research Foundation is underway which will promote and support interdisciplinary research projects, sharing of resources, and development of new technologies and approaches to better understand how the physiological changes associated with aging affect cancer development, progression, and response to therapy. NCI is also committing more resources aimed to increase enrollment for older patients in clinical trials.