More than 60% of cancers in the United States occur in people over the age of 65. Even though cancer is more common in older adults, they often face unique needs and concerns compared with other groups of people with cancer. Cancer.Net talked with Hyman Muss, MD, to learn more about what patients and families should know about cancer in older adults.

Q: What makes cancer in older adults different from other age groups?

A: What is different about cancer in older adults is that older adults frequently have other serious co-existing illnesses—what we call comorbidities—in addition to their cancer. These other illnesses make the treatment of cancer more difficult and may limit treatment options.

Q: What are some common comorbidities, and how do these affect treatment and recovery in older adults with cancer?

A: Common comorbidities include high blood pressure, heart disease, lung disease, diabetes, and severe arthritis. These illnesses will affect the treatment selection for cancer as well as the spectrum and severity of side effects related to treatment. It is essential that these co-existing illnesses be well managed before embarking on cancer therapy.

Q: What are some other factors for older adults and their families to consider when making treatment plan decisions with doctors?

A: Older adults, like younger adults, need to discuss with their physicians both the short and long-term goals of treatment. Is the major goal longer survival, which might require more intensive therapy, or is it a maintenance of quality of life with the focus on the present? These decisions will depend on the type of cancer, its stage, and the proposed treatment. It is essential that older adults and their families discuss frankly with their doctors the issues related to their care and the potential difficulties in management related to other co-existing illnesses.

Q: What should older adults living with cancer know about clinical trials, and what are some resources for them to learn about studies open to them?

A: A substantial body of research has shown that older adults are less likely to be offered clinical trials than younger adults. Older adults should be aware that almost all clinical trials allow participation of older patients and do not have age limits. Older patients should ask their physicians about available clinical trials and can use websites, such as Cancer.Net and the National Cancer Institute, to search for clinical trials. Depending on whom their primary oncologist is, they might ask for a second opinion at a major cancer center to further explore clinical trial options.

Q: What are some common emotional and practical concerns older adults with cancer may have and what resources are available to help?

A: Older patients, like younger patients, might have emotional issues related to their cancer or issues that may have existed before cancer. Anxiety and depression are common in older adults and should be managed appropriately. It is well documented that emotional issues are not as well evaluated by health-care personnel as physical problems. Older persons and their families should carefully discuss any emotional problems they have with their health-care team. Of note, however, is that older people with cancer tend to have less psychological distress in dealing with cancer compared with younger patients. This may be due to their greater experience in dealing with the travails of life, as well as the fact that they are less likely to have family members dependent on their welfare.

Q: What are some examples of some research that is ongoing in older adults with cancer?

A: Several clinical trials of cancer therapy have been designed specifically for older patients with more common types of cancers, such as lung cancer, breast cancer, prostate cancer, and leukemia. In addition, current research is focused on developing and validating short, mostly self-administered, comprehensive geriatric assessment instruments that may help in treatment selection and predict the likelihood of toxicity. These instruments collect information about functional status, comorbidity, nutrition, cognitive function, psychosocial function and support, and medication use.

Dr. Muss is Professor of Medicine at the University of Vermont and Vermont Cancer Center. He is a member of The ASCO Cancer Foundation Board of Directors.

More Information

Cancer in Older Adults

Additional Resources

CancerCare: Cancer and Older Adults: Getting the Care You Deserve

Last Updated: August 25, 2008