From the September 1, 2003 issue of the Journal of Clinical Oncology [1]Read the Study [2]It is a commonly held belief among both physicians and patients that some of the most effective cancer treatments, many of which come with greater side effects, are not appropriate for elderly cancer patients. Many physicians also presume that older patients would be unwilling to undergo aggressive chemotherapy if offered. Consequently, elderly patients are not always informed of their full range of treatment options, and survival and quality of life may suffer as a result.However, two new studies indicate that elderly cancer patients can benefit from aggressive treatment just as much as younger patients, and are willing to accept such treatment.Elderly and younger lung cancer patients benefit equally from combined chemotherapy and radiation treatmentA study led by Dr. Steven Schild at the Mayo Clinic in Scottsdale, Arizona compared the effect of chemotherapy and radiation treatment on older and younger patients with non-small cell lung cancer whose tumors have spread to nearby areas and cannot be surgically removed. The study found that while patients over 70 experienced worse side effects, they lived for the same length of time as younger lung cancer patients. Thirty-nine percent (39%) of younger patients survived for two years following diagnosis, compared to 36% of elderly patients.According to Dr. Schild, otherwise healthy older patients with non-small cell lung cancer should be encouraged to receive aggressive treatment, regardless of their age.Older American and European cancer patients willing to undergo aggressive treatmentAnother study, led by Dr. Martine Extermann and a team of researchers at the Moffitt Cancer Center in Tampa, Florida and in Lyon, France, counters the widely held view that older patients—especially Europeans—are unwilling to consider aggressive chemotherapy. This perception has often led physicians to refrain from offering patients such treatment.Dr. Extermann and her colleagues compared the willingness of French and American cancer patients to consider chemotherapy, given the side effects and potential benefits.The researchers found that both French and American elderly cancer patients were willing to consider chemotherapy as a potential treatment option. 77.8 percent of French cancer patients and 70.5% of American cancer patients were willing to accept an aggressive chemotherapy regimen. Study authors noted, however, that the patients' expected benefit of the chemotherapy—in terms of symptom relief, curing the cancer or prolonging life—was often unrealistically high.According to Dr. Extermann, these findings indicate that physicians should discuss all available treatment options with their patients, while ensuring that they accurately understand all of the potential advantages and disadvantages of treatment.What Does This Mean For Patients?These studies show that elderly patients can benefit from, and are generally willing to undertake, aggressive cancer treatments. Otherwise healthy elderly patients should ask their doctors about all available treatment options, including aggressive chemotherapy and radiation, but also make sure they have a full understanding of the potential advantages and disadvantages of each treatment.