The Older Cancer Patient

Approximately one-third of all persons reaching the age of 70 will receive a cancer diagnosis. By 2022, there will be 18 million cancer survivors in the United States, and approximately 63% will be 65 or older. Among the population 65 and older, cancer is the second leading cause of death. These increasing incidence rates combined with longer survival will place new demands on the cancer delivery system. The single largest payers for healthcare, Medicare and Medicaid, will experience increased stress as immunologic and other costly therapies become the standards of care. It is important to understand how to manage care for older persons with cancer, many of whom may already be dealing with other chronic health problems. Factors beyond chronological age must be considered when care decisions are made. Given the increased life expectancy resulting from improved treatment of cancer, as well as management of other chronic diseases, cancer and aging are important areas of concern for the future of healthcare. Older patients, even those with few or no comorbid conditions, are less likely to receive treatment with a curative intent. Older cancer patients face the challenge of finding individualized, patient-centered cancer care that considers how physiological, social, psychological, and, more recently, economic parameters interact with treatment options to attain outcomes that manage the disease while preserving quality of life. This chapter discusses these parameters as they pertain to cancer and cancer treatment in the older individual.