Parker County Today September 2016 - Page 39

Optimizing Cancer Treatment for Our Grandparents... “There is nothing more important to me as a physician than your cancer treatment. I’ve been in practice for nearly two decades and have had the privilege of telling many patients that there is life beyond cancer. As president of The Center for Cancer and Blood Disorders, I want to lead by example, practicing a firm belief that all patients should receive the finest medical care available, with the same concern and compassion as a cherished member of the family.” Ray Page, D.O., Ph.D. President and Medical Oncologist The Center for Cancer and Blood Disorders There are indeed changes, challenges, and new insights in treating cancer in our seniors today. What is the #1 risk factor for cancer? It is age! Fortunately, because of the tremendous advances we have made in healthcare, particularly in preventing and managing heart disease, controlling infectious diseases, and correcting disparities contributing to poorer health – Americans are living longer and longer. Unfortunately, the risk of getting a cancer also increases with advancing age. The average age of those diagnosed with all types of cancer is 70; for lung cancer it’s 72; colon cancer 71; breast cancer 68. Yet despite these statistics, surprisingly little is known about how cancers develop and progress in older patients or how best to treat them. Most importantly, a person’s age is not the primary determining factor for making treatment decisions and calculating prognosis and survival. There are many factors we must take into account in order to prescribe the best treatment options for a patient. For many reasons, older adults with cancer have different needs than younger adults with the disease. For example, older adults: •May be less able to tolerate certain cancer treatments. •Have a decreased reserve (the capacity to respond to disease and treatment). •May have other medical problems in addition to cancer. •May have functional problems, such as the ability to do basic activities (dressing, bathing, eating) or more advanced activities (such as using transportation, going shopping or handling finances). •May not always have access to transportation, social support or financial resources. Support services sponsored by: To learn more about cancer care issues or to consult with a physician about a cancer diagnosis, contact us at 817.596.0637. PA R K E R C O U N T Y T O D AY Schedule appointments by calling 817-596-0637 or online at SEPTEMBER 2016 With those reasons being considered, I have treated a patient in his 80’s with no other health problems who worked as a ski instructor in Colorado and had recently won the senior division of running a marathon to the summit of 14,108 foot Pike’s Peak. Conversely, I have managed young adults that have such severe debility and comorbid problems that they could not get any therapy at all. Using a cancer treatment team with a focus on personalizing care becomes important. The good news is that today there are often options available for avoiding or minimizing chemotherapy toxicities and drug interactions. And increasingly, there are ways of treating cancer in people at varying levels of overall health and function. Another major insight is that traditional measures of “performance status” that predict how well a person is likely to withstand the rigors of chemotherapy, surgery, and other forms of cancer treatment are not adequate for older patients. Instead, we’ve discovered that these measures, which focus on the ability to carry out daily living tasks like bathing, getting dressed, and following a medication schedule, have much greater predictive value if they are specific to the geriatric population. We are learning more and more about the nuances of optimally treating cancer patients with advanced age, physical and psychosocial hurdles. However, clinical trials often exclude the elderly or people with concurrent illnesses. We need more research and studies in the field of geriatric oncology. 37