Senior adult oncology
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Senior Adult Oncology. Overview. Cancer is the leading cause of death for those 60-79 years 60% of all cancers occur in patients who are 65 years or older Older individuals are more prone to develop cancer due to physiological changes associated with aging. Older Adults.

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Senior Adult Oncology

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Senior adult oncology

Senior Adult Oncology


Overview

Overview

  • Cancer is the leading cause of death for those 60-79 years

  • 60% of all cancers occur in patients who are 65 years or older

  • Older individuals are more prone to develop cancer due to physiological changes associated with aging


Older adults

Older Adults

Older patients can be classified into three categories:

  • Young Old: 65-75 years

  • Old: 76-85 years

  • Oldest Old: over 85 years


Age distribution of u s population 1980 1990 and 2005

Age Distribution of U.S. Population, 1980, 1990, and 2005

Year 1980

Year 1990

Year 2005

85+

80-84

75-79

70-74

65-69

60-64

55-59

50-54

45-49

40-44

35-39

30-34

25-29

20-24

15-19

10-14

5-9

0-4

Data source: The Bureau of the Census


Frailty

Frailty

Decreased reserve and resistance to stressors

Frail patients have an increased risk of complications from cancer treatments

Risk for falling, disability, hospitalization, and death


Fraility criteria

Fraility Criteria

  • Unintentional weight loss (10 lbs or more in past year)

  • Self reported exhaustion

  • Weakness

  • Slow walking speed

  • Low physical activity


Geriatric syndromes

Malnutrition

Polypharmacy

Lack of Social Support

Depression

Dementia

Fall Risk

Geriatric Syndromes


Falls

Falls

  • One of the most common geriatric syndromes

  • 30-40% of adults older than 65 years fall each year

  • Risk factors: muscle weakness and impairments in gait, vision, cognition, and ADLs


Activities of daily living adls

Activities of Daily Living (ADLs)

  • Able to bathe self

  • Able to dress self

  • Able to toilet self

  • Control over bowel & bladder

  • Able to transfer self

  • Able to feed self


Instrumental activities of daily living iadls

Instrumental Activities of Daily Living (IADLs)

  • Use the telephone

  • Get to places beyond walking distance

  • Grocery shop

  • Prepare meals

  • Housework

  • Laundry

  • Take medications

  • Manage money


Percent of medicare beneficiaries reporting difficulty with iadls or adls by age 2004

Percent of Medicare Beneficiaries Reporting Difficulty with IADLs or ADLs by Age, 2004

Percent (%)

Data Source: Medicare Current Beneficiary Survey


Senior adult oncology

Percent of Persons Age 65 and Over (age-adjusted) Reporting Selected Chronic Conditions by Sex, 2004-2005

Percent (%)

Data Source: National Health Interview Survey


Years of education among persons age 65 and over age adjusted by sex and race ethnicity 2006

Years of Education Among Persons Age 65 and Over (age-adjusted) by Sex and Race/Ethnicity, 2006

Female

Male

Percent (%)

Data source: Current Population Survey


Cancer treatment

Cancer Treatment

Benefits:

  • Prolonged survival

  • Maintenance and improvement of quality of life and function

  • Palliation of symptoms


Cancer treatments

Cancer Treatments

Risks:

  • Complications of surgery, radiation, and/or chemotherapy

  • Affects on cognition, function, balance, vision, hearing, continence, and mood


Treatment decisions

Treatment Decisions

  • Life Expectancy

  • Aggressiveness of Disease

  • Functional Abilities

  • Comorbidities

  • Patient Goals

  • Social Resources

  • Tolerance of Treatment


Treatment decisions1

Treatment Decisions

  • Advanced age alone should not preclude the use of effective cancer treatment

  • Older patients with good performance status are able to tolerate most forms of treatments

  • Treatment that diminishes quality of life with no significant survival benefit should be avoided


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