Cancer in the elderly

15/05/2024

Cancer is a dangerous disease that can attack anyone at any age. However, the risk of cancer increases with age, especially in older adults.

According to statistics, the incidence of cancer in people over 65 years old is much higher than in other age groups. This article aims to provide you with useful information about cancer in the elderly, including methods for diagnosing and treating cancer, as well as effective ways to prevent it.

1. Cancer in the elderly

Age is one of the leading risk factors for cancer in the elderly. Over time, the body’s immune system gradually weakens, reducing its ability to fight cancer cells. Besides, the elderly are also more likely to have underlying diseases such as cardiovascular disease, diabetes, high blood pressure,… creating favorable conditions for the development of cancer. In addition, unhealthy lifestyle over the years also contributes to increasing the risk of cancer in the elderly. An unbalanced diet, lack of exercise, smoking and excessive alcohol use are dangerous habits that can lead to cancer.

Regular health care for the elderly for early detection and treatment of diseases 

According to Dr. Ang Peng Tiam, Mount Elizabeth Hospital, Singapore, about 77% of cancers are diagnosed in people over 55 years old, especially those aged 65 and over who have a higher risk of cancer. The doctor explained that older people, due to long-term exposure to environmental and nutritional factors, suffer cumulative effects, while the body ages, limiting its ability to correct cell mutations which results in cancer.

According to GLOBOCAN 2020 statistics, cancer is the leading cause of death in Vietnam, with a cancer death rate of up to 73.5%. More worryingly, the incidence of cancer in the elderly is increasing. It is estimated that up to 50% of new cancer cases are diagnosed in this group of people. Common types of cancer in the elderly include:

– Lung cancer with the highest rate of 22.7% of newly diagnosed cases in men and 12.3% in women.

– Prostate cancer is a type of cancer found only in men, accounting for 11.8% of new cases.

– Colorectal cancer accounts for 9.7% of new cases in men and 8.8% in women.

– Breast cancer, found only in women, accounts for 8.7% of new cases.

In addition, the elderly are also at high risk of other types of cancer such as liver, stomach, pancreatic, and bladder cancer.

   

2. Cancer treatment in elderly patients

2.1 Characteristics of cancer in the elderly

Cancer in the elderly is a disease caused by many combined factors, but in general it includes 3 causes as presented below. First, long-term exposure to cancer-causing agents such as alcohol, tobacco, toxic substances, radiation… is the leading risk factor for cancer in the elderly. According to statistics from the US National Cancer Institute (NCI), smoking is the cause of 30% of cancer deaths in the elderly, followed by alcohol use (5%) and exposure to asbestos (4%). Next is aging in the elderly because over time, the body accumulates a lot of DNA damage in cells, increasing the risk of cancer. The aging process also weakens the immune system, reducing its ability to fight the growth of cancer cells. And finally, there is the genetic factor due to cancer genes from parents. These inherited gene mutations can increase the risk of certain types of cancer, such as breast cancer, ovarian cancer, and colon cancer.,…

Types of cancer are hereditary in families  

Another characteristic of cancer research in the elderly is that diagnosis can be difficult. Cancer symptoms can be similar to other diseases such as fatigue, weight loss, pain… and can easily be confused with common diseases in the elderly such as heart disease, diabetes, osteoporosis… leading to delay in diagnosis. In addition, many elderly people are afraid to go see a doctor due to fear of cancer, or due to lack of information about cancer screening. This makes early cancer detection even more difficult.

The danger of cancer lurks if the elderly suffer tiredness, anorexia, and weight loss

To diagnose cancer in the elderly, doctors often use methods including clinical examination, tests, imaging and biopsy depending on the stage and type of cancer suspected. Initially, the doctor asks about medical history, symptoms and carry out a general examination to detect any abnormal signs. Next comes the various tests used to diagnose cancer, including blood tests, urine tests, and imaging tests. Imaging techniques such as X-rays, CT scans, MRI scans… can help determine the location and size of the tumor. Finally, there is a biopsy – taking a small tissue sample from the tumor for testing under a microscope to help determine the type of cancer and its stage.

2.2 Cancer treatment methods in the elderly

According to research by the US National Cancer Institute (NCI), cancer treatment in the elderly needs to focus on balancing different treatment methods to ensure treatment effectiveness and improve quality of life for patients. The goal of cancer treatment in the elderly is to balance the rhythmic activity of the biological system, thereby prolonging life, maintaining quality of life and alleviating symptoms in cancer patients. Cancer treatments in the elderly need to be carefully considered based on many factors, including: type of cancer and stage of cancer, and the patient’s overall health, from which giving assessment and consideration for tolerance of the body before applying treatment methods, ultimately the patient’s wishes and family need to be involved in the process, thereby deciding on treatment methods that suit their wishes and needs.

Choose a treatment method that suits the cancer patient’s wishes and needs

Cancer treatment in the elderly is also much more difficult than in young people. Due to advanced age and many biological disorders such as underlying cardiovascular disease, diabetes, high blood pressure… making cancer treatment more difficult than expected. Most elderly people have 2 to 3 underlying diseases at the same time. Therefore, prescribing treatment will be much more difficult. The accompanying side symptoms of cancer such as fatigue, nausea, loss of appetite, pain… also make them have poor resistance and weak physical strength, leading to unresponsiveness to treatments such as surgery, chemotherapy and radiotherapy. This usually happens in patients over the age of 80. 

Chemotherapy in elderly patients with late-stage cancer has become an important issue for oncologists worldwide. Carefully consider the indications for chemotherapy in the elderly with advanced cancer, the tolerability and toxicity of chemotherapy in this age group. For patients who receive chemotherapy, the drug is often well tolerated and has the effect of prolonging the patient’s life. The relatively small number of elderly patients who do not receive chemotherapy may be due to poor physical condition and the effects of certain comorbidities. To limit the risk, doctors often use simple, low-toxic regimens and reduce doses for patients. Concomitant chemotherapy and radiotherapy cause side effects more frequently and more severely in older people than in younger people. Elderly patients also recover more slowly from treatment sessions. Therefore, careful consideration should be given when implementing this regimen.

Chemotherapy usually lasts from 3 to 12 months

Targeted treatment means using drugs that target the genetic or molecular characteristics of cancer cells, allowing to kill cancer cells more effectively and with less effect on healthy cells, with few side effects. should be given priority. A promising new therapy that stimulates the body’s immune system to attack cancer cells itself could be highly effective for some types of cancer..

3. Lifestyle changing is never too late to prevent and treat cancer

In a study to evaluate the results of gastrectomy to treat stomach cancer in the elderly and prognostic factors performed at Huu Nghi Hospital published in the Vietnamese Medical Journal, it was concluded that Radical surgery can be performed safely on elderly patients with stomach cancer . For elderly patients, performing radical surgery brings many benefits, specifically removing the majority of malignant cells, reducing tumor compression, thereby improving quality of life and increasing patient survival time.

In the case of Mr. Nanjundaswamy (102 years old) living in Bengaluru (India), he resiliently underwent three major surgeries to defeat colon cancer. Dr. Shabber Zaveri (Director of Surgical Oncology Department – Manipal Hospital) commented that it was his spirit, positive attitude and will to live that helped the old man have good health and overcome the evil disease. And now, the old man is still alive and well after curing cancer.

Or another case in Vietnam, Mr. Vu Huy Chuong (Ninh Binh) has always optimistically fought pituitary cancer for more than 9 years thanks to the resilient spirit of a soldier and was honored to receive the award “Inspiring Warrior to defeat cancer” at the Vietnam Academy of Science and Technology.

Mr. Chuong set foot on Fansipan peak after overcoming pituitary cancer

Although we know that illness does not spare anyone, with the spirit of optimism in fighting illness along with the continuous development of health and science, not only the two cases mentioned above but 30% of cancer cases have been cured and prolonged life if detected early and treated properly.

In addition, a balanced diet combined with functional products with ingredients and effects to enhance resistance and prevent cancer is also being applied in cancer prevention and treatment for the elderly. As the risk of malnutrition occurring before, during and after surgical, chemical and radiation treatment is very high. Every year in our country, about 115,000 patients die from cancer, of which 80% lose weight and 30% due to exhaustion before dying from the tumor. According to the American Institute for Cancer Research, a diet rich in plant products such as fruits, vegetables, whole grains, nuts and beans helps reduce the risk of cancer. Eating lots of fruits and vegetables in smoothies is a way to increase plant foods, thereby improving disease prevention. Therefore, older people required to provide meals with enough energy and nutrition and regularly change dishes to get enough nutrients needed for the body. Not only that, it is necessary to provide enough water to avoid dehydration and digestive diseases such as constipation and diarrhea.

A diet rich in fruits, vegetables, whole grains, nuts and beans allows reduce the risk of cancer 

At Hanoi Medical University Hospital, clinical research was conducted on 208 cancer patients with a diet of 2 cups of Leanmax Hope Medical Nutrition food at snacks every day for 8 weeks to prove the role of nutrition. The results showed that on average, these patients gained 1.4 kg of weight and 1.2 kg of muscle mass, and the health of this group of patients also improved after nutritional intervention: reduce fatigue, reduce pain, increase mobility, thereby improving quality of life. To produce positive results in this study, Leanmax Hope product contains high energy (474 kcal/ 100g of powder) with specific nutritional ingredients such as BCAA, Whey protein, and easily absorbed MCT fat to support restore weight and muscle mass with soluble fiber FOS/Inulin and B vitamins, which are substances that help appetite and improve digestion. Besides, Omega 3,6 and Antioxidant (vitamins A, C, E and Selenium) in the product are substances known to help increase resistance and reduce fatigue. In 2018, Nutricare’s Leanmax Hope product was recognized as a National Medical Nutrition Brand.

In addition to providing enough nutrients for the body, it is also necessary to maintain a healthy lifestyle: exercise regularly, limit alcohol and tobacco, and have regular health checks for early detection and effective treatment. Because physical activity helps strengthen the immune system, improve mood, reduce side effects of chemotherapy and radiotherapy, and support physical recovery after treatment. You should exercise at least 30 minutes a day, prioritizing gentle exercises such as walking, yoga, and swimming. And we all know that alcohol and tobacco are cancer-causing agents and weaken the immune system, negatively affecting the effectiveness of treatment. Quitting smoking and minimizing alcohol use is essential for cancer patients. 

Jogging is a suitable physical activity for the elderly

Conclusion: Raising awareness about cancer in the elderly is an extremely important factor for effective prevention and treatment. The community and especially the family need to pay attention, care for and encourage the elderly to maintain a healthy lifestyle, have regular health checks and follow doctors’ instructions to protect their health. Remember, early detection and timely treatment are the keys to defeating cancer.

References

1.WHO: Thế giới sẽ có 35 triệu ca ung thư mỗi năm vào 2050 – Tuổi Trẻ Online (tuoitre.vn)

2. https://vnexpress.net/trieu-chung-canh-bao-ung-thu-o-nguoi-lon-tuoi-4565584.html

3. https://moh.gov.vn/hoat-dong-cua-dia-phuong/-/asset_publisher/gHbla8vOQDuS/content/tinh-hinh-ung – thu-tai-viet-nam 

4. https://wikipredia.net/vi/National_Cancer_Institute

5. https://asia-genomics.vn/di-truyen-trong-ung-thu/ung-thu/

6. https://www.cancer.gov/

7. https://suckhoedoisong.vn/ung-thu-o-nguoi-cao-tuoi-nhung-van-de-tro-ngai-169210806221040202.htm

8. https://www.vinmec.com/vi/ung-buou-xa-tri/thong-tin-suc-khoe/ung-thu-o-nguoi-cao-tuoi/

9. Dũng, Hoàng Việt. “Phẫu thuật ung thư dạ dày ở người cao tuổi và các yếu tố tiên lượng.” Tạp chí Y học Việt Nam 526.1B (2023).

10. https://vnexpress.net/bi-quyet-giup-cu-102-tuoi-song-khoe-sau-khoi-ung-thu-4619047.html

11.https://dantri.com.vn/suc-khoe/chien-binh-truyen-cam-hung-chien-thang-ung-thu-cung-niem-tin-vao-khoa-hoc-20220725181517258.htm

12. https://dangcongsan.vn/y-te/neu-phat-hien-va-dieu-tri-som-30-ca-ung-thu-se-duoc-chua-khoi-42335.html

13. 30% bệnh nhân ung thư suy kiệt vì suy dinh dưỡng | VTV.VN

14. https://vnexpress.net/7-cong-thuc-sinh-to-giam-nguy-co-ung-thu-4730362.html

15. Đề tài cấp bộ: “Hiệu quả can thiệp dinh dưỡng cho bệnh nhân ung thư đường tiêu hóa điều trị hóa chất”. Ths. Nguyễn Thùy Linh, GS.TS Lê Thị Hương, 2020

 

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