“Patients aged 65 years and older are living longer after lung cancer surgery, and with older people representing a rapidly growing proportion of patients diagnosed with lung cancer, this improved survival is especially significant, according to an article posted online today by The Annals of Thoracic Surgery.
“The American Cancer Society estimates that the median age at diagnosis for lung cancer is 70, supporting the premise that lung cancer is predominantly a disease of the elderly. Despite this, older patients with cancer are generally under-represented in clinical cancer trials, including those for lung cancer. This makes the study by Felix G. Fernandez, MD, from the Emory Clinic in Atlanta, and colleagues particularly important.”
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“A new statistical model may help predict which patients are most likely to receive life-extending benefits from surgical treatment for malignant pleural mesothelioma (MPM), according to an article in the September 2015 issue of The Annals of Thoracic Surgery.
“MPM is an aggressive cancer that affects the lining of the chest cavity (pleura). The main cause of mesothelioma is believed to be repeated exposure to asbestos, which is a naturally occurring group of minerals found in soil and rocks around the world. Asbestos was previously used to make fireproof materials, such as theater curtains, insulation, flooring, and workers’ gloves, and is still used in some products today. About 3,000 cases of mesothelioma are diagnosed in the US each year, with many more worldwide. There is frequently a lag time of twenty years or more between exposure to asbestos and the development of the disease.
“Currently, there is no cure for advanced stage mesothelioma, and the 5-year survival rate is only about 10%.”
“Age and body mass index (BMI) were found to be independent predictors of anthracycline-related diastolic dysfunction in an analytical prospective cohort study of breast cancer patients undergoing treatment with broad-spectrum anthracycline chemotherapy, researchers said.
“Overall, the incidence of diastolic dysfunction during follow-up was 57% and persisted up to 12 months later in 73% of patients, reported Jose M. Serrano, MD, of the Hospital Universitario de Fuenlabrada, Servicio de Cardiologıa, Madrid, Spain, and colleagues in The Oncologist.
“Diastolic dysfunction is an important predictor of all-cause mortality and plays an essential role in the pathophysiology of other cardiac diseases, they noted.
” ‘We confirmed in our study the association of age with the development of diastolic dysfunction, with an odds ratio of 1.12 (95% CI: 1.03-1.19) in the regression model,’ said Serrano.”
“After treatment for localized prostate cancer, changes in quality of life will vary by age, as will men’s reactions to those changes, according to a new study.
“ ‘While older and younger men start with different baseline quality of life function, older men may be less bothered by certain declines that may affect younger patients more,’ Dr. Lindsay Hampson told Reuters Health in an email.
“Prostate cancer is the most common malignancy in men of all ages in the U.S. Almost 60 percent of new cases are diagnosed in men over the age of 65, and the average age is 66.
“Older men are often diagnosed with more aggressive disease and are less likely to get treatment, in part because they worry about the impact on their sexual and urinary function, Hampson and her colleagues write in European Urology.
“Determining quality of life priorities is vital to ensuring that patients make well-informed treatment decisions, said Hampson, a urologist at the University of California San Francisco.
“Survival rates are improving for many people with cancers of the breast, prostate, lung, liver and colon or rectum, especially for those diagnosed at younger ages, a new study reports.
“Cancer is still a leading cause of death in the United States, but advances in radiation, chemotherapy and targeted treatments have improved survival, the researchers said.
” ‘Although survival rates for most cancers have improved over the past few decades, the improvements were less remarkable among elderly patients,’ said lead researcher Dr. Wei Zheng, co-leader of the Cancer Epidemiology Research Program at the Vanderbilt-Ingram Cancer Center in Nashville.
“The study also found differences in survival based on race. Overall, blacks had poorer survival than whites. Black women with ovarian cancer experienced a decrease in survival over the past two decades for unknown reasons, he said.
” ‘Black Americans experienced poorer survival than whites for all cancers during the study period,’ Zheng said.”
“National guidelines recommend that men with low- and intermediate-risk prostate cancer who have life expectancies of fewer than 10 years should not be treated with radiation or surgery, since they are unlikely to live long enough to benefit from treatment. Yet a new study by UCLA researchers found that more than half of such men are receiving these aggressive treatments putting them at risk for potentially debilitating side effects.
“In the first study to rigorously address prostate cancer treatment trends by life expectancy in a large, nationally representative sample, UCLA researchers found that more than half of prostate cancer patients 66 years and older have life expectancies of fewer than10 years, but half of those still were over-treated for their prostate cancer with surgery, radiation or brachytherapy—the implantation of radioactive seeds in the prostate.
“Randomized controlled studies have suggested that significant differences in survival between watchful waiting—monitoring the cancer closely but not treating it—and aggressive therapies don’t develop until 10 years after treatment. Thus it makes sense not to treat men expected to die of something else within 10 years. But the UCLA researchers found that men were being treated aggressively anyway, with little regard for their quality of life, said study first author Dr. Timothy Daskivich, a UCLA Robert Wood Johnson fellow.
” ‘Life expectancy is poorly integrated into treatment decision-making for prostate cancer, yet it is one of the primary determinants of whether a patient will benefit from treatment with surgery or radiation,’ Daskivich said. ‘Because these treatments have side effects such as erectile dysfunction, urinary incontinence and bowel problems, it’s critical for men with limited life expectancies to avoid unnecessary treatment for low- and intermediate-risk prostate cancer.’ “
“A new analysis has found that while clinical trial data support omitting radiation treatments in elderly women with early stage breast cancer, nearly two-thirds of these women continue to receive it. The findings are published early online in Cancer, a peer-reviewed journal of the American Cancer Society.
“Results published in 2004 from a large, randomized clinical trial showed that adding radiation therapy to surgery plus tamoxifen does not reduce 5-year recurrence rates or prolong survival in elderly women with early stage tumors. Despite the findings, many doctors still administer radiation to these patients.
“To examine the extent to which elderly women still receive radiation to treat early stage breast cancer, Rachel Blitzblau, MD, PhD, of Duke University, and her colleagues analyzed information from the nation’s largest cancer registry, the Surveillance, Epidemiology and End-Results (SEER) database. The investigators identified 40,583 women older than 70 years of age who were treated with lumpectomy from 2000 to 2009. From 2000 to 2004, before the trial results were published, 68.6% of patients received some form of radiation therapy. From 2005 to 2009, 61.7% of patients received such treatment, although there was a shift in the type of radiation therapy used: fewer patients received standard whole breast radiation, and more received a short course of focused radiation treatment. The results indicate that publication of the trial results had only a very small impact on practice patterns.”
“Older people are less likely to have cancer surgery compared to younger people according to new data* published today (Friday).
“The new report by Cancer Research UK and the National Cancer Intelligence Network reveals the difference in rates of surgery across 21 different cancer types. While many factors might be at play – frailty, suffering more than one illness, being diagnosed at a late stage, patients choosing not to undergo surgery – these statistics paint a worrying picture.
“Younger cancer patients were more likely to have surgery for 19 cancer types, with the largest differences between age groups seen in kidney and ovarian cancers.
“Surgery was performed on almost three quarters (73 per cent) of all kidney cancer patients aged between 15 and 54. This halved to a third (36 per cent) of patients aged between 75 and 84, and fell even more dramatically to only one in ten (11 per cent) of patients over 85 having surgery.
“Around 80 per cent of women under 55 had surgery for ovarian cancer. This fell to around 37 per cent of women between 75 and 84, and then to 15 per cent of women over 85.”
“A common prostate cancer therapy should not be used in men whose cancer has not spread beyond the prostate, according to a new study led by researchers at Henry Ford Hospital.
“The findings are particularly important for men with longer life expectancies because the therapy exposes them to more adverse side effects, and it is associated with increased risk of death and deprives men of the opportunity for a cure by other methods.
“The research study has been published online in European Urology.
“The focus of the new study is androgen deprivation therapy (ADT), in which an injectable or implanted medication is used to disrupt the body’s ability to make testosterone. ADT is known to have significant side effects such as heart disease, diabetes, increased weight gain and impotence; however a growing body of evidence suggests ADT may in fact lead to earlier death.
“Since the 1940s, the therapy has been a mainstay of treatment for prostate cancer that has metastasized, or spread beyond the prostate gland. Still other studies support the use of ADT when it is used as an adjuvant, or in addition to, radiation therapy for higher risk prostate cancer. No evidence exists to support the exclusive use of ADT for low risk or localized prostate cancer.”