Navigating the waters of a cancer diagnosis in older adults
Kathryn E. Vinson, MS, CCRC
Cancer In Seniors – Cancer is never easy. It is difficult for a multitude of reasons, but when the patient has difficulty communicating their symptoms, or their symptoms aren’t typical, if becomes that much harder. Sadly, this is often the case with our senior citizens. The reasons for these difficulties are many, but all must be dealt with compassionately. As the caretakers of those who gave us so much love, it is not only our duty, but our honor, to show these lovely people the same kindness, patience, and devotion that they lavished on us in our growing years. Today, I’d like to talk about some of the obstacles that we face when a senior citizen has cancer, or any other illness for that matter.
It seems to be almost common knowledge that cancer risks increase as we age. Our exposures to chemicals, UV radiation, smoking, obesity, and a host of other causes all combine to increase this risk. Statistics show that men over 65 years of age stand a 7x greater risk of developing cancer than their counterparts in the 30-64-year-old age bracket, with women at a 4x greater risk when similarly matched. This year’s (2019) Cancer Facts and Figures publication by the American Cancer Society contains some interesting information concerning our seniors over the age of 85. The risk of a cancer diagnosis is 16.4% and 12.8% for men and women, respectively. Sadly, many of these will result in death (14.4% and 9.6%) as many physicians feel that the risks of treatment at that age outweigh the potential benefits.
While we see the accumulated risks of these exposures as a leading cause of cancer in our senior citizens, I began to wonder – what other factors come in to play?
The aging immune system
Recently, a senior woman very dear to my heart was hospitalized by a simple urinary tract infection. Most of us younger ladies that have experienced these may wonder how it could get that bad. Well, the simple answer is – as we age, our immune systems don’t work the way they are supposed to. In a woman my age (I’m 38), my body would respond with inflammation and pain which are the two biggest clues that we are aware of. Fever from the infection is a big clue as well, as our body changes the “set point” for our temperature when there is an infection as a way to burn out the infection. Our white blood cell counts increase as these natural defense cells set out to eradicate the bacteria. This is the ideal case.
As we age, however, our immune system declines. Its funny to me (funny interesting, not funny haha), that we don’t think twice about declining heart, lung, or kidney function as we get older, but we don’t often think about our immune system. But, just as those systems, as well as our knees and hips fail, so do our immune systems. What this means is that simple infection won’t show the same symptoms in an elderly person as in a young person. The fever may not be there, the inflammation doesn’t show and cause pain, the white blood cells don’t start their fight.
I bring this up as an illustration to show you how symptoms of any disease can be drastically different in younger adults versus seniors – it is vital that we are aware of this.
Symptoms of cancer in the elderly
The Merck Manual, a highly respected publication in the medical field, tells us that many seniors show unusual symptoms to many diseases. Of the most common symptoms seen over a variety of diseases we see:
- Loss of appetite
- Weight loss
- Non-specific metal deterioration
Indeed, much of my research has shown that cancer symptoms in the very elderly show up with weight loss and confusion. This lends credence to the fact that knowing our elder loved one’s daily habits is vital – sudden changes in these habits can be a warning sign that something is wrong on the inside.
This is not to say that typical symptoms will not occur – but we must be aware of the fact that typical presentations aren’t always there.
Most common cancers in the elderly
Men and women over the age of 85 have different cancers that show up most commonly. The five most common are:
For those of you that are blessed to have, as a dear friend says “Vintage People” in your lives, I urge you to understand how diseases show up differently in those of advanced years. The symptoms of we see in our 20s, 30s, 40s, and 50s are massively different that what may show up in the 80s and 90s. Perceptions of pain are different. Some older people “don’t want to make a fuss.” Make sure that they understand that they aren’t making a fuss if they hurt.These are the beautiful people that changed our diapers, taught us to feed ourselves and tie our shoes, gave us the courage to ask out our first dates, wept as we left home for the first time, and in many cases welcomed us back with open arms when things went south. It is our blessing to be able to show them the love that they have showered upon us.As always, much love, many prayers, and abundant blessings to all of the warriors out there!
|Lung & Bronchus||Breast|
|Prostate||Colon & Rectum|
|Urinary bladder||Lung & Bronchus|
|Colon & Rectum||Pancreas|