Cardiotoxicity in the Elderly

  • Lucia Fratino
  • Massimiliano Berretta


The age distribution of population greatly affects its burden of disease and disability, including cancer incidence and mortality. Cancer is now the leading cause of death. Actually, cancer cases reported over the world have doubled in the past 25 years and could even triple by 2030. In fact, the elderly population is rapidly increasing, in Europe 15 % of the population is elderly, and 55 % of cancers are in this group of age [1, 2]. Therefore, age is an important risk factor for cancer. And, as we know, the cancer is forty times higher after 65 years, than when you are aged between 20 and 44 years. Older adults with cancer have different needs than younger adults with the disease. So treatment for older adults needs to consider many issues because they have unique needs by reason of their complex medical histories, numerous drugs taking, their social situations, possible problems with cognitive dysfunction related to age, and general diminution of organ function that occurs naturally in the older population. In contradiction with the fact that the risk of cancer increases with age, there is little interest in their clinical problem. In fact, clinical trial guidelines for treatment of cancer were mainly based on assessment for young age and rarely in elders. That disparity is demonstrated by a low percentage of research in this area. But now there’s a big shift in the way oncologists approach treatment for elderly, and oncology management began to raise the consciousness that age was not a contraindication per se and starting in the mid-1980s the need of data and information [3, 4]. Ageing is associated with the decline in organ function that occurs over time and even in the eventual presence of injury, illness or poor lifestyle choices (e.g. unhealthy diet, lack of exercise, substance abuse). Initially, the changes in organ function do not affect baseline function; the first manifestations are a reduced capacity of each organ to maintain homeostasis under stress (e.g. illness, like cancer and, injury, like chemotherapy). The cardiovascular, renal and central nervous systems are usually the most vulnerable (the weakest links) [5].


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Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Department of Medical OncologyNational Cancer Institute, IRCCSAviano (PN)Italy

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