Skip to main content
SpringerLink
Log in

Cancer in Older Adults

  • Living reference work entry
  • First Online:
Principles and Practice of Geriatric Surgery

  • 168 Accesses

Abstract

The management of cancer, often considered a disease of the elderly, is becoming an increasingly common challenge for surgeons and oncologists caring for older adults. As the geriatric population has grown, so too have opinions and standards as to what constitutes an appropriate treatment approach in the elderly cancer patient. Not surprisingly, oncology treatment regimens in elderly populations have become increasingly individualized. When applying these tailored, treatment paradigms to elderly cancer patients, a crucial consideration is whether the benefits of a proposed cancer treatment outweigh their perceived risks within the context of patients’ residual life expectancy. In some circumstances, optimal implementation of these tailored approaches may require deviation from treatments that would otherwise constitute standard of care in younger patients of similar cancer and stage. As such, a strong working knowledge of the nuances involved in the preoperative assessment of the elderly cancer patient, as well as alternative treatment strategies, is crucial for surgeons caring for these patients to ensure optimal perioperative and postoperative decision-making, care, and outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  1. Bureau UC (2011) The older population: 2010. Available from: https://www.census.gov/prod/cen2010/briefs/c2010br-09.pdf

  2. Chow WB et al (2012) Optimal preoperative assessment of the geriatric surgical patient: a best practices guideline from the American College of Surgeons National Surgical Quality Improvement Program and the American Geriatrics Society. J Am Coll Surg 215(4):453–466

    Article  PubMed  Google Scholar 

  3. NCCN (2016) Older adult oncology (version 2.2016). Available from: https://www.nccn.org/professionals/physician_gls/pdf/senior.pdf

  4. Ginwalla RF, Reiss AD, Sangji NF, Ehlers AP, Ward WH (2016) Exploring the limits of surgeon disclosure: where are the boundaries? Bull Am Coll Surg 101(8):44–49

    Google Scholar 

  5. Armstrong KW et al (2016) Recent trends in surgical research of cancer treatment in the elderly, with a primary focus on lung cancer: presentation at the 2015 annual meeting of SIOG. J Geriatr Oncol 7(5):368–374

    Article  PubMed  Google Scholar 

  6. Korc-Grodzicki B et al (2014) Surgical considerations in older adults with cancer. J Clin Oncol 32(24):2647–2653

    Article  PubMed  Google Scholar 

  7. Epstein AS et al (2016) Discussions of life expectancy and changes in illness understanding in patients with advanced cancer. J Clin Oncol 34(20):2398–2403

    Article  PubMed  PubMed Central  Google Scholar 

  8. Kristjansson SR et al (2010) Comprehensive geriatric assessment can predict complications in elderly patients after elective surgery for colorectal cancer: a prospective observational cohort study. Crit Rev Oncol Hematol 76(3):208–217

    Article  PubMed  Google Scholar 

  9. Fleischmann KE et al (2009) 2009 ACCF/AHA focused update on perioperative beta blockade. J Am Coll Cardiol 54(22):2102–2128

    Article  PubMed  Google Scholar 

  10. Devereaux PJ et al (2005) Perioperative cardiac events in patients undergoing noncardiac surgery: a review of the magnitude of the problem, the pathophysiology of the events and methods to estimate and communicate risk. CMAJ 173(6):627–634

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Corrada MM et al (2008) Prevalence of dementia after age 90: results from the 90+ study. Neurology 71(5):337–343

    Article  CAS  PubMed  Google Scholar 

  12. McGory ML et al (2009) Developing quality indicators for elderly surgical patients. Ann Surg 250(2):338–347

    Article  PubMed  Google Scholar 

  13. Steffens DC et al (2009) Prevalence of depression among older Americans: the aging, demographics and memory study. Int Psychogeriatr 21(5):879–888

    Article  PubMed  PubMed Central  Google Scholar 

  14. Li C et al (2007) Validity of the patient health questionnaire 2 (PHQ-2) in identifying major depression in older people. J Am Geriatr Soc 55(4):596–602

    Article  PubMed  Google Scholar 

  15. Hinkin CH et al (2001) Screening for drug and alcohol abuse among older adults using a modified version of the CAGE. Am J Addict 10(4):319–326

    Article  CAS  PubMed  Google Scholar 

  16. Berks J, McCormick R (2008) Screening for alcohol misuse in elderly primary care patients: a systematic literature review. Int Psychogeriatr 20(6):1090–1103

    Article  PubMed  Google Scholar 

  17. Dasgupta M, Dumbrell AC (2006) Preoperative risk assessment for delirium after noncardiac surgery: a systematic review. J Am Geriatr Soc 54(10):1578–1589

    Article  PubMed  Google Scholar 

  18. Ansaloni L et al (2010) Risk factors and incidence of postoperative delirium in elderly patients after elective and emergency surgery. Br J Surg 97(2):273–280

    Article  CAS  PubMed  Google Scholar 

  19. Marcantonio ER et al (1994) A clinical prediction rule for delirium after elective noncardiac surgery. JAMA 271(2):134–139

    Article  CAS  PubMed  Google Scholar 

  20. Robinson TN et al (2009) Postoperative delirium in the elderly: risk factors and outcomes. Ann Surg 249(1):173–178

    Article  PubMed  Google Scholar 

  21. Fried LP et al (2001) Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 56(3):M146–M156

    Article  CAS  PubMed  Google Scholar 

  22. Fried LP et al (2004) Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci 59(3):255–263

    Article  PubMed  Google Scholar 

  23. Makary MA et al (2010) Frailty as a predictor of surgical outcomes in older patients. J Am Coll Surg 210(6):901–908

    Article  PubMed  Google Scholar 

  24. Robinson TN et al (2009) Redefining geriatric preoperative assessment using frailty, disability and co-morbidity. Ann Surg 250(3):449–455

    PubMed  Google Scholar 

  25. Robinson TN et al (2011) Accumulated frailty characteristics predict postoperative discharge institutionalization in the geriatric patient. J Am Coll Surg 213(1):37–42; discussion 42–44

    Article  PubMed  PubMed Central  Google Scholar 

  26. Schiesser M et al (2009) The correlation of nutrition risk index, nutrition risk score, and bioimpedance analysis with postoperative complications in patients undergoing gastrointestinal surgery. Surgery 145(5):519–526

    Article  PubMed  Google Scholar 

  27. Kaiser MJ et al (2010) Frequency of malnutrition in older adults: a multinational perspective using the mini nutritional assessment. J Am Geriatr Soc 58(9):1734–1738

    Article  PubMed  Google Scholar 

  28. Tomaka J, Thompson S, Palacios R (2006) The relation of social isolation, loneliness, and social support to disease outcomes among the elderly. J Aging Health 18(3):359–384

    Article  PubMed  Google Scholar 

  29. Moran J et al (2016) The ability of prehabilitation to influence postoperative outcome after intra-abdominal operation: a systematic review and meta-analysis. Surgery 160(5):1189–1201

    Article  PubMed  Google Scholar 

  30. Yun JA et al (2014) The role of palliative resection for asymptomatic primary tumor in patients with unresectable stage IV colorectal cancer. Dis Colon Rectum 57(9):1049–1058

    Article  PubMed  Google Scholar 

  31. Folkert IW, Roses RE (2016) Value in palliative cancer surgery: a critical assessment. J Surg Oncol 114(3):311–315

    Article  PubMed  Google Scholar 

  32. Silver JK et al (2015) Cancer rehabilitation and palliative care: critical components in the delivery of high-quality oncology services. Support Care Cancer 23(12):3633–3643

    Article  PubMed  Google Scholar 

  33. Stubblefield MD et al (2013) Current perspectives and emerging issues on cancer rehabilitation. Cancer 119(Suppl 11):2170–2178

    Article  PubMed  Google Scholar 

  34. Donato V, Valeriani M, Zurlo A (2003) Short course radiation therapy for elderly cancer patients. Evidences from the literature review. Crit Rev Oncol Hematol 45(3):305–311

    Article  PubMed  Google Scholar 

  35. Kunkler IH et al (2014) Review of current best practice and priorities for research in radiation oncology for elderly patients with cancer: the International Society of Geriatric Oncology (SIOG) task force. Ann Oncol 25(11):2134–2146

    Article  CAS  PubMed  Google Scholar 

  36. Hernandez L et al (2015) Aging and radiation: bad companions. Aging Cell 14(2):153–161

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Choi Y et al (2016) Preoperative chemoradiotherapy for elderly patients with locally advanced rectal cancer-a real-world outcome study. Jpn J Clin Oncol 46(12):1108–1117

    PubMed  Google Scholar 

  38. Wasil T et al (2000) Radiation therapy in cancer patients 80 years of age and older. Am J Clin Oncol 23(5):526–530

    Article  CAS  PubMed  Google Scholar 

  39. Zachariah B et al (1997) Radiotherapy for cancer patients aged 80 and older: a study of effectiveness and side effects. Int J Radiat Oncol Biol Phys 39(5):1125–1129

    Article  CAS  PubMed  Google Scholar 

  40. Mitsuhashi N et al (1999) Cancer in patients aged 90 years or older: radiation therapy. Radiology 211(3):829–833

    Article  CAS  PubMed  Google Scholar 

  41. Smith GL, Smith BD (2014) Radiation treatment in older patients: a framework for clinical decision making. J Clin Oncol 32(24):2669–2678

    Article  PubMed  PubMed Central  Google Scholar 

  42. Ortman JM, Velkoff VA, Hogan H (2014) An aging nation: the older population in the US., U.S.D.o.C.E.a.S.A.U.S.C. BUREAU, Editor

    Google Scholar 

  43. Vijayvergia N et al (2016) Chemotherapy use and adoption of new agents is affected by age and comorbidities in patients with metastatic colorectal cancer. Cancer 122(20):3191–3198

    Article  PubMed  PubMed Central  Google Scholar 

  44. Hurria A et al (2015) Improving the evidence base for treating older adults with cancer: american society of clinical oncology statement. J Clin Oncol 33(32):3826–3833

    Article  PubMed  Google Scholar 

  45. Hutchins LF et al (1999) Underrepresentation of patients 65 years of age or older in cancer-treatment trials. N Engl J Med 341(27):2061–2067

    Article  CAS  PubMed  Google Scholar 

  46. Freedman RA et al (2016) Accrual of older patients with breast cancer to alliance systemic therapy trials over time: protocol A151527. J Clin Oncol 35(4):421–431, p JCO2016694182

    Article  PubMed  Google Scholar 

  47. Cunningham D et al (2013) Bevacizumab (bev) in combination with capecitabine (cape) for the first-line treatment of elderly patients with metastatic colorectal cancer (mCRC): results of a randomized international phase III trial (AVEX). J Clin Oncol 30(Suppl 34):337

    Article  Google Scholar 

  48. Meropol NJ et al (2008) Cancer patient preferences for quality and length of life. Cancer 113(12):3459–3466

    Article  PubMed  PubMed Central  Google Scholar 

  49. Centers for disease control and prevention: healthy aging: helping people to live long and productive lives and enjoy a good quality of life. http://stacks.cdc.gov/view/cdc/6114

  50. Maggiore RJ, Gross CP, Hurria A (2010) Polypharmacy in older adults with cancer. Oncologist 15(5):507–522

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  51. Riechelmann RP et al (2005) Potential for drug interactions in hospitalized cancer patients. Cancer Chemother Pharmacol 56(3):286–290

    Article  PubMed  Google Scholar 

  52. Turner JP et al (2016) Polypharmacy cut-points in older people with cancer: how many medications are too many? Support Care Cancer 24(4):1831–1840

    Article  PubMed  Google Scholar 

  53. Peterson LL et al (2016) Association between renal function and chemotherapy-related toxicity in older adults with cancer. J Geriatr Oncol 8(2):96–101

    Article  PubMed  Google Scholar 

  54. Balducci L, Repetto L (2004) Increased risk of myelotoxicity in elderly patients with non-Hodgkin lymphoma. Cancer 100(1):6–11

    Article  PubMed  Google Scholar 

  55. Crivellari D (2002) Results of adjuvant treatments in breast cancer patients over 70 years old: the IBCSG experience. International breast cancer study group. Tumori 88(1 Suppl 1):S81–S82

    PubMed  Google Scholar 

  56. Langer CJ et al (2002) Cisplatin-based therapy for elderly patients with advanced non-small-cell lung cancer: implications of eastern cooperative oncology group 5592, a randomized trial. J Natl Cancer Inst 94(3):173–181

    Article  PubMed  Google Scholar 

  57. Lyman GH et al (2003) Evidence-based use of colony-stimulating factors in elderly cancer patients. Cancer Control 10(6):487–499

    Article  PubMed  Google Scholar 

  58. Rivera E et al (2003) Targeted filgrastim support in patients with early-stage breast carcinoma: toward the implementation of a risk model. Cancer 98(2):222–228

    Article  PubMed  Google Scholar 

  59. Lyman GH, Kuderer NM, Djulbegovic B (2002) Prophylactic granulocyte colony-stimulating factor in patients receiving dose-intensive cancer chemotherapy: a meta-analysis. Am J Med 112(5):406–411

    Article  CAS  PubMed  Google Scholar 

  60. Smith TJ et al (2006) 2006 update of recommendations for the use of white blood cell growth factors: an evidence-based clinical practice guideline. J Clin Oncol 24(19):3187–3205

    Article  CAS  PubMed  Google Scholar 

  61. Aapro MS et al (2011) 2010 update of EORTC guidelines for the use of granulocyte-colony stimulating factor to reduce the incidence of chemotherapy-induced febrile neutropenia in adult patients with lymphoproliferative disorders and solid tumours. Eur J Cancer 47(1):8–32

    Article  CAS  PubMed  Google Scholar 

  62. Kelly CM, Power DG, Lichtman SM (2014) Targeted therapy in older patients with solid tumors. J Clin Oncol 32(24):2635–2646

    Article  CAS  PubMed  Google Scholar 

  63. Rosell R et al (2012) Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutation-positive non-small-cell lung cancer (EURTAC): a multicentre, open-label, randomised phase 3 trial. Lancet Oncol 13(3):239–246

    Article  CAS  PubMed  Google Scholar 

  64. Cardinale D et al (2010) Trastuzumab-induced cardiotoxicity: clinical and prognostic implications of troponin I evaluation. J Clin Oncol 28(25):3910–3916

    Article  CAS  PubMed  Google Scholar 

  65. Solana R et al (2012) Innate immunosenescence: effect of aging on cells and receptors of the innate immune system in humans. Semin Immunol 24(5):331–341

    Article  CAS  PubMed  Google Scholar 

  66. Nishijima TF et al (2016) Comparison of efficacy of immune checkpoint inhibitors (ICIs) between younger and older patients: a systematic review and meta-analysis. Cancer Treat Rev 45:30–37

    Article  CAS  PubMed  Google Scholar 

  67. Chiarion Sileni V et al (2014) Efficacy and safety of ipilimumab in elderly patients with pretreated advanced melanoma treated at Italian centres through the expanded access programme. J Exp Clin Cancer Res 33:30

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  68. Helissey C, Vicier C, Champiat S (2016) The development of immunotherapy in older adults: new treatments, new toxicities? J Geriatr Oncol 7(5):325–333

    Article  PubMed  Google Scholar 

  69. Puts MT et al (2014) Factors influencing adherence to cancer treatment in older adults with cancer: a systematic review. Ann Oncol 25(3):564–577

    Article  CAS  PubMed  Google Scholar 

  70. VanderWalde N et al (2016) NCCN guidelines insights: older adult oncology, version 2.2016. J Natl Compr Cancer Netw 14(11):1357–1370

    Article  Google Scholar 

  71. Decoster L et al (2013) The influence of clinical assessment (including age) and geriatric assessment on treatment decisions in older patients with cancer. J Geriatr Oncol 4(3):235–241

    Article  PubMed  Google Scholar 

  72. Luciani A et al (2010) Detecting disabilities in older patients with cancer: comparison between comprehensive geriatric assessment and vulnerable elders survey-13. J Clin Oncol 28(12):2046–2050

    Article  PubMed  Google Scholar 

  73. Soubeyran P et al (2014) Screening for vulnerability in older cancer patients: the ONCODAGE prospective Multicenter cohort study. PLoS One 9(12):e115060

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  74. Hurria A et al (2011) Implementing a geriatric assessment in cooperative group clinical cancer trials: CALGB 360401. J Clin Oncol 29(10):1290–1296

    Article  PubMed  PubMed Central  Google Scholar 

  75. Extermann M et al (2010) The chemotherapy risk assessment scale for high-age patients (CRASH) score: design and validation. J Clin Oncol 28(7S):9000

    Article  Google Scholar 

  76. Hurria A et al (2016) Validation of a prediction tool for chemotherapy toxicity in older adults with cancer. J Clin Oncol 34(20):2366–2371

    Article  PubMed  PubMed Central  Google Scholar 

  77. Hurria A et al (2011) Predicting chemotherapy toxicity in older adults with cancer: a prospective multicenter study. J Clin Oncol 29(25):3457–3465

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  78. McCleary NJ et al (2013) Feasibility of computer-based self-administered cancer-specific geriatric assessment in older patients with gastrointestinal malignancy. Oncologist 18(1):64–72

    Article  PubMed  PubMed Central  Google Scholar 

  79. Diab SG, Elledge RM, Clark GM (2000) Tumor characteristics and clinical outcome of elderly women with breast cancer. J Natl Cancer Inst 92(7):550–556

    Article  CAS  PubMed  Google Scholar 

  80. Giuliano AE et al (2011) Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis: a randomized clinical trial. JAMA 305(6):569–575

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  81. Kunkler IH et al (2015) Breast-conserving surgery with or without irradiation in women aged 65 years or older with early breast cancer (PRIME II): a randomised controlled trial. Lancet Oncol 16(3):266–273

    Article  PubMed  Google Scholar 

  82. Muss HB et al (2009) Adjuvant chemotherapy in older women with early-stage breast cancer. N Engl J Med 360(20):2055–2065

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  83. Peto R et al (2012) Comparisons between different polychemotherapy regimens for early breast cancer: meta-analyses of long-term outcome among 100,000 women in 123 randomised trials. Lancet 379(9814):432–444

    Article  CAS  PubMed  Google Scholar 

  84. Ishida T et al (1990) Long-term results of operation for non-small cell lung cancer in the elderly. Ann Thorac Surg 50(6):919–922

    Article  CAS  PubMed  Google Scholar 

  85. Palma D et al (2011) Treatment of stage I NSCLC in elderly patients: a population-based matched-pair comparison of stereotactic radiotherapy versus surgery. Radiother Oncol 101(2):240–244

    Article  PubMed  Google Scholar 

  86. Mizushima Y et al (1997) Survival and prognosis after pneumonectomy for lung cancer in the elderly. Ann Thorac Surg 64(1):193–198

    Article  CAS  PubMed  Google Scholar 

  87. Schild SE et al (2003) The outcome of combined-modality therapy for stage III non-small-cell lung cancer in the elderly. J Clin Oncol 21(17):3201–3206

    Article  CAS  PubMed  Google Scholar 

  88. Gridelli C (2001) The ELVIS trial: a phase III study of single-agent vinorelbine as first-line treatment in elderly patients with advanced non-small cell lung cancer. Elderly lung cancer Vinorelbine Italian study. Oncologist 6(Suppl 1):4–7

    Article  CAS  PubMed  Google Scholar 

  89. Frasci G et al (2001) Gemcitabine plus vinorelbine yields better survival outcome than vinorelbine alone in elderly patients with advanced non-small cell lung cancer. A southern Italy cooperative oncology group (SICOG) phase III trial. Lung Cancer 34(Suppl 4):S65–S69

    Article  PubMed  Google Scholar 

  90. Gridelli C et al (2003) Chemotherapy for elderly patients with advanced non-small-cell lung cancer: the Multicenter Italian lung cancer in the elderly study (MILES) phase III randomized trial. J Natl Cancer Inst 95(5):362–372

    Article  CAS  PubMed  Google Scholar 

  91. Yuen AR et al (2000) Similar outcome of elderly patients in intergroup trial 0096: cisplatin, etoposide, and thoracic radiotherapy administered once or twice daily in limited stage small cell lung carcinoma. Cancer 89(9):1953–1960

    Article  CAS  PubMed  Google Scholar 

  92. Schild SE et al (2005) Results of combined-modality therapy for limited-stage small cell lung carcinoma in the elderly. Cancer 103(11):2349–2354

    Article  PubMed  Google Scholar 

  93. Ardizzoni A et al (2005) Platinum-etoposide chemotherapy in elderly patients with small-cell lung cancer: results of a randomized multicenter phase II study assessing attenuated-dose or full-dose with lenograstim prophylaxis–a Forza Operativa Nazionale Italiana carcinoma Polmonare and Gruppo studio Tumori Polmonari Veneto (FONICAP-GSTPV) study. J Clin Oncol 23(3):569–575

    Article  CAS  PubMed  Google Scholar 

  94. Rossi A et al (2012) Carboplatin- or cisplatin-based chemotherapy in first-line treatment of small-cell lung cancer: the COCIS meta-analysis of individual patient data. J Clin Oncol 30(14):1692–1698

    Article  CAS  PubMed  Google Scholar 

  95. Adam R et al (2010) Liver resection of colorectal metastases in elderly patients. Br J Surg 97(3):366–376

    Article  CAS  PubMed  Google Scholar 

  96. Rutten H et al (2007) Survival of elderly rectal cancer patients not improved: analysis of population based data on the impact of TME surgery. Eur J Cancer 43(15):2295–2300

    Article  PubMed  Google Scholar 

  97. Garcia-Aguilar J et al (2015) Organ preservation for clinical T2N0 distal rectal cancer using neoadjuvant chemoradiotherapy and local excision (ACOSOG Z6041): results of an open-label, single-arm, multi-institutional, phase 2 trial. Lancet Oncol 16(15):1537–1546

    Article  PubMed  PubMed Central  Google Scholar 

  98. Habr-Gama A et al (2017) Management of the complete clinical response. Clin Colon Rectal Surg 30(5):387–394

    Article  PubMed  Google Scholar 

  99. Habr-Gama A, Perez RO (2009) Non-operative management of rectal cancer after neoadjuvant chemoradiation. Br J Surg 96(2):125–127

    Article  CAS  PubMed  Google Scholar 

  100. Folprecht G et al (2004) Efficacy of 5-fluorouracil-based chemotherapy in elderly patients with metastatic colorectal cancer: a pooled analysis of clinical trials. Ann Oncol 15(9):1330–1338

    Article  CAS  PubMed  Google Scholar 

  101. Cassidy J et al (2010) Effect of bevacizumab in older patients with metastatic colorectal cancer: pooled analysis of four randomized studies. J Cancer Res Clin Oncol 136(5):737–743

    Article  CAS  PubMed  Google Scholar 

  102. Kozloff MF et al (2010) Clinical outcomes in elderly patients with metastatic colorectal cancer receiving bevacizumab and chemotherapy: results from the BRiTE observational cohort study. Oncology 78(5–6):329–339

    Article  CAS  PubMed  Google Scholar 

  103. Sastre J et al (2011) First-line single-agent cetuximab in elderly patients with metastatic colorectal cancer. A phase II clinical and molecular study of the Spanish group for digestive tumor therapy (TTD). Crit Rev Oncol Hematol 77(1):78–84

    Article  CAS  PubMed  Google Scholar 

  104. Kozyreva ON et al (2011) A multicenter retrospective study on clinical characteristics, treatment patterns, and outcome in elderly patients with hepatocellular carcinoma. Oncologist 16(3):310–318

    Article  PubMed  PubMed Central  Google Scholar 

  105. Wong H et al (2011) The outcomes and safety of single-agent sorafenib in the treatment of elderly patients with advanced hepatocellular carcinoma (HCC). Oncologist 16(12):1721–1728

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  106. D’Amico AV et al (2008) Androgen suppression and radiation vs radiation alone for prostate cancer: a randomized trial. JAMA 299(3):289–295

    Article  PubMed  Google Scholar 

  107. Ehdaie B et al (2012) Androgen deprivation and thromboembolic events in men with prostate cancer. Cancer 118(13):3397–3406

    Article  CAS  PubMed  Google Scholar 

  108. Denham JW et al (2011) Short-term neoadjuvant androgen deprivation and radiotherapy for locally advanced prostate cancer: 10-year data from the TROG 96.01 randomised trial. Lancet Oncol 12(5):451–459

    Article  CAS  PubMed  Google Scholar 

  109. Chamie K et al (2008) Cystectomy in the elderly: does the survival benefit in younger patients translate to the octogenarians? BJU Int 102(3):284–290

    Article  PubMed  Google Scholar 

  110. Grossman HB et al (2003) Neoadjuvant chemotherapy plus cystectomy compared with cystectomy alone for locally advanced bladder cancer. N Engl J Med 349(9):859–866

    Article  CAS  PubMed  Google Scholar 

  111. Joudi FN et al (2006) The impact of age on the response of patients with superficial bladder cancer to intravesical immunotherapy. J Urol 175(5):1634–1639; discussion 1639–1640

    Article  PubMed  Google Scholar 

  112. Fairfield KM et al (2011) Completion of adjuvant chemotherapy and use of health services for older women with epithelial ovarian cancer. J Clin Oncol 29(29):3921–3926

    Article  PubMed  Google Scholar 

  113. Petignat P et al (2004) Poorer survival of elderly patients with ovarian cancer: a population-based study. Surg Oncol 13(4):181–186

    Article  CAS  PubMed  Google Scholar 

  114. Hilpert F et al (2007) Feasibility, toxicity and quality of life of first-line chemotherapy with platinum/paclitaxel in elderly patients aged >or=70 years with advanced ovarian cancer–a study by the AGO OVAR Germany. Ann Oncol 18(2):282–287

    Article  CAS  PubMed  Google Scholar 

  115. Kothari R et al (2010) The effect of age on the tolerability of intraperitoneal chemotherapy, complication rate, and survival in patients with ovarian cancer. Gynecol Oncol 119(3):491–495

    Article  PubMed  Google Scholar 

  116. NCCN (2016) NCCN clinical practice guidelines in oncology. Melanoma V. 1.2017. NCCN, Fort Washington

    Google Scholar 

  117. Hodi FS et al (2010) Improved survival with ipilimumab in patients with metastatic melanoma. N Engl J Med 363(8):711–723

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  118. Hodi FS et al (2014) Ipilimumab plus sargramostim vs ipilimumab alone for treatment of metastatic melanoma: a randomized clinical trial. JAMA 312(17):1744–1753

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  119. Chapman PB et al (2011) Improved survival with vemurafenib in melanoma with BRAF V600E mutation. N Engl J Med 364(26):2507–2516

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  120. Flaherty KT et al (2012) Improved survival with MEK inhibition in BRAF-mutated melanoma. N Engl J Med 367(2):107–114

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Departments of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA

    William H. Ward & Nestor F. Esnaola

  2. Medical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA

    Efrat Dotan

  3. Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA

    Joshua E. Meyer

Authors
  1. William H. Ward
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Efrat Dotan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Joshua E. Meyer
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nestor F. Esnaola
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nestor F. Esnaola .

Editor information

Editors and Affiliations

  1. Surgical Service, Yale University School of Medicine VA Connecticut Health Care System, West Haven, Connecticut, USA

    Ronnie A. Rosenthal

  2. SUNY Downstate School of Public Health, National Capital Region Johns Hopkins Medicine, Bethesda, Maryland, USA

    Michael E. Zenilman

  3. Center for Geriatric Surgery, Sinai Hospital of Baltimore, Baltimore, Maryland, USA

    Mark R. Katlic

Section Editor information

  1. Department of Surgery, David Geffen School of Medicine at the University of California, Los Angeles, CA, USA

    Marcia McGory Russell

  2. Ariadne Labs, Boston, MA, USA

    Zara Cooper

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing Switzerland

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Ward, W.H., Dotan, E., Meyer, J.E., Esnaola, N.F. (2018). Cancer in Older Adults. In: Rosenthal, R., Zenilman, M., Katlic, M. (eds) Principles and Practice of Geriatric Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-20317-1_13-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-20317-1_13-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-20317-1

  • Online ISBN: 978-3-319-20317-1

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation