Cancer in the Elderly
Facts You Should Know
Cancer is common among the elderly. As the population ages, seniors are at greater risk for getting the disease even if they don’t have a family history. There are several reasons why this is true. Some cancers are hereditary and others are caused by long-term exposure to cancer-causing substances, like those in tobacco smoke.
Cancer also becomes more likely as you get older and everyday damage to your cells and genes accumulates. Even though our bodies work to restore and manage the damage, the cells may become abnormal and replicate, causing a mass of tissue known as a “growth tumor.” If that tumor continues to grow it can harm nearby organs and tissues sending cancer cells to other parts of your body.
Cancer has a wide range of symptoms. Here are some of the more notable ones for which to be on the lookout:
- A thickening or lump in your body, typically found in women
- A new mole or a change in an existing one
- A sore that won’t heal
- Hoarseness or a persistent cough
- Changes in your bowel or bladder habits
- Difficulty swallowing
- Discomfort after you eat
- Unexplained weight gain or loss
- Unusual bleeding or discharge
- Weakness or fatigue
These symptoms are not always linked to cancer. That is why it’s important to check with your physician if you experience any of these or observe changes in your physical or mental health.
Many doctors encourage their elderly patients to be screened regularly for cancer. This may include a physical examination, laboratory tests and other examinations to check your internal organs. Prior to suggesting a screening test your physician will want to know your age, past medical issues, family medical history, overall health and lifestyle.
The following tests check for specific cancers and are recommended for those over 50, which a number of are now covered by Medicare:
Breast Cancer is the most common cancer in women and their risk for developing it increases with age. While not as prevalent, men can develop breast cancer too. It typically strikes those between ages 60 and 70.
Clinical Breast Exam: A doctor or health care professional will examine your breasts and underarms for lumps or other changes that may suggest breast cancer.
Mammogram: This special breast x-ray frequently detects cancers too small for you or your doctor to feel. The National Cancer Institute (NCI) recommends women over 50 have a mammogram every one to two years.
Cervical Cancer is caused by a virus called the human papilloma virus (HPV), which can stay in your body for years.
Pap Test: Your doctor will gently scrape cells from your cervix and vagina and send them to the laboratory to see if they are abnormal. Women should have this test every three years.
Pelvic Exam: During a pelvic exam your physician checks your vulva, vagina, cervix, uterus, rectum and pelvis, including your ovaries, for masses, growths or other abnormalities. Typically performed during your routine checkup, it may be done if you are having unusual vaginal discharge or pelvic pain.
Colorectal Cancer is the fourth most common cancer in men and women in the United States. If detected early it is often curable. Generally found in those over 50, your risk increases with age. You are also more likely to develop colorectal cancer if you have polyps (growths inside your colon and rectum that may become cancerous), a high-fat diet, a family history or personal history of colorectal cancer, ulcerative colitis or Crohn’s disease.
A fecal occult blood test, or FOBT, checks for hidden blood in your stool. Sometimes cancers or polyps can bleed and an FOBT can detect small amounts of bleeding.
A sigmoidoscopy uses a lighted instrument called a sigmoidoscope to examine your rectum and lower colon or sigmoid colon.
A colonoscopy examines your rectum and entire colon using a lighted instrument called a colonoscope. This is considered the gold-standard exam for colorectal cancer.
A virtual colonoscopy, which requires the same preparation as a standard colonoscopy, uses an external scanning machine instead of a device that is inserted into your colon. The colon must be inflated with gas for proper scanning.
A digital rectal exam, or DRE, calls for your doctor to insert a lubricated, gloved finger into your rectum to feel for abnormal areas.
Prostate Cancer is the most commonly diagnosed cancer in American men. It results from the uncontrollable growth of abnormal cells in the prostate gland. When cells in the prostate are malignant, they cluster together to form small “islands” of cancer. In many cases it takes years for the cancer to spread and often times it does not. This type of cancer typically grows slowly and occurs mainly in older men. Nearly two-thirds of the cases are diagnosed in men aged 65 or older and it is rare before age 40. The average age at the time of diagnosis is about 67.
Prostate-specific antigen (PSA) blood test is the most common screen for prostate cancer. It is recommended for men between 40 and 75 and those with an increased risk of prostate cancer.
Digital rectal exam (DRE) requires your doctor to feel part of your prostate through the rectal wall. Any swelling or enlargements, firm spots or lumps may suggest cancer. If cancer is suspected, your physician will order a biopsy to remove a small sample of your prostate tissue. If the results are positive additional tests may be performed to determine if the cancer has spread.
Skin Cancer is the most common type of cancer in America. The only way to accurately detect this type of cancer is to perform a biopsy. A small piece of tissue is taken from the suspected area and then viewed under a microscope to determine if the cells are cancerous.
When cancer is detected early there is a greater chance that your treatment will be effective. Early treatment can shrink or eliminate a tumor while keeping it from growing and spreading. In the case of the elderly, how they are treated may depend more on their overall health and quality of life than their age. These are some common treatment methods:
Radiation therapy shrinks tumors and kills cancer cells. X-rays, gamma rays and charged particles are types of radiation used for treating cancer. It may be used as an initial treatment method if your cancer is contained, hasn’t been completely removed or has returned following surgery. In advanced cases radiation is used to shrink the tumor and alleviate symptoms. Radiation therapy may be used alone or in combination with surgery, chemotherapy or both. Possible side effects of radiation are diarrhea, urinary incontinence, blood in the urine, rectal bleeding and pain, fatigue and erectile dysfunction.
Chemotherapy is generally used when the cancer is advanced. It uses drugs to destroy the cancerous cells. Side effects may include low blood cell count, hair loss, decreased appetite, nausea, vomiting, diarrhea, mouth and lip sores and fatigue.
Cancer surgery is performed to repair or remove a part of your body to diagnose or treat cancer and to relieve your symptoms. It may be used in conjunction with radiation, chemotherapy, hormone therapy and/or biological therapy.
Hormone therapy may help kill cancer cells, slow their growth or prevent them from growing. You may have to take medications that interfere with hormone activity or halt their production.
Biological therapy (also known as immunotherapy, biotherapy or biological response modifier therapy) is a relatively new cancer treatment. It uses your body’s immune system, directly or indirectly, to fight cancer or reduce the side effects of some treatments.
It is estimated that nearly two-thirds of cancers are caused by factors beyond our control. Here are some things you can do to lower your risk:
- Avoid tobacco products
- Limit your alcohol consumption
- Restrict your exposure to sunlight
- Maintain a healthy diet, lifestyle and weight
- Get plenty of exercise
- Get immunized
- Take early detection seriously
Here is a list of helpful resources for more information on cancer and the elderly.
American Cancer Society
National Cancer Institute
Cancer Information Service
Visit the National Institute on Aging and the National Library of Medicine’s senior-friendly website for more health information for older adults. The site’s special features allow you to click on a button to have the text read out loud or to enlarge the type.
Written by home care expert Mary S. Yamin-Garone.