How Old is too Old to Treat Cancer?


Bob Riter
Bob Riter

The older you are, the more likely it is that you’ll be diagnosed with cancer. The average age at diagnosis is now 66 and it’s increasingly common for people in their late 80s and even older to consider cancer treatment.

Is this a good thing?

I think it’s great when an 85 year old says, “I want to aggressively treat my cancer. Give me chemo, give me whatever.”

But I cringe when the relatives of an 85 year old say, “We want to aggressively treat our father’s cancer. Give him chemo, give him whatever.”

The distinction, of course, is in who’s making the request.

Treatment decisions are based on the likely benefits (e.g., extending one’s life) and the likely costs (e.g., unpleasant side effects) of that treatment. Neither is known with certainty because there is so much individual variation, but doctors can provide some general guidance. They might say, “This treatment is relatively easy to tolerate and may extend your life for a few months, but no one knows for sure.”

It’s then up to the patient to decide if the treatment is worth pursuing. I’m very wary if I sense the family is more interested in aggressive treatment than is the patient. This is sometimes communicated quite subtly, “Oh Dad. I don’t know if Mom can manage without you.”

I also think some people pursue aggressive treatment because they “don’t want to disappoint their doctors.” Please don’t worry about disappointing your doctors. They almost always have one more drug to try and they’re trained to keep trying.

I said I love it when an 85 year old wants to aggressively treat his cancer. I also love it when an 85 year old says, “I’ve had a good life and now I want to focus on the quality of my remaining life. Don’t give me drugs to extend my life if those drugs will make me feel worse.”

And be cautious if deciding on no additional treatment.  Sometimes people say, “No more treatment” when they mean to say, “No more life-extending treatment.” Radiation therapy is often given to reduce pain. Even some surgical procedures and chemotherapy treatments are designed not to extend life, but to provide comfort. Keep these options open.

Physicians and family members should also realize that age is not a good predictor of what others might decide. A few decades ago, some doctors automatically performed mastectomies on older patients with breast cancer (rather than considering less extensive surgery) because they assumed that older women wouldn’t mind losing a breast. A word of advice I freely share with my readers: never, ever make assumptions about anyone else’s body parts.

 

Excerpted with permission from When Your Life is Touched By Cancer: Practical Advice and Insights for Patients, Professionals, and Those Who Care by Bob Riter, copyright (c) 2014, Hunter House Inc., Publishers.