If you are over the age of 65 and have been diagnosed with cancer, you should know that you are not alone. In fact, most people who are diagnosed with cancer and most cancer survivors are older than 65. Because of this, most cancer care teams have experience treating people who are older. This means that they often know how aging can affect cancer and cancer treatment. In some places, there are also specialists who can provide additional help for older adults.
When you are choosing a doctor for your cancer care, you can ask about their experience treating adults over age 65 and about any specific concerns you may have. You may also choose to work with a doctor who specializes in treating older adults.
Your overall health and cancer treatment
Your age is just one of the many factors that your cancer care team considers when planning your treatment. Your overall health is even more informative than just your age. The best cancer treatment plan for you depends on your specific diagnosis, your general health, and any other medical conditions you might have. Your health care team will also consider your lifestyle, your goals, social support, and other factors.
But there are challenges that are more common when you are older. Knowing about these challenges and how they can affect cancer and cancer treatment is important.
Before you begin cancer treatment, your health care team needs to get a complete picture of your overall health. This can include your treatment team learning about:
Your activity levels
Your nutrition and eating habits
If you need help with daily living tasks
Other health issues, called co-existing conditions
Vision or hearing concerns
Cognitive abilities, including memory problems
A history of falls
Your emotional health
Recent hospital stays
The medications you are taking
Your health priorities and treatment goals
Whether you live alone or with others
During one of your first visits with your cancer care team, they will ask you questions and do a physical exam. This is an important part of how they learn about your overall health. Some care centers will also do a special assessment, called a geriatric assessment or GA.
A geriatric assessment is a group of surveys about the factors listed above. They may ask you to complete tasks like walking, balancing and standing. These assessments look for health concerns that happen more frequently over age 65 and that are especially common in adults over 75. Addressing these concerns before treatment can improve health outcomes.
During this visit, your health care team will also want to learn about your co-existing conditions. These are any health conditions that you have in addition to cancer. Many conditions are more common in adults older age 65. These include:
High blood pressure
Co-existing conditions and the medication to treat them can have an important impact on cancer and cancer treatments. Your cancer care team needs to be aware of all medications you are taking, including prescriptions, over-the-counter medications, and any supplements. This is to avoid drug interactions, effects on other conditions, and unwanted side effects. They will also ask how to contact the health care providers who are treating you for those other conditions. Learn more about co-existing conditions and cancer.
How cancer treatment can differ when you are older
Cancer treatment can help people of any age and age should never bee the only factor considered in creating a treatment plan. But it is also known that cancer treatment may be more challenging and complicated for older adults. For example, older adults are more likely to experience serious side effects from treatment.
This is why you, your family, and your doctor should make decisions together about what treatment plan is best. This is called "shared decision making." Some of the common ways cancer treatments can affect older adults are explained below.
Therapies using medication. Medications can be given through the bloodstream to reach cancer cells throughout the body. This is called systemic therapy. These types of treatments affect your whole body. Examples include chemotherapy, hormonal therapy, immunotherapy, and targeted therapy. They all can cause side effects. Older and younger patients have similar responses to systemic therapies on their cancers, but the older you are, the more frequent and difficult the side effects can be. These side effects are often called "toxicities." Other medications you are taking can also affect the type and strength of systemic therapy you can safely take.
Surgery. Surgery and anesthesia, the medicine you are given to block pain during surgery, carry small risks for everyone. But the older you are and the more extensive the surgery is, the more likely you are to experience complications after the surgery. How well your heart, kidneys, liver, and lungs are currently working can affect whether or not surgery is a recommended treatment option. It can also take longer for older people to recover after an operation, which means you may need additional care afterwards.
Radiation therapy. Radiation therapy is often used to lower the risk of cancer returning or to help other treatments like chemotherapy and surgery work better to help prevent recurrence. The side effects a person experiences depend on which part of the body is treated. Depending on your health, your doctor may recommend less intense treatments for a shorter time.
Bone marrow transplantation. This type of treatment is also called a stem cell transplant. It can be an effective treatment for certain cancers that commonly affect this age group, particularly cancers of the blood, but it is higher risk. Learn more about transplantation for adults over age 65.
Understand your treatment options
Before deciding on your cancer treatment, you should know all of your options. Studies show that older adults are not always offered every treatment available. This may be due to concerns about side effects, assuming you want less treatment because of older age, or other reasons. This might mean:
Having fewer tests, such as biopsies, to learn the extent of cancer. A biopsy is when a doctor removes a small sample of tissue and checks it for cancer.
Getting milder treatments or no treatment at all, although several studies have shown that cancer treatment helps older adults as much as younger ones.
Not being invited to join cancer clinical trials. It is important for research studies to include people over age 65 so we can learn what treatments work best for everyone.
No matter your calendar age, you have the right to know all of your treatment options so you can make the best decision with the help of your doctor.
Learn more about how to make the best cancer treatment decisions.
How to stay safe and independent during cancer treatment
Everyone needs extra care when they have cancer. People who are diagnosed with cancer when they are over age 65 might have additional concerns about maintaining their independence and staying safe at home while they are treated for cancer.
There are ways that family, friends, and professionals can help:
Providing transportation to and from appointments
Helping with daily household activities, including personal care
Organizing and managing paperwork, including tracking medical bills
Making sure medications at home are taken on schedule and tracking side effects
Helping with meals, including grocery shopping and meal preparation
Making changes at home to reduce the risk of falls
Providing companionship and other social and emotional support
Arranging for spiritual support
How to pay for cancer care and other costs
Cancer care can be expensive. You might be worried about how to pay for your cancer care and other necessities, like housing, utilities, food, and additional support. Many older adults are on a fixed income and might not have the money to pay for the things they need.
If you are worried about costs, it is okay to talk to your health care team. They can help you understand what costs are covered by your insurance, if they have programs to help you manage the costs of cancer care, and/or can direct you to other organizations that can help with cancer treatment costs.
How to take care of your mental health
At any age, many people have a hard time dealing with the stress and other mental and emotional challenges of cancer. You might have grown up in a time when people did not share their experiences with depression or anxiety. You might also worry about taking medications for it or working with a mental health professional. But taking care of your mental health is just as important as taking care of your physical health.
It is normal to experience emotional challenges when you have cancer. Having anxiety is not just feeling worried and depression is not just feeling sad. They can be serious issues requiring help. Symptoms of these mood disorders can range from mild to severe. When they are severe, they affect your relationships and your day-to-day life. Learn more about how to recognize and treat anxiety and depression.
Resources for People Age 65 and Older with Cancer
Cancer Care Decisions When You're Over 65
How Do Geriatric Assessments Help Older Adults with Cancer?
Cancer and Aging Research Group: Resources for the Older Adult
National Council on Aging: Benefits CheckUp