Carter diagnosis puts spotlight on cancer treatment for elderly


By Susan Hartley



PITTSBURGH, Pa. — Aging puts you at increasingly greater odds of getting cancer, a reality highlighted this week by former President Jimmy Carter’s disclosure that he has the disease.

But age alone doesn’t always dictate how well cancer treatment works, experts say.

The diagnosis of Carter, who is 90, spotlights various methods for treating cancer in the elderly, ranging from chemotherapy and radiation to medication and surgery. Those options depend on a patient’s mental capacity, physical strength and support system, cancer specialists said.

“How the patient functions in life is much more important than their biological age,” said Dr. Gijsberta van Londen, oncologist and geriatrician at UPMC CancerCenter. “Some people at age 50 function at a lower level than others at age 80. We can’t automatically think that a 90-year-old person cannot tolerate treatment, because sometimes they can.”

The liver is often a place to which cancer spreads and less commonly is the primary source of it.

Factors considered by cancer doctors include a patient’s organ function, muscle strength and diet, along with cancer type.

When possible, van Londen said, she recommends a preparation period, ranging from days to months, for elderly patients undergoing chemotherapy to build strength through physical therapy and dietary improvements.

“Chemotherapy makes almost everybody weak and tired,” she said. “For an older person, building up strength to tolerate the treatment is very important. Obviously, sometimes the cancer is aggressive and the patient can’t afford to wait.”

In previous decades, Lichtenfeld said, treating cancer in the elderly was almost unheard of. Now, it’s not uncommon.

“Doctors no longer look at years in the calendar, they look at the person sitting in front of them,” he said. “Nowadays, there are some treatments with side effects that aren’t as severe.”

Dr. David Parda, chairman of the Allegheny Health Network Cancer Institute, agreed.

“You don’t want to discriminate against someone because of their age,” he said. “Overall, what we’re trying to do with a 30-year-old is no different than a 90-year-old: The goal is to administer the least amount of treatment to get the maximal possible outcomes in terms of cancer control and maximizing quality of life.”

While news of Carter’s cancer is unfortunate, elderly cancer awareness could be a positive offshoot, Parda said.

“We’ve got an aging population, and we’re living longer, and these are the types of cancer patients we are going to be treating more and more,” he said. “We’ve got to get better at it, and we’ve got to learn more about it.”

Two out of three Americans diagnosed with cancers are now living five years or longer, according to the American Cancer Society.

Parda said studies indicate the number of new annual cancer cases is expected to increase over the next five years from 1.6 million nationally to 2.3 million. He attributed the rise to people living longer along with unhealthy lifestyles and obesity.

When treatments like chemotherapy are ineffective or ravage the body, the decision to halt it is often a personal one.

“Deciding when enough is enough varies from person to person and family to family,” van Londen said. “There’s not a one size fits all with the elderly or a golden standard that I can point to.”

By Susan Hartley

Ben Schmitt is a staff writer for Trib Total Media. He can be reached at 412-320-7991 or bschmitt@tribweb.com. The Associated Press contributed to this report.

Ben Schmitt is a staff writer for Trib Total Media. He can be reached at 412-320-7991 or bschmitt@tribweb.com. The Associated Press contributed to this report.