Chapter 63 • The older population continues to expand as a result of reduced mortality and birth rates. Currently 60% of all malignancies occur in persons aged 65 years and older, and this proportion is expected to rise to 70% by the year 2030. Although cancer-related mortality is declining among younger persons, it is increasing among the oldest persons. • It is of special interest that cancer appears to affect mainly older persons who are otherwise healthy and would have lived longer were it not for the cancer. • Carcinogenesis is a time-consuming process, the end-product of which—cancer—is more likely to develop at an advanced age. • Aging is associated with molecular changes that mimic carcinogenesis; older cells are primed to the effects of environmental carcinogens. • Aging is associated with environmental phenomena such as immune senescence or proliferative senescence that favor the development of cancer. • The biology of the tumor cells (e.g., the prevalence of multidrug resistance protein 1 in acute myeloid leukemia increases after age 60 years, causing a worse prognosis). • The aging of the patient: an age-related increase in circulating concentrations of interleukin-6 (IL-6) may favor the growth of lymphomas, whereas hormonal senescence may inhibit the growth of breast cancer. • Aging involves a progressive shortening of life expectancy and reduction in the functional reserve of multiple organ systems. • Personal and social resources to cope with stress may become more limited. • Reduced life expectancy and reduced stress tolerance lessen the benefits and enhance the risks of medical intervention.
Cancer in the Elderly
Biology, Prevention, and Treatment
Summary of Key Points
Epidemiology of Aging and Cancer
Aging and Carcinogenesis
Aging and Cancer Biology
Assessment of the Older Person
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Cancer in the Elderly: Biology, Prevention, and Treatment
