The population of Western countries is aging, and cancer in older aged persons is becoming increasingly common. The management of these neoplasms is a novel problem. Direct information on the outcome of cancer prevention and of cytotoxic chemotherapy in older individuals is scarce, especially for those aged 80 and over, and it is not clear whether the same process should direct medical decisions in younger and older persons. It is reasonable to assume that the benefits of cancer prevention and treatment diminish and the dangers increase with age. The expected gains from cancer treatment may be lessened by shorter life expectancy. The risk of therapeutic complications may be increased and the consequences of these complications may become more serious due to limited functional reserve of multiple organ-systems, and fading social support and economic resources. In addition, the biology of cancer may change with the age of the patient, due to a series of events that have been clarified only in part. For example, the prevalence of Multidrug Resistance in Acute Myelogenous Leukemia is much higher for patients over 60, which make the treatment less effective and the risk of treatment-related deaths higher. At the same time, the risk of local recurrence of breast cancer after partial mastectomy declines with age, indicating a more indolent disease
Epidemiology of cancer and aging. 1
Lodovico Balducci and Matti Aapro.
Biological interactions of aging and carcinogenesis. 17
Vladimir N. Anisimov.
Replicative senescence and cancer. 53
Peter J. Hornsby.
The influence of advanced age on cancer occurrence and growth. 75
William B. Ershler.
Age and comorbidity in cancer patients: a population based approach. 89
Maryska L.G. Janssen-Heijnen, Saskia Houterman, Valery E.P.P. Lemmens, Marieke W.J. Louwman, and Jan Willem W. Coebergh.
Hemopoiesis and aging. 109
Lodovico Balducci, Cheryl L. Hardy, and Gary H. Lyman.
Clinical and biochemical evaluation
changes over aging. 135
Angela Abbatecola, B. Gwen Windham, Stefania Bandinelli, Fulvio Lauretani, Giuseppe Paolisso, and Luigi Ferrucci.
Biological screening and impact in elderly cancer patients. 165
Anne-Chantal Braud and MartineExtermann.
Biological basis of the association of cancer and aging comorbidity. 173
Biological basis of cancer in the older person. 189
Claudia Beghe'and Lodovico Balducci.
Decision analysis for cancer prevention and cancer treatment in the elderly. 223
Guidelines for the management of the older. 109
Cancer patient. 233