Geriatrics cancers

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Geriatrics Cancers

Geriatrics cancer - SPOC

India is in a phase of demographic transition. With 8.6% of total of 1210 million population being over the age of 65.
Of the total older persons, 8.3 % are males and 9% are females.
Men have 15 times greater risk and women 8 times greater risk in developing cancer than the persons below the age of 65.
23% of all cancers occur in above 65. Cancer related mortality accounts for 15% of all deaths in age more than 65 years.
Ageing is the universal process seen from intrauterine life and continues till death.
Ageing is defined as irreversible structural and functional changes that occur in
Molecular level
Cellular level
Tissue
Organs and
Organ systems level.
Most common cancers seen in elderly are
In men
1. Lung cancer
2. Prostate cancer
Women
1. Breast
2. Cervix
3. Ovary
4. Colorectal
Followed by non-Hodgkin’s lymphomas , gastro intestinal ,liver and kidney cancers.

Lung cancer

Most of patients diagnosed with this cancer is diagnosed with advanced stage of the disease. It has relatively short survival rate if diagnosed in advanced stage. Though outcomes are improving with targeted therapy and immunotherapy in recent times. 30% of all death cancer death is due to lung cancer.
Commonest type of lung cancer is non-small cell lung cancer.
Though, reduced tobacco consumption has reduced the risk, still it is the commonest type in elderly.

Breast cancer

Most common cancer see in women over 65 among all types of cancers
Breast cancer accounts for 28% of all cancers in women. Next to age,
Family history confers highest relative risk.

Early diagnosis with clinical breast examination and annual mammographic screening helps in early diagnosis and treatment.

Cervical cancer

Both incidence and mortality rate increase with age with mortality rate of up to 40 %.
Early diagnosis with simple and effective Pap smear yields successful outcomes

Colorectal cancers

It is seen 6 times higher in > 65 compared to younger population and is seen more frequently in men than women.
Screening program includes
Annual faecal occult blood test and barium colonoscopy and sigmoidoscopy at 10-year intervals are suggested.

Prostate cancer

Most frequently seen cancer in male patients after lung cancer, it is common after the age of 70 years.
Routine digital rectal examination and prostate specific antigen tests are performed from 50 yrs of age.

Non- Hodgkin’s lymphoma
5 th most common cancer in the elderly with 1:46 life time risk. Typically presents with painless , enlarged lymph nodes .

Cancer prophylaxis

1. Maintaining healthy body weight
2. Avoid/minimise meat consumption
3. Daily intake of 2 1/2 cup of vegetable and fruits
4. Avoid alcohol and tobacco.
5. Regular physical activity.
6. Yoga
7. Pranayama

Since mechanisms which control cell proliferation weaken, repair mechanism slows down and cellular destructive changes accumulate along with physiological ageing process, screening process should be performed even in a healthy individual.

Early diagnosis should be the priority to lessen the cancer burden and decrease the mortality.

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