With Age, Comes Strength
Cancer – “the Big C.” At one time, older patients
who heard that word interpreted it as a death
sentence. But not anymore. Research is finding that older adults in
some cases actual fare better against the disease than their younger
counterparts. The single greatest risk factor for cancer may be advancing
age but age is not necessarily a disadvantage.
“When I first started talking to people about how to treat
cancer in older patients, it was like talking to walls,” says
Sarah H. Kagan, PhD, RN, The Doris R. Schwartz Assistant Professor
of Gerontological Nursing at the University of Pennsylvania and a
gerontology clinical nurse specialist.
“That was 16 years ago.
Today, there are an increasing number of doctors, nurses and other
clinicians that specialize in gerooncology, or the care of older adults
with cancer. Our goal is not to segregate patients but to ensure they
receive the diagnostic services, treatment and support they need.”
How does cancer treatment differ in older versus younger patients?
In general, older patients are often more resilient
than they or their families expect when faced with a cancer diagnosis.
Further, older adults tolerate the side effects of cancer treatment
better because they often have more life experience dealing with acute
and chronic symptoms.
It’s probably not the first time they have
been sick and, as a result, they tend to know their bodies better,
can more easily identify when something feels right or wrong and possess
the emotional and psychological foundations necessary to deal with
chronic illness. In fact, according to Kagan, there are a number of
strategies older cancer patients can implement when they are initially
diagnosed. These strategies can help capitalize on that reslience
and other sources of strength.
Create a Team
Everyone should have a health care team that fits their needs. This
team can include family members, doctors, nurses, clinicians, and
nutritionists – all of the people who will contribute both
in terms of treatment and support. Every team, of course, needs a
leader. In some cases, as the patient you may want to be the team
leader or you might designate a family member or a doctor or a combination
of both to help you make decisions about your care.
Regardless of how you are making decisions today, be sure to designate
a surrogate decision maker through a living will or durable power
of attorney for health care. This person will be in charge of your
health care when you cannot make decisions yourself so be sure he
or she knows what you want.
Identify Your Needs
What team members are necessary for your treatment? “For example,
many patients don’t add a nutritionist to the team until much
later in the treatment process,” says Kagan.“You really
need a nutritionist with you in the beginning so that he or she
can help develop creative strategies to make good nutrition easy.
It’s better to be proactive with good nutrition than to wait
until a problem develops.”
Find a Buddy
It’s best to have one or two family members or friends attend
every appointment with you. This way you are never alone when dealing
with questions or concerns you may have. In addition, it helps to
have others in the room to help hear and interpret any information
the doctor may provide.
Keep a Log
On a daily basis,write down any symptoms or problems that you may be
having. Identify what troubles you the most and what bothers you the
least. This will enable you to see the progress of your treatment,
will provide a good reservoir of information and can be a source of
questions you may want to ask your doctor, your nurse or other team
“The most important thing to remember,” says Kagan,“is
that cancer is not the only thing you do. Be sure to take time for
yourself and your family. Account for what’s important to you
in your life and note the things that give you contentment. Cancer
is not your whole life.”