In a study of more than 20,000 patients 65 and older with non–small cell lung cancer (NSCLC), treatment rates declined more in relation with increasing age than with the worsening of other illnesses.
The study, led by a team at the San Francisco VA Medical Center (SFVAMC) and University of California San Francisco (UCSF), found that for all stages of cancer, younger patients were more apt to receive treatment than older patients, regardless of general health and prognosis.
Researchers analyzed the VA Central Cancer Registry electronic health records of 20,511 patients aged 65 and older between 2003 and 2008. The study was published May 1 in the Journal of Clinical Oncology.
Study results showed patients aged 65 to 74 and severely ill from other illnesses received treatment at approximately the same rate as patients in the same age range with no comorbidities. Treatment of these patients took place even though they were less likely to benefit and more likely to be harmed from cancer treatment. Furthermore, these same patients were more likely to receive treatment than patients between 75 and 84 with no comorbidities and much better prognoses.
Study authors cited previous research indicating that older patients with NSCLC who are otherwise healthy can benefit from treatment. However, those with comorbidities are less likely to complete a course of treatment due to increased susceptibility to cancer treatment toxicities. Life expectancy can also be limited by significant comorbidity, hence undermining the potential for survival benefit of treatment.
“The message here is, don’t base cancer treatment strictly on age,” said lead author Sunny Wang, MD, an SFVAMC physician and an assistant clinical professor of medicine at UCSF. “Don’t write off an otherwise healthy 75-year-old, and don’t automatically decide to treat a really ill 65-year-old without carefully assessing the risks and benefits for that patient.”
Source: UCSF.