NEOPLASMS IN THE

ELDERLY
DONE BY
CAROLINE HAMOOYA
JOSEPH .N.NYAMBE
INTRODUCTION
• Age significantly increases the risk of cancer. In elderly
people, other lifestyle- associated risks will also accumulate.
• Early-stage cancer can often be operated even though a
patient is elderly. Surgery may improve the patient’s quality
of life, even if the aim is not to extend her or his life span.
INTRO CONTINUES..
• There is only little research data on anti-tumor and radiation
treatments of elderly patients.
• Chemotherapy and radiation therapy cause side effects more
often and in greater severity to the elderly than to the
young. Elderly patients also recover from treatments more
slowly
BRAIN TUMOR
• A brain tumor is a collection, or mass, of abnormal cells in your brain.
Your skull, which encloses your brain, is very rigid. Any growth inside
such a restricted space can cause problems.
• Gliomas are the most frequent primary brain tumors and the
incidence data has increased in the elderly population.
• The elderly population is growing in many countries; therefore, the
number of Glioblastoma patients diagnosed at age >65 is expected to
continue to increase.
MANAGEMENT OF BRAIN TUMORS
• Clinical management of elderly patients with primary brain
tumors is difficult, owing to multiple comorbidities,
polypharmacy, decreased tolerance to chemotherapy, and an
increased risk of radiation-induced neurotoxicity.
• In fact, the therapeutic approach is also influenced by other
prognostic factors such as grade, Karnofsky performance
status (KPS), and comorbidity.
MANAGEMENT CONTINUES…..
• Surgery remains the first-line management strategy to obtain
the histological proof of the diagnosis and to determine the
tumor molecular profile.
• After surgery, the standard treatment of gliomas includes
chemotherapy combined with or without radiotherapy after
the radical resection.
• Supportive care and treatment with corticosteroids and anti
epileptics (AEs) play an important role in elderly patients
PROSTATE CANCER
• The average age of prostate cancer patients is about 70
years. Roughly one-third of prostate cancer diagnoses are
given to patients over the age of 75.
• Prostate cancer usually grows slowly, and approximately 90%
of patients are alive five years after the diagnosis.
• According to studies, latent, asymptomatic prostate cancer
occurs in even up to approximately 60% in men over the age
of the 80.
• However, prostate cancer is the second most common cause
of cancer mortality within the age group of over 75 years.
MANAGEMENT OF PROSTATE CANCER
• Surgery requires the patient to be in better general condition
than radiation therapy, and thus radiation therapy is often
selected for treating elderly patients.
• Metastatic prostate cancer, in turn, is treated with hormone
therapy, which may keep cancer spread to the bones
asymptomatic for many years.
MANAGEMENT CONTINUES…
• Chemotherapy treatments require the patient to be in fairly
good general condition, so they are not suitable for very
elderly or patients with multiple diseases.
• Hormone therapies do not result in sudden and severe harm,
but may be associated with osteoporosis, sweating, loss of
muscle tone and increased cardiovascular disease risk.
BREAST CANCER
• Breast cancer in the elderly is rarely a biologically aggressive
subtype, yet nevertheless the mortality rate of breast cancer
in older people is greater than in younger people.
• One reason for this is the fact that the cancer has often
advanced more widely in elderly patients at the moment it is
diagnosed. In breast cancer, the prognosis is especially good
if it is diagnosed at an early stage.
MANAGEMENT OF BREAST CANCER
• Mastectomy
• Radiation therapy may be provided in a short, three-week
treatment cycle.
• Active Breathing Control technique also enables minimizing
the radiation dose received by the heart.
•  Adjuvant (immune system booster) treatments are also used
after the surgery, which reduces the risk of breast cancer
recurrence.
MANAGEMENT CONTINUES…..
• A five-year hormonal drug therapy with tablets can usually
be started for older patients. If the breast cancer has spread,
hormonal drugs can slow down its progression and relieve
symptoms.
• There are a number of different chemotherapies used, and
they are administered individually.
COLON CANCER
• The most common intra–abdominal cancer is colon cancer,
which today has a good prognosis.
• Intestinal disorders are common in older people, and
therefore they may be left unexamined. On the other hand,
emphasis is currently placed on the active investigation of
elderly patients with intestinal symptoms, because the risk of
cancer increases significantly with age.  
• The risks related to surgery of the abdominal cavity are
significant.
MANAGEMENT OF COLON CANCER
• Therefore, symptomatic treatment may be settled with in cases
where patients have other serious illnesses, such as heart
failure.
• Colon and rectal cancer surgery also improve the quality of life
of the elderly patient, even if the surgery would not prevent the
progression of metastases outside the intestine. 
• Chemotherapy is used as adjuvant therapy after colon cancer
surgery. Adjuvant treatments cannot be performed if the patient
has other medical conditions and multiple other medications.
MANAGEMENT CONTINUES….
• However, chemotherapy given as tablets may be suitable for
the elderly patients with no heart disease. Advanced colon
cancer treatment has a number of medicinal options
• It is important to always anticipate the potential harm for the
heart or the kidneys.
CERVICAL CANCER
• Cervical cancer is the second most common cancer in
women with 500.000 new cases every year.
• While the global incidence has decreased with the
implementation of screening programs, and may be
improved by the use of tumor marker, the incidence in older
women has remained unchanged, with a quarter of cases
occurring after the age of 65 years.
• Moreover, older patients often present with later stages of
cervical cancers.
MANAGEMENT OF CERVICAL CANCER
• Treatment of localized cervical cancer includes surgery,
brachytherapy, and concomitant radio-chemotherapy.
• However, the benefit-risk balance for these treatments
among older patients has been poorly studied.
• Treatment decisions in older patients are complex due to
frequent comorbidities and age-related impairments, such as
malnutrition, functional dependence, and cognitive decline.
MANAGEMENT CONTINUES…..
• Moreover, older patients are at increased risk of treatment
toxicity.
• For all these reasons, treatment of cervical carcinoma is not
consistent in the geriatric population.
CONCLUSION
• In the elderly patients, no standard treatment has been
established and therefore there are actually many studies to
evaluate treatment regimes and outcomes in elderly patients
with neoplasms.
• Supportive care plays an important role in the management
of neoplams in elderly patients.
REFERENCES
Current basic tables. cancer.fi/syoparekisteri/
Statistics Finland. The life-expectancy of newborns in 2015. [Updated
14.4.2016] findikaattori.fi.
The National Institute for Health and Wellbeing. Mortality. [Updated
11.12.2015] thl.fi/web/hyvinvointi-ja-terveyserot/…/kuolleisuus.
Karihtala P, Puistola U. Syöpä iäkkäällä naisella. Duodecim 2015; 131: 1507–12.
Ng O, Watts E, Bull CA, Morris R, Acheson A, Banerjea A. Colorectal cancer
outcomes in patients aged over 85 years. Ann R Coll Surg Engl 2016; 98: 216–
21.
 
THANK YOU…