Treating Cancer in Elderly Patients

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Cancer is a disease that impacts a multitude of people around the world. While cutting-edge cancer research seeks to combat the globally significant disease, specific populations are not always considered. Treating cancer in elderly patients poses unique challenges to biomedical scientists and healthcare professionals due to the lack of data on the particular age cohort.

Conventionally, elderly patients are under-treated and less likely to be included in clinical trials than younger patients, leading to underrepresentation in cancer treatment papers1. This lack of scientific attention to treating cancer in elderly patients creates a space for innovative solutions to address and improve existing therapeutics.

Reports from the National Cancer Intelligence Network show evidence that cancer treatments like surgery and radiotherapy are offered at different rates to differently aged patients2. As a patient ages, their chances of receiving effective and appropriate treatment dwindles, based on this information. Furthermore, questions of whether or not cancer treatment is appropriate for a specific elderly patient’s case, is actually offered, is accepted by the patient, or is accurately recorded remain2. This gap in the data makes treating cancer in elderly patients in great need of personalized and forward-thinking healthcare plans.

This article will focus on treating cancer in elderly patients with specific attention to important considerations for researchers and caregivers to consider when developing cancer therapeutics – including the patient’s personal situation. Additionally, this piece will highlight multiple applications of brachytherapy technology as an efficient method of treating cancer in the elderly and the importance of a holistic view of cancer treatment and healthcare for cancer in elderly patients.

Important Considerations for Improving Treatments of Cancer in the Elderly

When treating cancer in elderly patients, an important question to ask is: is the patient’s personal situation being taken into account or just the treatments of the cancer itself? To effectively treat cancer in the elderly, which poses specific social and medical challenges to care, the conditions in which a patient exists must be accounted for and assessed. Key features of effective therapeutics for cancer in the elderly include the type of cancer treatment and the speed of treatment delivery, the need for surgery, and the impact of patient decision-making.

Understanding and addressing drivers of patient decisions is crucial to the improvement of treatments of cancer in elderly patients. For example, will an older woman with breast cancer have a breast removed because she is unable to make the commute to and from hospital? In a study published in Annals of Surgical Oncology in 2017, researchers measured the effect of travel distance and time to radiotherapy on the likelihood of receiving a mastectomy for elderly patients with breast cancer3. The paper found that the distance and time needed to travel to a radiotherapy facility for treatment were barriers to treating breast cancer in elderly patients and impacted whether or not they chose to undergo standard cancer care, including techniques like breast conservation surgery and whole-breast irradiation3.

For example, patients residing further than 9.2 miles from a radiation facility were over 40% more likely to receive a mastectomy compared with those residing closer than 9.2 miles. In addition, patients requiring more than 19 minutes of travel time were 36 % more likely to receive a mastectomy than those traveling less than this amount of time3.

Moreover, consider the impact on an elderly patient’s quality of life when fitted with a stoma, a type of treatment for anal or bowel cancer. Are they physically able to change the stoma? What happens with the onset of dementia in elderly patients on the ability to manage a stoma? Also, will there be physical scarring to the skin from surgical removal of small superficial skin cancers? With all of these important considerations around the unique conditions in which an elderly patient exists, it is vital for cancer researchers and caregivers alike to embrace a multidisciplinary approach to develop and execute individualized treatment of cancer in the elderly1.

Can X-Ray Brachytherapy Help Treat Cancer in Elderly Patients?

Often, complications and survival rates in surgery rise with a patient’s age and decrease the suitability of surgical intervention as a treatment option for cancer in the elderly. Thus, radiotherapy offers an alternative treatment option for cancer in elderly patients. For example, using data around rectal cancer in elderly patients, scientific experts suggest that while there are limited results around treating cancer in elderly with contact radiotherapy ­– also known as Papillon radiotherapy or X-ray brachytherapy – the method has great potential to be effective and safe in elderly patients with early-stage rectal cancer4.

Radiotherapy is an emerging solution to treating cancer in the elderly and can address many of the specific social and circumstantial constraints on this unique population of patients. Specifically, intra-operative radiotherapy delivers large doses of radiation targeted to tumors or tumor beds, maximizing treatment to cancerous cells while simultaneously minimizing radiation to healthy cells, all whilst the patient is under anesthetic5. Due to its very nature, a single radiotherapy “boost” to the tumour bed offers an alternative to the multiple fractions needed when delivering partial or full breast irradiation when undertaking breast-conserving surgery for the treatment of breast cancer in elderly patients.

Continuing to Innovate Solutions for Cancer in the Elderly

The Papillon+™ X-ray Brachytherapy system by Ariane Medical Systems has three main clinical applications – combatting colorectal cancer, executing breast intra-operative radiotherapy, and treating superficial skin cancer6. Due to its flexibility in duration, dose, and brachytherapy fractions, this system can tailor treatments for cancer in the elderly to meet personalized patient care needs.

Furthermore, the Papillon+ ™ X-ray Brachytherapy system is designed with consideration of drivers around patient decisions, ultimately increasing cancer treatment accessibility, usability and comfort6. In cases of colorectal cancers, this platform can treat tumors with little to no physical invasion of the patient through surgery. Regarding breast cancer in the elderly, the Papillon+ can increase the speed of treatment delivery and reduce repetitive hospital visits. Thirdly, the system can non-invasively and effectively target superficial skin cancer tumors with little scarring or cosmetic damage to an elderly patient’s more fragile skin6. By reducing the need for surgery to treat cancer in elderly patients, Ariane Medical Systems‘ Papillon+™ X-ray Brachytherapy solution prioritizes patient choice and care.

In summary, existing treatments for cancer in elderly patients need to be examined with a critical eye and consider both clinical outcomes as well as individual consequences. Furthermore, patient circumstances such as where they live, their caring obligations, and their mental health carry as much weight in developing a treatment plan as the default go-to choice of a “gold standard” treatment option. Barriers like distance and time and resulting quality of life for patients are significant factors to think about while creating treatment plans for cancer in the elderly. 

Ariane Medical Systems is a leader in targeted cancer therapeutics and offers services globally. The biomedical experts and oncologists at Ariane Medical Systems provide patients with individualized treatments using innovative techniques such as the Papillon+™ X-ray Brachytherapy system, which is particularly effective in treating cancer in the elderly. If you are interested in learning more about cancer in the elderly and our holistic, multidisciplinary approach to ensuring individualized healthcare, please contact a member of our team today.

References:

  1. Millan, M., Merino, S., Caro, A., Feliu, F., Escuder, J., & Francesch, T. (2015). Treatment of colorectal cancer in the elderly. World Journal of Gastrointestinal Oncology, 7(10), 204. https://doi.org/10.4251/wjgo.v7.i10.204
  2. The Age Old Excuse: The Under Treatment of Older Cancer Patients. ‌(2022). Macmillan Cancer Support. https://www.macmillan.org.uk/documents/getinvolved/campaigns/ageoldexcuse/ageoldexcusereport-macmillancancersupport.pdf
  3. Goyal, S., Chandwani, S., Haffty, B. G., & Demissie, K. (2014). Effect of Travel Distance and Time to Radiotherapy on Likelihood of Receiving Mastectomy. Annals of Surgical Oncology, 22(4), 1095–1101. https://doi.org/10.1245/s10434-014-4093-8
  4. Contact radiotherapy for elderly patients with early low rectal cancers. (2020). British Journal of Hospital Medicine. https://www.magonlinelibrary.com/doi/abs/10.12968/hmed.2013.74.7.391
  5. Intra Operative Radiotherapy | Alternative Cancer Treatment. (2022, April 20). Ariane Medical Systems. https://www.arianemedicalsystems.com/patients/?doing_wp_cron=1653938536.2735350131988525390625
  6. News-Medical. (2022, February 15). Improving X-Ray brachytherapy treatment using the Papillon+TM. News-Medical.net. https://www.news-medical.net/whitepaper/20220215/Using-the-Papillon2be284a2-to-Improve-X-ray-Brachytherapy-Treatment.aspx