CANCER AND AGE

Cancer is the second leading cause of mortality after heart disease and the leading cause of death among women ages 40 to 79 and men ages 60 to 79. Within the 65þ age group, the population 85 years and older is projected to double from 4.3 million in 2005 million by 2030.

Life expectancy has increased. More people are treated successfully after a cancer diagnosis, resulting in a greater prevalence of the elderly living with or developing cancer. It is important for all professionals dealing with the elderly to understand what the disease is and how to deal with it. In the past, the elderly were denied treatment because they were considered ‘too old.’ We now know that in many instances the elderly do as well or better with cancer treatments than the young. This article reviews the causes and biology of cancer, possible ways of preventing it, clinical descriptions of some of the common cancers, how to screen for cancer, and new targeted treatment options. Cancer may be defined by the four characteristics that describe how cancer cells behave differently from normal cells:

1. Cancer usually begins from a single cell that proliferates to form a clone of malignant cells.

2. Cancer cells grow autonomously, are not regulated by the normal controls, and do not die appropriately via programmed cell death (apoptosis).

3. Cancer cells do not differentiate in a normal coordinated manner and do not look the same as the normal cells surrounding them.

4. Cancer cells develop the capacity for discontinuous growth and spread to other parts of the body (metastasis).

Cancer is also called malignant neoplasm. This implies that the growth is a new growth (neoplasm) that if unchecked will kill the host (malignant). Normal cells can express some of the preceding properties at certain appropriate times, such as in wound healing, embryogenesis, organ repair and regeneration, and revascularization, but the proliferation is coordinated, orderly, and self-limited. In cancer, however, these characteristics are excessive, disordered, and not self-limited, resulting in an inappropriate proliferation (tumor burden) and spread that is inappropriate to the host and that has morbid implications if not successfully treated.

Cancer traditionally was classified as being either a carcinoma or a sarcoma named for the presumed cell of origin: epithelial (carcinoma) or mesenchymal (sarcoma). Recent evidence has demonstrated that most if not all neoplasms arise from immature stem cells that then differentiate along normal cell lines, but mutate and acquire the properties of autonomous growth as described previously. We now realize that carcinomas of the lung, breast, and stomach do not arise from well-differentiated ‘normal’ cells in these organs but from stem cells that begin to differentiate in the direction of these tissues but then become autonomous and have impaired apoptosis. These cells lose their normal self-limiting capacity and acquire properties that allow them to enter the circulation and spread to other organs. These cancer cells are the ‘seed,’ and if other organ’s ‘soil’ supports their growth, metastases grow distant to the primary site.

So the golden age to growth the cancer is in geriatric or in old age so care your health today and keep healthy every day.