Radiation, chemotherapy benefits decrease in older patients with breast cancer

HOLLYWOOD, Fla. – Competing causes of morbidity and death could increase with age in older adult breast cancer patients, according to Robert W. Carlson, MD, professor of medicine at Stanford Comprehensive Cancer Center and Stanford University Medical Center.

Carlson presented findings from the NCCN Task Force Report: Breast Cancer and the Older Woman at the NCCN 13th Annual Conference: Clinical Practice Guidelines and Quality Cancer Care.

“The benefit of breast-conserving radiation therapy appears to decline with age, so you do not need breast-conserving radiation in appropriately selected patients who are older. The benefit of chemotherapy declines with age and the benefits of endocrine therapy appear to persist with age,” Carlson said.

He added that the toxicity experience associated with chemotherapy increases with age, though little data is available to balance all the considerations in older patients.

“We also have a very strong need for efficient tools to determine functional and physiological reserve in the older patient population,” Carlson said.

Aging is a heterogenous process and a progressive erosion occurs in the physiological reserve over time, Carlson said. The reduction in physiological reserve becomes more evident when under stress, such as surgery, infection or chemotherapy.

“Understanding of these physiological changes with age and stress for the individual patient could assist us in the early recognition of potential toxicity from therapy that we use for cancer, as well as allow us to anticipate them and therefore initiate supportive care to minimize those risks,” Carlson said. – by Paul Burress

For more information:

Carlson RW. NCCN Task Force Report: Breast Cancer in the Older Woman. Presented at: NCCN 13th Annual Conference; March 5-9, 2008; Hollywood, Fla.