Chemotherapy In The Elderly – A Cause For Concern?

By Ng Hui Cheng, Senior Pharmacist, NCC

Although the incidence of Cancer is not specifically tied to any age, it can still be considered a 'disease of aging,' as figures show a steep increase in the number of cancer cases affecting individuals over 60 years. Studies have shown that 60 per cent of new cancer cases and two-thirds of cancer deaths occur in individuals with ages greater than 65 years, that is, the elderly.

Ageing is an individualised process and on its own does not account for increased toxicity in the elderly. During ageing, other medical conditions may exist, and kidney or liver function may deteriorate. It is this change in the organ functions and/or other co-existing medical conditions that can affect the way drugs are being absorbed, used, and finally removed from the body. The elderly also have a higher tendency to be on many other drugs and this will increase the risk of possible drug-drug interactions. Hence any or all of these factors may contribute a greater risk of side effects from chemotherapy.

Unlike surgery and radiation therapy, chemotherapy affects the whole body, which increases the risk of side effects. Listed below is a list of side effects that may have increased severity in the elderly, compared to the younger population, who are receiving chemotherapy. One exception is the incidence of nausea and vomiting, which tends to be lower in the elderly than the younger population.