UPI Science News
CHICAGO, Nov. 29 (UPI) -- Doctors said Monday elderly women who develop
breast cancer should be treated aggressively with chemotherapy and
radiation because most of them die of their cancer, not some other
disease of old age.
''Doctors may feel that older women will probably die of something else
before the breast cancer,'' said Dr. Peter Johnstone, head of the
radiation oncology division at the Naval Medical Center, San Diego,
''or doctors may consider older women too frail to treat aggressively.
But that's not always the case.''
In data presented at the annual meeting of the Radiological Society of
North America in Chicago, Johnstone said 58 percent of the women over
age 75 eventually died of breast cancer -- even though 80 percent of
them had other potentially life-threatening medical conditions such as
high blood pressure, heart disease and diabetes.
''It looks like we could be more aggressive in treating these women,''
Johnstone said. ''People are living longer and better, and age and
coexisting medical problems seem less important than we previously
considered.''
The data correlate with a recent Institute of Medicine report that
elderly women are less likely to receive radiation and chemotherapy
therapy for breast cancer.
When researchers at the Naval Medical Center and the Tripler Army
Medical Center in Honolulu looked at their records of 68 women over age
75 with breast cancer, Johnstone said he was surprised to find that the
patients were not getting what might be considered standard of care
treatment.
During the 10-year period investigated 30 women received lumpectomies,
but only 64 percent of them also received radiation. In the United
States, 80 percent of women who have the breast conserving surgery also
receive radiation.
Thirty-four women underwent mastectomy, but only 17 percent of these
women who had cancer that spread to lymph nodes were given
chemotherapy. Younger women with similar conditions receive
chemotherapy 60 percent of the time.
The only treatment given to six women in the study was a biopsy of the
tumor.
''Few of these women refused treatment,'' Johnstone said. ''Nonstandard
therapy in these cases may reflect widely held assumptions that
aggressive therapy is riskier in older patients, or that older patients
may die of their other medical problems before the cancer progresses.''
He noted that the life expectancy of a women 75 years of age is 11
years and that the American Cancer Society predicts that 10,000 women
over age 80 will die of breast cancer this year.
