Lung cancer is one of the most common causes of death among the elderly. According to the book "Clinical Oncology," lung cancer causes more deaths than prostate, colorectal and breast cancers combined. Prognosis of lung cancer in the elderly is poor and depends on the stage of the lung cancer at the time of diagnosis.
Types
Lung cancer in the elderly often is classified into non-small-cell lung cancer and small-cell lung cancer, according to the size and the shape of cancer cells.
Treatment options for non-small-cell lung cancer include surgery, chemotherapy and radiation therapy. Treatment options for small-cell lung cancer include chemotherapy and radiation therapy. Surgery is not used often to treat small-cell lung cancer, as the cancer spreads quickly and surgical removal of the primary tumor does not improve survival of patients, according to UpToDate.com.
Prognosis
Prognosis of older patients diagnosed with lung cancer often is worse than younger patients.
According to the Surveillance, Epidemiology and End Results (SEER) database, the five-year survival rate for a 77-years-old male diagnosed with Stage III lung cancer is only 5.2 percent. On the other hand, the five-year survival rate for a 62-year-old male and 30-year-old male diagnosed with Stage III lung cancer are 10.2 percent and 14.7 percent, respectively. The same trend is observed for females and patients diagnosed with Stage I and II lung cancer. For patients older than 75 diagnosed with Stage IV lung cancer, the five-year survival rate is less than 1 percent.
Treatment Effects
According to a 2007 review published in "Journal of Clinical Oncology," there are not enough studies on treatment of lung cancer among elderly patients. Elderly patients often are excluded from clinical trials. Existing data indicates that response to medications and therapies in older patients mirrors results observed among younger patients; however, the toxicity and side effects among elderly patients tend be worse.
Considerations
Selecting an optimal treatment for elderly lung cancer patients is difficult due to their medical and physiological characteristics, a 2008 review published in "Journal of Clinical Oncology" reports. Elderly patients often have pre-existing comorbid conditions, such as diabetes, cardiovascular diseases or mental health problems, which can severely affect treatment and recovery.
Expert Insight
With the existing evidence, the optimal treatment for advanced non-small cell lung cancer in the elderly is single-agent chemotherapy with a third-generation agent (for example, gemcitabine, vinorelbine and taxanes), according to a 2008 review published in "Journal of Clinical Oncology."
