Cancer in older adults poses some serious medical and ethical challenges, as this population often possesses unique health concerns. Over 60% of all cancers are diagnosed in individuals aged 65 years and older, and the rising numbers of incidents of cancer within this age bracket spur the demand for specialised care in cancer specifically for the older population. Management of cancer in the elderly is much more complicated compared to that in younger patients due to the interaction of processes such as ageing, frailty, and comorbidities.

The main complications to treat cancer in the elderly population also arise from their physiological vulnerabilities. Most elderly patients with various chronic diseases, such as diabetes, cardiovascular diseases, or arthritis, complicate the management of cancer with chemotherapy or radiation treatments. Such treatments carry heightened risks due to frailty, reduced organ function, or compromised immune systems, making standard protocols for cancer difficult to apply. For example, the side effects of chemotherapy are quite serious, including fatigue, suppression of the activity of immune cells, and increased infection risk; in older adults with predisposing conditions, all could be lethal (Reis da Silva, 2024a).

Health care providers, especially nurses, are challenged to weigh medical interventions against the patient's personal objectives and preferences with the aim that treatments do not cause excessive suffering or a great reduction in life quality. The considerations make cancer care for the elderly not just a medical issue but a deeply personal and ethical one where the patient's autonomy and clinical expertise must both align (Reis da Silva, 2024b).

It is important to involve nursing in the care of older adults with cancer, and they can not only provide excellent clinical care but they can also deliver psychological and emotional care and advocate for the patients. For oncogeriatric care, nurses are important members of the multidisciplinary teams. Comprehensive assessments done by nurses may identify risks and assure appropriate individualised treatment. Many of these require coordination in personal care, including specialists such as oncologists, geriatricians, and social workers, among others, who address the many dimensions of need in older adults (Reis da Silva, 2024a).

Moreover, nurses are in an optimal place to offer psychosocial support and ensure that both the older adult and family members are educated about potential risks and benefits of treatments. Nurses apply appropriate communication to ensure that treatment is consistent with patient preferences for symptom-directed palliative care or continued life-prolonging treatments.

This is indeed a growing subfield that really brings forth the need for such tailored multidisciplinary approaches. Nurses at the head of this sort of model would enable cancer care in older adults to easily be more adaptive and responsive to the complexities of aging that allow a compassionate and effective response to a diagnosis often too unforgiving.

References

Reis da Silva, T. H (2024). Oncology and cancer medicine: Understanding the complexities in older patients. Biomed J Sci & Tech Res 55(3)-2024. DOI: 10.26717/BJSTR.2024.55.008720

Reis da Silva, Tiago Horta. Death and its significance in nursing practice (PDF). Palliat Med Care Int J. 2024; 4(3): 555640. 

Reis da Silva, T.H. (2024) Pharmacokinetics in older people: an overview of prescribing practice. Journal of Prescribing Practice. 6 (9). 374-381.