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How Old is Too Old for Chemotherapy?

November 19, 2018

By Dr. Martine Extermann
Program Leader, Senior Adult Oncology Clinic

Half of all cancers occur in people age 70 and older. We hear a lot of things about chemotherapy in older age. Which are myths and which are true?

Can older people tolerate chemotherapy?

There are many different chemotherapies. Some have few side effects. Others can be hard on the body. With careful consideration some chemotherapy can be given to people in their 90s.

I am really concerned about the side effects. I do not feel as robust as when I was young.

We did a study to see how chemotherapy side effects were affecting older patients. Half of all patients had some side effects, but with proper management the majority of patients could still do all or most of what they could do before.

But what about the risk that something may still go wrong?

An oncologist can take many steps to minimize the risks. We use tools to tailor the treatment to what the patient can tolerate. We also make sure there is good support at home. That may mean organizing some help from family or community resources.

Doesn’t the benefit of chemotherapy decrease with age?

In most cases, it does not. A healthy older person often has the same chances of responding to treatment or being cured than a younger one. Even for patients with more health issues chemotherapy may help decrease cancer symptoms and growth, and help people live better and longer.

So what is the difference between an older and a younger cancer patient?

Most younger patients are fairly healthy and that is a benefit. As people age more health concerns arise. In an older patient, you have to carefully check their strengths and weaknesses to give optimal care. You need a trained oncologist who can "custom tailor" your treatment.