Former President Jimmy Carter, who is 90, announced on Wednesday that he has cancer.
He did not reveal what kind of cancer he has, though members of his family have died of pancreatic cancer. He will receive treatment at Emory University in Atlanta, with more information revealed in the coming days.
Carter’s diagnosis at the age of 90 shines a spotlight on how health care professionals, preparing for a spike in older cancer patients as the U.S. population ages, are researching and discussing new strategies for treating cancer in the elderly.
Age is considered the greatest risk factor for developing cancer; the disease affects more older people than young.
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People older than 65 account for 60 percent of newly diagnosed cancer cases and 70 percent of all cancer deaths.
According to Johns Hopkins Medicine research, over the last 30 years the incidence of cancer has increased 26 percent in people over the age of 65 compared with a 10 percent increase among people younger than 65.
Researchers at the Case Comprehensive Cancer Center at Case Western Reserve University in Cleveland are researching how the medical community can better serve older cancer patients.
Among the issues: Why is cancer more prominent in older patients? Is cancer different in older patients? Should cancer be treated differently in younger and older patients?
At the American Society of Clinical Oncology annual conference in early June oncologists discussed another growing concern: older patients not being served well by clinical drug trials.
For example, it’s not often that an older patient is treated with a cancer drug that’s been tested on a patient close to the person’s age. Though two-thirds of cancer patients are older than 65, only about 25 percent of people involved in cancer trials are in that age group, cancer experts say.
When trials sponsored by the National Cancer Institute were studied in 2002, older adults were underrepresented, and there was almost no data for patients over the age of 80. A study of those trials 10 years later showed little had changed.
“Cancer clinical trials have been conducted primarily in middle-aged patients, 50 to 60 years of age, 10 to 15 years younger than the incidence of the disease in the population,” Stuart Lichtman, an oncologist at Memorial Sloan Kettering Cancer Center in New York City, told his American Society of Clinical Oncology colleagues.
“We treat older patients, particularly over the age of 80, with no evidence base whatsoever.
“Is it ethical to treat older patients with regimens based on data in which they were not adequately represented? Is it ethical to design clinical trials in which older patients are ineligible, despite that they are the majority of patients with the disorder being studied?”
Another issue for older cancer patients is that they often receive less frequent screening for cancer and fewer tests such as biopsies that help determine how far advanced the disease has become.
And, in some cases, they also receive milder cancer therapy – surgery, chemotherapy and radiation – or no treatment at all even though several studies have shown that chemotherapy can prolong life for older patients with most cancers.
But even that point is debatable. A new study led by researchers at the University of Texas Health Science Center at Houston found that for women over the age of 80 with breast cancer, chemotherapy treatment did not significantly reduce their chances of dying as much as it did for younger women.
Referring to Carter’s diagnosis, Lodovico Balducci, a geriatric cancer specialist at the Moffitt Cancer Center in Tampa, Fla., told Fox News that old age doesn’t prevent successful cancer treatment.
A lot depends on the patient’s “biological” age versus his actual age, Balducci said.
“A man 90 years old normally would have a life expectancy of two or three years, but Jimmy Carter is probably much younger than that” in terms of his function, Balducci said.
“Cancer in a 90-year-old is a serious problem, but that does not mean a 90-year-old cannot benefit from treatment.”