Understanding Cancer

Although cancer strikes both young and old, it is primarily a disease of aging. In the United States, 50 percent of all malignancies and 67 percent of cancer deaths occur in persons over the age of sixty-five. (That's currently one American in eight; by the year 2030, it's expected to be one in five.) Yet, even though they are ten times more likely than younger persons to develop cancer, the elderly are not screened as often; they're referred less frequently to major cancer centers where they have a better chance of being cured; and they're usually treated less aggressively for their disease.

Older people are more vulnerable to cancer because of their longer exposure to carcinogens: pollution, radiation, tobacco, sun, alcohol, the wrong diet, chemical or physical irritation, hormonal imbalance, and possibly even stress. Random genetic mutations that can lead to cancer also occur more frequently. The body's DNA repair system, which is constantly on the lookout for dangerous changes that may cause a cell to become cancerous—and aborts the cell when such mutations are detected—is less effective as we grow older.

The outcome of cancer in many older persons is adversely affected by a combination of social, psychological, educational, financial, cultural, and economic factors. The elderly are not always aware of all the hows, whys, and wheres of cancer diagnosis and therapy because much of the pertinent educational material is not geared toward them. As a result, they may assume that all cancers are uniformly fatal, and that there's nothing to be done about them. They may attribute their symptoms to some other cause, or to "old age," and they put off seeing a doctor until it's too late. If they live in social isolation, without a strong support network of family, friends, and neighbors, they may not be able to get to the clinic or the doctor's office because they don't have a car or can't drive, or they have physical limitations. Finally, the chances of curing their cancer may be affected by a coexisting chronic illness, such as a respiratory problem, arthritis, diabetes, or heart trouble.

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