Chemotherapy may help relieve symptoms of non-small cell lung cancer in patients over the age of 65 years, according to recent results published in the Journal of Clinical Oncology.

Lung cancer is the leading cause of cancer death in North America . Approximately 75% of individuals who have lung cancer have a type of cancer referred to as non-small cell lung cancer (NSCLC). Stage IV NSCLC refers to cancer that has spread from its site of origin to distant areas in the body, often including vital organs. Half the patients are diagnosed with metastatic (stage IV) disease which is essentially incurable and patients diagnosed with earlier disease will usually experience a recurrence after initial treatment. It is estimated that metastatic NSCLC will affect over 130,000 Americans each year and more than half will be over the age of 65 years.

Chemotherapy is not considered a curative treatment option for patients with metastatic NSCLC, but may provide temporary disease control, improved quality of life, and a modest increase in survival. Patients with advanced NSCLC treated with cisplatin-containing chemotherapy regimens have an increase in average survival of about 6 weeks and a 10% improvement in 1-year survival compared with those managed with supportive care only. However, many physicians do not offer adjuvant therapy to their elder patients due to perceived potential intolerance of therapy and/or a considered short life expectancy. It is estimated that only 20% of elderly patients with advanced lung cancer ever receive chemotherapy.

Researchers at the Dana-Farber Cancer Institute recently analyzed treatment and outcome data of over 6,000 elderly patients with stage IV NSCLC who were treated with palliative chemotherapy. Data was retrieved from 11 registries participating in the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) program. Palliative (treatment to relieve symptoms) chemotherapy in this group of patients increased the average survival by approximately one month and the one year survival by 9%. These results are comparable with those achieved in younger patients with this disease treated with chemotherapy.

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These findings suggest that chemotherapy for metastatic IV NSCLC was as effective in elderly patients as it was in younger patients and there is no reason to deny therapy based solely on age. These researchers suggest that elderly patients without other major health problems should be given the opportunity to consider palliative chemotherapy for metastatic NSCLC. However, it needs to be emphasized that the benefits of chemotherapy in terms of survival are small and individual patients need to decide for themselves whether or not to receive treatment.

Elderly patients with metastatic NSCLC may wish to discuss palliative chemotherapy with their physician or discuss the risks and benefits of participating in a clinical trial evaluating other new treatment strategies for lung cancer. Two sources of information on ongoing trials that can be discussed with a doctor include comprehensive, easy-to-use listing services provided by the National Cancer Institute (cancer.gov) and eCancerTrials.com. eCancerTrials.com also provides personalized clinical trial search on behalf of patients. (Journal of Clinical Oncology, Vol 19, Issue 4, pp 1064-1070, 2001)

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