Cancer: the Indiscriminate Killer of Young and Old

Cancer is becoming a more common diagnosis and cause of death each year in Canada. This is being driven by several factors: the aging of the population, the age-related decline in death from cardiovascular disease, and more aggressive attempts to diagnose cancer because treatments are becoming more effective. This has resulted in several geriatric oncology issues coming to the fore:

- Are geriatric principles (multidisciplinary, focus on function) being applied to care of older cancer patients?
- Are older patients getting the appropriate cancer treatments?
- Are older patients properly represented in research trials?

Several years ago, Professor Rory Fisher, an eminent geriatrician at the University of Toronto, responded to deficiencies in palliative care by publishing a guide to palliative care in the older population. In the United States, most oncology residency training programs provide a module on principles of geriatric medicine. Initiatives such as these address the first issue above. One of the most efficient ways to address issues two and three is to have geriatricians involved in cancer research. One of the bright young stars in that field is our own senior editor Dr. Shabbir Alibhai who, with his colleague Dr. S. Gogov, deals with the topic “Prevention, Diagnosis, and Management of Prostate Cancer: An Update.” We have several other articles on this edition’s theme of cancer. In our monthly CME feature, Drs. Christina Brezden-Masley and Maureen Trudeau discuss “Treatment Strategies for Breast Cancer,” while Dr. Natasha Leighl reviews the “Diagnosis and Management of Lung Cancer in Older Adults.” Drs. Manmeet Ahluwalia and Hamed Daw discuss “Multiple Myeloma” in their article, and we also present “Pancreatic Cancer--A Review of Current Management Principles” by Drs. Christine Brezden-Masley and Monika Krzyzanowska.

As well, we have our usual collection of columns and articles of interest. Our ethics column in this issue reflects our theme topic and is entitled “Cancer Diagnosis and Consent to Treatment in the Older Adult” by Drs. Goran Eryavec, Gabriel Chan, and Brian Hoffman. Our biology of aging column is the second part of our series on sudden deafness and covers the topic “Sudden Deafness: Rehabilitation.” The dementia column by Donna Algase is on “Wandering: Clues to Effective Management.” The technology in medicine column, by Elizabeth Richard, continues on the theme of wandering with the brief article “Software Tracks Wandering Patients.” As well, Drs. L. Giangregorio, A. Papaioannou, and J.D. Adachi cover an ever-important area of women’s health in “Osteoporosis: Preventing the Deterioration of Bone.”

Enjoy this issue,
Barry Goldlist