Christine B. Brezden-Masley, MD, PhD, Staff Physician, Department of Medicine, Division of Hematology and Oncology, St. Michael’s Hospital; Assistant Professor, Department of Medicine, University of Toronto, Toronto, ON.
Monika K. Krzyzanowska, MD, MPH, Staff Physician, Department of Medical Oncology & Hematology, Princess Margaret Hospital; Assistant Professor, Department of Medicine, University of Toronto, Toronto, ON.

Pancreatic cancer is the fourth and fifth leading cause of cancer-related death for men and women, respectively (following lung, colon, and prostate cancers in men; lung, breast, colon, and ovarian cancers in women). Patients usually present with advanced disease, making curative attempts difficult. Surgery is the only curative therapy; however, local disease recurrence with or without spread to distant organs occurs in over 80% of patients. Attempts at better therapeutic modalities are necessary in order to improve outcome in this disease. This review will focus on staging, risk factors, and therapies for resectable, locally advanced, and advanced (metastatic) pancreatic cancer. Novel molecular targeted therapies will also be briefly highlighted.
Key words: pancreatic cancer, chemotherapy, radiation therapy, Whipple procedure, staging.

The accredited CME learning activity based on this article is offered under the auspices of the CE department of the University of Toronto. Participating physicians are entitled to one (1) MAINPRO-M1 credit by completing this program, found online at www.geriatricsandaging.ca/cme

Christine B. Brezden-Masley, MD, PhD, Staff Physician, Department of Medicine, St. Michael’s Hospital; Assistant Professor, Department of Medicine, University of Toronto, Toronto, ON.
Maureen Trudeau, BSc, MA, MD, Acting Regional Vice President, Cancer Services--Clinical; Head, Division of Medical Oncology/Hematology, Sunnybrook & Women’s College Hospital Sunnybrook Campus; Head, Systemic Therapy Program, Toronto Sunnybrook Regional Cancer Centre; Associate Professor, Department of Medicine, University of Toronto, Toronto, ON.

Breast cancer is the most common cause of cancer mortality in women over 65 years of age. Older women with breast cancer are usually understaged and undertreated as a result of factors such as significant patient comorbidities, patient preferences, age-biases, and poor cognition. Furthermore, women over the age of 70 have been excluded from many breast cancer clinical trials, making treatment conclusions difficult. Patients’ characteristics (including age and comorbidities) should be considered when deciding on the final treatment, a decision ideally made by both the treating physician and the patient. This review will discuss current treatment strategies for breast cancer patients, with a focus on the older population.
Key words: breast cancer, older adults, staging, systemic chemotherapy, radiotherapy.