Robert D. Helme, PhD, FRACP, FFPMANZCA, Barbara Walker Centre for Pain Management, St. Vincent’s Hospital, Melbourne, Australia.

Narcotics are commonly required for the treatment of severe pain due to malignancy at all ages. In recent years, it has been recognized that they may also benefit older people with nociceptor pain that is unresponsive to other management strategies. In this circumstance, narcotic treatment should be undertaken in the full knowledge of relevant laws and potential for side effects in patients who are fully informed and involved in their treatment program. The choice of narcotic depends on the preference and experience of the clinician. It must be recognized that both benefits and side effects of narcotics occur at lower doses in older people than in younger cohorts.
Key words: aging, pain, narcotics, comorbidity, side effects.

Jeremy L. Freeman, MD, FRCSC, FACS, Professor of Otolaryngology, University of Toronto; Temmy Latner/Dynacare Chair in Head and Neck Oncology, Otolaryngologist-in-Chief, Mount Sinai Hospital, Toronto, ON.

Carsten E. Palme, MB BS, FRACS, Fellow, Head and Neck Oncology, Department of Otolaryngology, University of Toronto, Toronto, ON.

The management of thyroid nodules in the elderly patient involves paying specific attention to risk factors for malignancy. Certainly, patients over 45 years of age have a higher risk of harbouring a malignancy than younger patients. When a decision is made for intervention, one must keep in mind comorbidity issues balanced against the risk of surgery for a potential malignant tumour of low biological activity.
Key words: thyroid, risk factors, comorbidity, malignant tumour.