SHOULD OLD PEOPLE GIVE CHEMOTHERAPY?
Question 1. My father is 85 years old. Two masses were found in the liver. Doctors recommend performing a biopsy. Is it okay to do this to a person of this age? Can a patient in this situation take chemotherapy?
Answer 1. You did not give detailed information about the nature of the masses. It is unclear whether there is a mass elsewhere in the body. However, masses in the liver can have many causes. They don’t always have to be cancer, either. Sometimes benign diseases can also manifest themselves as masses. These include vascular structures called hemangiomas, benign, inflammatory diseases such as tubeculosis and sarcoidosis. Moreover, even if the diagnosis is cancer, the same treatment is not applied to all of them. Sometimes surgery may be sufficient. Chemotherapy is also not uniform and differs between cancers. In addition to chemotherapy with more side effects, there are treatments that are more easily tolerated.
Therefore, I recommend a biopsy. The biopsy is performed by pulling the tissue with a needle, giving local anesthesia under ultrasonography. If the result is cancer, body scans should be done. PET-CT can be used for this.
If the tumor is of liver origin, that is, primary liver cancer and there is no metastasis elsewhere, local treatments for the tumor, including surgery, can be applied. In this case, there is no need for chemotherapy. In addition to local treatment, oral pills that slow the growth of cancer can also be used.
Tumors that metastasize to the liver most commonly originate from the large intestine, stomach, lung, and pancreas. If the location of the original tumor cannot be determined by PET-CT, colonoscopy and gastroscopy should be performed to investigate colon and stomach cancers. Tumor markers in the blood may also contribute to determining the origin.
If the diagnosis is colon cancer, surgery can be performed on both the original tumor and metastases. Depending on the antibody and even the condition of your patient, mild chemotherapy can be applied. The possibility of getting rid of the disease completely with these treatments should not be ignored.
In the decision to administer chemotherapy to a patient, the general condition of the patient is more important than age. There are people who are 85 years old but can have the performance of a 70 year old person. Sometimes it’s the other way around. Even though he is 70 years old, the function of vital organs such as heart, kidney and liver is below the expected level.
In order not to miss diseases such as lymphoma that completely heal with chemotherapy, it is useful to make a definitive diagnosis by performing a biopsy.
Prof. Dr. Coşkun Tecimer
