Understanding cancer in older adults

Understanding the unique needs of older adults with cancer and how the disease and its treatment impact their physical, emotional and social health deserves immediate exploration, says Keith M. Bellizzi, assistant professor of human development and family studies and a CLAS alumnus ('03, PhD).

Bellizzi, himself a cancer survivor, biked cross-country with Lance Armstrong and a team of 24 cyclists to raise awareness about cancer research.

He recently served as a guest editor for a special issue of the international journal Cancer, entitled Aging in the Context of Cancer Prevention and Control: Perspectives from Behavioral Medicine .

In the supplement, Bellizzi and Professor Thomas O. Blank, his colleague in human development and family studies, and other researchers say there is an urgent need for clear, evidence-based practice guidelines to assist physicians, oncologists and others who provide short- and long-term care management to older adults with cancer.

Only with more immediate research will appropriate prevention efforts, screening, treatment approaches, post-treatment survivorship and end of life care be put in place to serve this rapidly growing population, the supplement says.

The single greatest risk of cancer is age. More than 60 percent of all malignant cancer diagnoses in the U.S. occur in people age 65 or older. Currently, there are an estimated 6.5 million adults age 65 or older in the U.S. with a history of cancer.

That number is expected to rise as the country's baby boomer population ages and the number of men and women age 65 and older – currently about 36.8 million – doubles by the year 2030.

Due to advances in medical science, cancer is no longer a uniformly fatal illness. Approximately 43 percent of older cancer survivors are expected to live for 10 years or more and approximately 17 percent will survive for 20 years or more after their initial diagnosis, according to recent estimates.

“The coalescence of three factors has the potential to create one of the biggest public health problems our country has faced in decades,” says Bellizzi, “These are: the aging of the baby boomers, the age sensitive nature of cancer, and the increased survival for those diagnosed with cancer.”

There is growing consensus, Bellizzi says, that researchers and clinicians will need to take a multidisciplinary approach to address this challenge incorporating perspectives from geriatrics, oncology, behavioral medicine, and public health to ensure the best quality care.

In making his case for further research, Bellizzi cites two recent reports which warn of a looming shortage of adult oncologists and geriatricians due to expected retirements and a lack of new specialists to replace them.

“Two pressing questions that need to be addressed are: 1) Who and how will we care for the growing population of older individuals with cancer, many of whom also will have competing health conditions, and 2) what are the unique physical, mental and social issues that they face,” Bellizzi says.

His own research interests extend to cancer's impact on families.

“Cancer is something that reverberates across the family system and leaves no one untouched,” he says. “We want to look at how well families adapt as a unit to these life crises and teach them coping techniques of needed.” – Colin Poitras, CLAS ‘85, and UConn Magazine

Learn more: Keith Bellizzi talks to the Philadelphia Inquirer about fear of cancer treatment: http://www.philly.com/philly/news/homepage/20090311_The__routine__fear_for_cancer_patients.html?viewAll=y&c=y

UConn Magazine story about Bellizzi: http://uconnmagazine.uconn.edu/fwin2008/pf004/