Crafting Cancer Care to Fit the Needs of Elders

senior-adult-onc-resizedLast April, Edward could barely stand.

He couldn’t breathe and felt like he was drowning. He was taken to a local emergency room and put on oxygen. Fluid was drained from his lungs.

The diagnosis was scary: stage IV lung cancer.

Edward was 83 years old and recently learned that his granddaughter was expecting a baby.

“I didn’t think I would get to see my granddaughter have the baby,” he says.

That same month, Edward came to the Senior Adult Oncology Center of the Kimmel Cancer Center at Jefferson for his first appointment. At the time, he had difficulty walking and needed oxygen 24 hours a day, seven days a week.

Each member of the Center’s multidisciplinary team, including Jefferson medical oncologist and Center Co-Director Andrew E. Chapman, DO, FACP, spent time examining Edward and discussing his – and his family’s – goals for treatment during a 3-hour visit.

In addition to the lung cancer, he was on 13 different medications, his diabetes was not well managed, he’d lost weight (20 pounds), he needed physical therapy and his wife had advanced Alzheimer’s disease. Needless to say, there were “real concerns about support as his condition deteriorates,” Dr. Chapman recalls.

The team noted that Edward and his family were “aware of the incurable nature of his disease and the goal of treatment is palliative.” Edward was too frail for aggressive chemotherapy. Instead, the team decided to treat him with the drug Tarceva, which blocks a protein that signals cancer cells to multiply and, thus, slows the growth of the tumor.

Six weeks later, Edward returned for a check-up. He’d improved significantly. He’d gained weight and felt much better. Moreover, he was only on oxygen at night.

Over the next nine months, Edward’s cancer remained stable while his overall health continued to improve. He was able to get back to his garden and do some work around the house.

He was going to the gym three times a week for vigorous 40-minute workouts. He’d also become a great grandfather.

The cancer in his right lung remained, but the latest scans had not shown a significant progression of the disease.

Last Sunday, Edward attended his great grandson’s christening. Three days later, he celebrated his 84th birthday.

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