Chemotherapy can help older breast cancer patients as well

Chemotherapy has traditionally not been recommended for older women -- roughly those over 65 or 70 -- after breast cancer surgery. "Historically, there have been some biases against older women in terms of could they tolerate the [chemotherapy] treatment and whether they would benefit from it," said Dr. Arash Naeim, assistant professor of medicine at the University of California, Los Angeles' David Geffen School of Medicine. The bias did have some rationale, however. "The number of women over age 70 in clinical trials [testing chemotherapy regimens] is limited. And so it is difficult to draw inferences," added Naeim, who's also director of the geriatric oncology program at the Jonsson Comprehensive Cancer Center in Los Angeles. About half of all new breast cancers in the United States are diagnosed in women 65 years or older. Older women are also at higher risk of cancer recurrence, for which chemotherapy is considered an effective treatment. Yet, these are the very women who are frequently not offered this type of therapy. But some recent studies have begun to suggest that chemotherapy should be considered for older women with breast cancer. One, led by Dr. Hyman Muss, a professor of medicine at the University of Vermont and Vermont Cancer Center in Burlington, concluded that age alone should not be a reason to rule out chemotherapy in older women who are in good general health. In the study, which appeared in the March 2, 2005, issue of the Journal of the American Medical Association, Muss and his colleagues analyzed data on nearly 6,500 women who took part in clinical trials between 1975 and 1999. The researchers compared less aggressive chemotherapy with more aggressive treatments.

Eight percent of the women were 65 and older, and 2 percent were age 70 and above. The researchers found no association between age and disease-free survival. They did find that overall survival was worse for those women age 65 and older, but that was due to death from causes other than breast cancer. Also, older women were more likely to die of complications related to chemotherapy treatment (1.5 percent) vs. younger women (0.2 to 0.7 percent). But read more