But older and younger women derived similar decreases in death rates from breast cancer and in recurrence when they were on the regimens containing the more aggressive chemotherapy, the study found. "The message, at least for healthy older women, is if you're considering
chemotherapy and you feel that that's appropriate, then it would be perfectly reasonable to give it," Muss told HealthDay. No one is saying it's best to offer all older women chemotherapy, Naeim emphasized. "It's a very complicated process, the pathway to the treatment decision," he said. "There is no right answer to whether the chemotherapy is the right or the wrong treatment." Naeim, who has also published on the topic, said it's important to take the total patient into account when deciding whether to recommend chemotherapy. "Take an older woman with arthritis, in a wheelchair, with coexisting disease [such as heart problems], who just had surgery for breast cancer," he said. "The doctor is saying he can give you
chemo, and this may help you not get breast cancer down the road. That person may not be interested in down the road.
Their baseline quality of life may not be so good. And having a worse quality of life [during chemotherapy] is not worth it for them, perhaps." "It's easy [for the doctor] to say something improves your survival or quality of life, but it might be that the amount it improves it is so small you may decide it is not worth doing it," Naeim said. For older women with breast cancer facing treatment decisions, Naeim offered this advice: "Understand the goals and objectives of the treatment. Patients often don't understand why they are getting [a specific treatment], the purpose of the treatment." It's wise to ask. "Ask for alternatives," Naeim said. "There is no one right answer and there are multiple options." Making such decisions should be easier for older women in the future, he said. "There are more and more researchers actively looking at the older population and the more studies that come out that focus on that, the more information we will have to make rational decisions."
