Thursday, October 30, 2008

chemotherapy and polypharmacy

Medications and polypharmacy should be of major concern to seniors. With the glut of information on websites, and potentially inaccurate information, we are hard pressed to ensure that receive timely and research-based data, and statistics. For my part, I read everything carefully, and check its source. If there is a lot of advertising on a site I tend to ignore the information. My bottom line is that we have to contact the professionals to ensure that we are getting timely, accurate, and adequate information.

The Ontario Government recommends that seniors be monitored carefully to determine if polypharmacy is an issue causing more harm than good. H.M. Holmes and colleagues (Holmes, et al., 2006 and 2008) have done much research in this area. There are questions we must ask regarding polypharmacy. Many studies exist, but many more exclude seniors in their study population. Some have studied chemotherapy (defined as any prescribed chemicals) to better manage cancer in older patients.

Researchers show that cancer is related to the sequential mutations of key genes that control cell growth. Cumulative damage, such as exposure to carcinogens due to smoking or workplace risks, has contributed to the incidence rates. In addition, as seniors age, their defences are lowered and their immune systems become compromised. In a recent study (Balducci and Carreca, 2002), it was found that the diagnosis of cancer occurs eighty percent of the time at or above age fifty-five. Two-thirds of all cancer-related deaths occur in those over age sixty-five, and they found that patients over the age of sixty-five were less likely to be treated than those younger.

While advanced age is not a contraindication to cancer treatment, we must be vigilant in determining the risk versus reward of treatment, based on studies that tend not to include older patients. The toxicity of chemotherapy presents great risks for those already frail and dosages must be carefully prescribed.

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