This is a question raised by netizens.
Cancer is a type of malignant tumor, let's say malignant tumor.
Why would a cardiologist answer such a question?
Because I worked in the cardiovascular ward of geriatrics for many years. Although the specialty is cardiovascular, but the disease of the elderly is so simple?
Many patients with cardiovascular disease have malignant tumors, and some patients are also mixed. In addition, patients with malignant tumors also need to be evaluated by a cardiologist before surgery, before chemotherapy, and sometimes under the supervision of a cardiologist. Therefore, we have treated many elderly patients with malignant tumors under the guidance of specialists. If you count, there are oral cancer, lung cancer, esophageal cancer, cardia cancer, stomach cancer, colorectal cancer, liver cancer, gallbladder cancer, pancreatic cancer, breast cancer, bladder cancer, and lymphoma.
The elderly have a malignant tumor or can not be cured? Of course, it still needs to be treated, but the method of treatment needs to be better weighed and selected.
★ First of all, should the elderly, 80 years old or older people have malignant tumors, or other diseases? A very important point is that age is not the main factor for the elderly to decide whether to operate, radiotherapy and chemotherapy, the main determining factor is whether the elderly patients need such treatment, physical condition, organ function can withstand such treatment, such treatment on the patient's ultimate benefit is not great.
Of course, the elderly themselves have decreased organ function, especially the elderly over 80 years old, even if there are fewer underlying diseases, the potential risks are to be considered, but can not simply be judged by age. The same is the 80-year-old man, some people have surgery is very good, some people can not bear, these are need to be individualized judgment.
Not long ago, an 80-year-old patient of mine had positive fecal occult blood, did gastrointestinal endoscopy and found colorectal cancer, and went to surgery to successfully perform surgery. Previously, there were also 80-year-old patients with rectal cancer who did not undergo radical surgery due to the consideration of the large scope of surgery, local resection of the lesions and radiotherapy, and the tumor did not recur until the age of 88. However, I have also encountered colorectal cancer patients in their 80s, and the doctor considered the risk of surgery but insisted on surgery, and as a result, he died in the ICU for 1 month after surgery.
In fact, these are the same for young and middle-aged people. Surgery, radiotherapy and chemotherapy and other treatments with large injuries must be fully weighed against the pros and cons.
★ Second, there are many ways to treat malignant tumors, surgical resection, radiotherapy, chemotherapy are treatments, some palliative care to alleviate symptoms and improve quality of life, nutritional support is also treatment. It is not a treatment or surgery, chemotherapy, nor should it be said that the elderly have a malignant tumor and should give up.
In addition, many surgeries now have minimally invasive methods, radiation therapy also has conformal irradiation, gamma knife, Tuo saber, etc. more accurate, drugs also have targeted drugs, which greatly reduce the damage to the human body and adverse reactions, so that more elderly people can also bear.
For example, 80-year-old colorectal cancer can be operated on, and 80-year-old lymphoma can also be treated with chemotherapy. We have treated malignant lymphoma patients around the age of 80, some of whom can tolerate chemotherapy, and some of which cannot be tolerated after two cycles of chemotherapy. The latter, under the guidance of experts in the cancer hospital, applied interferon therapy, and also achieved good results, and the patient survived for more than 10 years.
★ Third, the treatment of advanced malignant tumors. If it is in the advanced stage of the tumor, do not say that it is the elderly, even if it is young and mature, the general surgical radical treatment method cannot be performed, and the same is true for radiotherapy and chemotherapy.
Surgery at this time is generally palliative care to relieve symptoms, and it is also done if necessary. For example, the stent or ostomy tube is placed after the obstruction of esophageal cancer to solve the problem of eating in patients; ostomy after intestinal tumor obstruction solves the problem of defecation; biliary obstruction is stented to drain bile, etc., to solve part of the patient's dysfunction, alleviate symptoms, and alleviate pain.
At this time, radiotherapy and chemotherapy do not point to killing tumors and curing diseases, but can inhibit the growth of tumor cells, reduce the damage of tumors themselves and metastasis, delay the progression of diseases, protect patients' organ functions, and prolong patients' survival.
Patients with advanced tumors are depleted, tumor infiltration compresses and metastasis causes pain and dysfunction, and nutritional support and symptomatic analgesic treatment are also needed.
For older patients, the rate of tumor growth is also slowed. If life expectancy is limited and the patient cannot tolerate treatment, it is possible to go with the flow without treatment. One of our patients, coronary heart disease, pacemakers installed, large-scale cerebral infarction, bilateral carotid artery severe stenosis (90% to 95%), one side did endometrial peeling, 6 years ago found lung cancer without special treatment, lung cancer is also growing in recent years, but the patient is 99 years old this year.
The weakening of physical function in the elderly, the reduction of organ function is a common phenomenon, the tolerance to surgery and radiotherapy and chemotherapy will also be reduced, and the life expectancy is limited; many people still have a variety of chronic diseases, there is a potential risk of acute attack, so whether it is surgery or chemotherapy, it is more prudent. In the advanced stage of cancer, treatment is to weigh the pros and cons, can not blindly emphasize the treatment and hurt the patient, accelerate the patient's failure.
At present, for the treatment of malignant tumors, multidisciplinary consultation is emphasized, and the treatment plan is formulated based on the overall condition of the patient.
Therefore, for the malignant tumors of the elderly, whether it is surgery, radiotherapy, chemotherapy, all kinds of treatment should be carried out individually on the basis of principles.
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