The King’s doctors must avoid some common treatment mistakes, writes top cancer expert PROFESSOR KAROL SIKORA. These are the crucial decisions they will consider
The king’s cancer diagnosis has taken everyone by surprise, just days after his successful treatment for a benign prostate condition.
But the odds are clearly in his favor when it comes to his chances of a full recovery. He is fit, eats well, drinks little alcohol and – most importantly – his yet-to-be-identified cancer appears to have been detected at a very early stage.
Yet at the age of 75, there are some crucial factors that need to be taken into account by both the King’s doctors and those treating the tens of thousands of men and women of the same age who are diagnosed with cancer on the NHS every year.
First, cancer cells can behave very differently in the elderly – seventy years and older – than in younger people.
In women, for example, older age is associated with fewer high-grade tumors, the kind that are likely to spread quickly and aggressively and have a much lower survival rate.
It is not entirely clear why, but there are indications that cancer cells – just like healthy cells – can also become ‘tired’ as they age. Their biochemistry may differ from malignant cells found in a younger body and their ability to colonize other organs and tissue is often weakened.
The odds are heavily in favor of King Charles (who leaves hospital today). He is fit, eats well, drinks little alcohol and – most importantly – his yet-to-be-identified cancer appears to have been detected at a very early stage
On the other hand, prostate cancer in older men is often much more aggressive.
For example, a 75-year-old man’s chances of surviving the disease are likely to be much lower than those of someone in their 50s or 60s – even if the tumor is picked up at an early stage, research shows.
In fact, cancer in the elderly is so different that in some circles it is now called its own medical specialty: geriatric oncology.
And with good reason. In the past, older cancer patients treated on the NHS were given toxic and potentially even fatal high doses of chemotherapy to try to erase their tumours, while many of them – as we now know – were unable to withstand such an attack to resist.
Fortunately, today the idea is to treat such patients so that they have a decent quality of life (itals) with (end itals) their cancer, rather than trying to destroy it at all costs.
On the other side of the coin, the NHS also has an unfortunate history of under-treating some patients in their 70s or older, because they are old and would see only limited benefit from expensive treatments that could go to someone younger. .
His cancer diagnosis took everyone by surprise, just days after his successful treatment for a benign prostate condition
But things have changed. Men and women in their 70s today are generally much healthier than those of 20 or 30 years ago and better able to cope with cancer therapy. In addition, medicines and treatments are a lot gentler than before; the risks of being poisoned by it are much smaller.
And this will only get better. Within the next decade, we will be able to sample the DNA of tumor cells and then use artificial intelligence to predict exactly which drug or treatment each individual patient will respond best to – choosing the right one in one go and saving a large portion of the trial and errors that we currently see in cancer care.
We still don’t know what King Charles’ diagnosis is, but I’m very optimistic about his prognosis – and equally about the future prospects for cancer patients diagnosed around the same age.