According to professional estimates, about 37% of new cancer cases worldwide are currently diagnosed among people over 70/ShutterStock
In the Western world, including in the State of Israel, in recent decades we have been dealing with the consistent increase in life expectancy that leads to the aging of the population.
This demographic figure has implications for all areas of life, and one of them is the need for health care systems all over the globe to deal with diseases that characterize old age - primarily cancer, which is considered the main cause of death in Israel as of 2020.
According to professional estimates, about 37% of cases The new cancers around the world are currently diagnosed among people over the age of 70 and it is expected that this number will double by the year 2040.
Despite this consistent increase, not enough attention has yet been given to the unique needs of older people dealing with cancer, and not enough has been done to improve existing services to better meet their needs during this difficult journey.
The fact that many elderly patients come to the oncologist only at a late stage is due to many reasons, mainly the difficulty of the medical and public system to provide an adapted response to the elderly, which includes the management of the disease in a holistic manner by multidisciplinary teams, and also, limited scientific information regarding the various treatments among the elderly due to a minority Clinical studies are tailored to this population.
"The increase in life expectancy and the increase in the size of the elderly population also requires a specific attitude towards it in the worlds of health"/ShutterStock
The person who is intimately familiar with all of these challenges is Prof. Gil Bar Sela, chairman of the Oncology and Radiotherapy Association and director of the oncology department at the Emek Medical Center: "The increase in life expectancy and the increase in the size of the elderly population also requires a specific attitude towards it in the worlds of health," he explains. "If In the past, the age of 65 was defined as the beginning of the 'third age', but today it is no longer considered as such, and the older population is defined in the decade between the ages of 70 and 80.
We make another division between them and the ultra-elderly population, which includes those aged 80 and over," adds Prof. Bar Sela.
"If we focus on the world of oncology, there are a variety of challenges and complexities in the treatment of the elderly and those suffering from cancer.
These include the difficulty for older patients to withstand oncology treatments, especially chemotherapy treatments or complex surgeries, as well as the fact that most of the third and fourth year olds often take medications for various diseases, and the interactions between the proposed treatment and those medications must be checked.
In addition, emphasis must be placed on the home support system, since most of the side effects of the treatments occur at home after the treatment and not every elderly person has a sufficient support system."
While until now not enough attention has been given to the issue, recently things are beginning to change. "In response to these complexities, the Oncology Association Currently promoting the establishment of a unique forum with the participation of additional medical associations, public sector bodies and pharmaceutical companies.
The purpose of the forum is to act in order to improve and optimize oncology treatment in the elderly," says Prof. Bar Sela. "This forum is in the practical stages of establishment and I hope that in April we will be able to welcome the completion and it will begin to operate," he notes.
It is of great importance to be examined by a dermatologist in every case of a new skin lesion/ShutterStock
As mentioned, the incidence of cancer is increasing as a result of the increase in life expectancy, and within this group also non-melanoma skin cancers.
This is a very common cancer among adults who were exposed to the sun during their lives (and Israel, as you know, is a sunny country).
The most common location for the development of non-melanoma skin cancers is in the parts of the body exposed to the sun in daily life - head, neck, upper limbs and more.
The appearance of these tumors is very diverse and often misleading since it can look like a callus or a wound that does not heal, itches and itches.
Therefore, beyond the routine examinations that are recommended to be done regularly by dermatologists, it is of great importance to be examined by a dermatologist in every case of a new skin lesion that does not "heal"
. They are basal cell carcinoma and squamous cell carcinoma.
These lesions appear with the aging of the skin and they result from long-term exposure to solar radiation," explains Prof. Bar Sela. "When today's older generation was younger, there was no awareness of the damage of solar radiation, and therefore these tumors are seen with high frequency in many adults, and without treatment they may grow and become life-threatening."
How dangerous is this disease?
"Thanks to early diagnosis and advanced treatment methods, in most cases non-melanoma skin cancers can be cured by various methods such as standard surgery or Mohs surgery, radiation, scraping and cauterization with an electric needle, nitrogen freezing liquid, ointments and more. Early detection of the disease is possible and relatively simple compared to other cancers mainly due to the fact that the lesion is seen with the naked eye. However, among some of the older population, especially those to whom the medical system is less accessible, the skin lesions are neglected and they come to treatment Only when the skin lesion became a large and bleeding ulcer to the point of significantly affecting their quality of life, and sometimes putting their lives at risk if it invaded the deep tissues or sent metastases," explains Prof. Bar Sela.
"One of the main problems we see in the encounter between skin cancer and elderly patients is the issue of late diagnosis"/ShutterStock
What are the treatment methods for non-melanoma skin cancer in an advanced local stage or with metastases?
"In addition to surgery, which is the lot of surgeons, in the arsenal of tools of the oncologist you can find the classic treatment tools of radiation treatments and chemotherapy. In addition, in the last decade, new treatments such as biological treatments and immunotherapy have entered. 'Immunotherapy' is a treatment that acts on the immune system and causes it to recognize the tumor as an "enemy" and to fight it," explains Prof. Bar Sela.
"In the beginning, immunotherapy proved to be the most effective in melanoma tumors, but today it is also given in non-melanoma skin cancer cases, because these tumors, like melanoma, which is also caused by a lot of sun exposure, are characterized by significant genetic changes, which exposes them to detection and subsequent attack by the immune system of the body. It can be said that the immunotherapy treatments help the immune system to be more effective against those cancerous tumors. Today, these treatments help us prolong the lives of patients with non-melanoma skin cancer, and expand the treatment options for older patients."
Einval Cohen Toval, CEO of the Israeli Skin Cancer Association adds
: "One of the main problems we see in the encounter between skin cancer and elderly patients is the issue of late diagnosis.
The patient often tends to think that his lesion is something insignificant that will go away, and if it hasn't gone yet, it's because of his age, and usually by the time the patient goes to check one or another lesion, he will go to the family doctor first and not to the dermatologist, thus further delaying the diagnosis of the disease." According to her, after the diagnosis, Patients in their third and fourth years face many additional difficulties as part of the disease, such as difficulty in getting treatments, dealing with the side effects, daily functioning, etc. "The association helps patients and patients of all kinds to deal with skin cancer in all its stages, in addition, we developed a training program last year whose entire purpose is To identify warning signs of skin cancer among the elderly population and thus lead to an early diagnosis of the disease," concludes Cohen-Toval.
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