Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Geriatric oncology: challenges and rewards of treating elderly cancer patients

Dr. Damane Zehra
Conditions
June 2, 2024
Share
Tweet
Share

If anyone asks me, “What part of oncology do you hate the most?” I would definitely answer without much thought, “geriatric oncology.” I think that’s the most difficult specialty because it needs extraordinary skills and patience to deal with elderly patients dealing with cancer. Although cancer is much more prevalent in the elderly, their needs are quite different compared to other adult patients. They are mostly very weak and malnourished, have multiple co-morbidities and complex medical histories, are already on a lot of medications, and may have very limited activity of daily living. They are the most difficult patients to treat because you have to think a lot before starting them on any kind of treatment. It needs a lot of experience and foresight to look at all the treatment options for them because they might not tolerate your treatment at all and may even end up in intensive care units. Sometimes I feel as if they are just like fragile flowers that can wilt with just a little extra sunlight. They need tender love and care, a harsh word or slight insensitivity in their treatment may lead to negative outcomes. That’s why I hate it because this specialty needs a lot of patience and extra empathy.

Today, a very elderly patient diagnosed with bladder cancer came to our OPD. He was 97 years old and was accompanied by two of his sons and two grandsons. He was too fragile and weighed only 45 kg. He was diagnosed after having two episodes of frank hematuria. The urologist did his transurethral resection of the bladder tumor and referred him to oncology to decide further treatment for him. He was such a cute and sweet gentleman, a retired banker who had led a very productive life and was still active enough to offer his prayers and go to the washroom on his own. When I was examining him and I touched his hands, his skin was as soft as if they were the hands of a child. Sometimes when I see very elderly patients, I complain to God, why does He make them suffer at such an age when they have already gone through many trials of life all those years? Why does He test them so much, even in the end? When they have spent their whole life independently, why does He make them dependent on others during their treatment at such an age? Maybe that’s why life is called a test because that test never ends, even till your last breath.

We decided to give him palliative radiation to his bladder only to control the bleeding, as he was in such a delicate age and health state that it would be very cruel to subject him to bladder surgery, chemotherapy, or a definitive long course of radiation treatment. When we explained the treatment process of a few days of radiation treatment to him, which is a very simple and painless treatment, he smiled and asked me, “Doc, can you please tell me you would be able to complete my century? I am really looking forward to it.”

At that moment, I felt as if I should do my best in my limited abilities to help him achieve his goal. We decided on a very nice protocol for him, which would not only control his disease for a long time but would maintain his quality of life as well. I can just hope and pray that his dream comes true and that he may live a healthy and happy life with his grandchildren and even their children, who were so hopeful and worried for him at the same time. I think dealing with such cases is a lot difficult for the oncologist because it tests our skills to choose the best possible well-crafted treatment for our elderly patients while maintaining their quality of life. And we have to put an extra effort to keep them in high spirits so they don’t get demotivated or exhausted during the treatment.

“To care for those who once cared for us is one of the highest honors.”
– Tia Walker

Damane Zehra is a radiation oncology resident in Pakistan.

Prev

Embracing innovation in the digitized operating room

June 2, 2024 Kevin 0
…
Next

The diversity-performance trade-off in academic medicine

June 2, 2024 Kevin 0
…

Tagged as: Oncology/Hematology

Post navigation

< Previous Post
Embracing innovation in the digitized operating room
Next Post >
The diversity-performance trade-off in academic medicine

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More by Dr. Damane Zehra

  • A female doctor’s day: exhaustion, sacrifice, and a single moment of joy

    Dr. Damane Zehra
  • How one simple breakfast question can transform patient care

    Dr. Damane Zehra
  • A doctor’s emotional struggle with a young leukemia patient

    Dr. Damane Zehra

Related Posts

  • Why new cancer treatments cannot save us

    Yongjia Wang
  • Cancer patients who want to take unproven supplements

    Marc Braunstein, MD, PhD
  • As cancer patients wait, states play favorites

    Jaimie Cavanaugh, JD and Daryl James
  • We must help patients recognize how important their opinions are

    Karen Sepucha, PhD
  • The deadly consequences of a shortage: The Pluvicto crisis leaves metastatic prostate cancer patients in limbo

    Matt Drewes
  • Cancer care costs everyone too much. What can we do about it?

    Andrew Hertler, MD

More in Conditions

  • Hope is the lifeline: a deeper look into transplant care

    Judith Eguzoikpe, MD, MPH
  • From hospital bed to harsh truths: a writer’s unexpected journey

    Raymond Abbott
  • Bird flu’s deadly return: Are we flying blind into the next pandemic?

    Tista S. Ghosh, MD, MPH
  • “The medical board doesn’t know I exist. That’s the point.”

    Jenny Shields, PhD
  • When moisturizers trigger airport bomb alarms

    Eva M. Shelton, MD and Janmesh Patel
  • Medicaid cuts are quietly fueling the diabetic kidney failure crisis

    Jane Zill, LICSW
  • Most Popular

  • Past Week

    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • Why recovery after illness demands dignity, not suspicion

      Trisza Leann Ray, DO | Physician
    • Addressing the physician shortage: How AI can help, not replace

      Amelia Mercado | Tech
    • Bureaucracy over care: How the U.S. health care system lost its way

      Kayvan Haddadan, MD | Physician
    • Why does rifaximin cost 95 percent more in the U.S. than in Asia?

      Jai Kumar, MD, Brian Nohomovich, DO, PhD and Leonid Shamban, DO | Meds
    • Why medical students are trading empathy for publications

      Vijay Rajput, MD | Education
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • Residency as rehearsal: the new pediatric hospitalist fellowship requirement scam

      Anonymous | Physician
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • The hidden bias in how we treat chronic pain

      Richard A. Lawhern, PhD | Meds
  • Recent Posts

    • When errors of nature are treated as medical negligence

      Howard Smith, MD | Physician
    • Physician job change: Navigating your 457 plan and avoiding tax traps [PODCAST]

      The Podcast by KevinMD | Podcast
    • The hidden chains holding doctors back

      Neil Baum, MD | Physician
    • Hope is the lifeline: a deeper look into transplant care

      Judith Eguzoikpe, MD, MPH | Conditions
    • Why medical students are trading empathy for publications

      Vijay Rajput, MD | Education
    • From hospital bed to harsh truths: a writer’s unexpected journey

      Raymond Abbott | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • Why recovery after illness demands dignity, not suspicion

      Trisza Leann Ray, DO | Physician
    • Addressing the physician shortage: How AI can help, not replace

      Amelia Mercado | Tech
    • Bureaucracy over care: How the U.S. health care system lost its way

      Kayvan Haddadan, MD | Physician
    • Why does rifaximin cost 95 percent more in the U.S. than in Asia?

      Jai Kumar, MD, Brian Nohomovich, DO, PhD and Leonid Shamban, DO | Meds
    • Why medical students are trading empathy for publications

      Vijay Rajput, MD | Education
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • Residency as rehearsal: the new pediatric hospitalist fellowship requirement scam

      Anonymous | Physician
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • The hidden bias in how we treat chronic pain

      Richard A. Lawhern, PhD | Meds
  • Recent Posts

    • When errors of nature are treated as medical negligence

      Howard Smith, MD | Physician
    • Physician job change: Navigating your 457 plan and avoiding tax traps [PODCAST]

      The Podcast by KevinMD | Podcast
    • The hidden chains holding doctors back

      Neil Baum, MD | Physician
    • Hope is the lifeline: a deeper look into transplant care

      Judith Eguzoikpe, MD, MPH | Conditions
    • Why medical students are trading empathy for publications

      Vijay Rajput, MD | Education
    • From hospital bed to harsh truths: a writer’s unexpected journey

      Raymond Abbott | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...