A gerontologic perspective on cancer and aging

Most people diagnosed with cancer are aged > 65 years, and many diagnosed younger live to become older survivors. Geriatric oncology is becoming recognized as a specialty area within oncology. It focuses specifically on the functional impacts of the interplay of aging and cancer, including the role of comorbidities. Nevertheless, to the authors' knowledge, little attention has been given to cancer from a gerontologic and lifespan perspective, especially quality of life and psychologic impact. Research has shown that the amount and type of psychologic impact of cancer is highly variable and that part of that variation is related to age, in that older persons are often less affected in both negative and positive ways. Gerontologic concepts and empiric findings related to physical, psychologic, and social aging processes may serve as partial explanations for that age-related pattern. Important potential contributors include psychologic factors, such as changes in future time perspective and goals, as well as social ones, such as roles and previous experience. The result is a complex interplay of factors that vary across persons but are covaried with age. Empiric findings regarding 1-year to 8-year prostate cancer survivors illustrate the age differences and the differential impacts of age itself and comorbidity. The use of gerontologic concepts to explain the age-related impact of cancer will benefit both research and clinical practice by providing a means to target interventions more effectively by taking into account the psychologic and social changes that often accompany aging.