Radiation versus Chemotherapy in the Elderly with Breast Cancer

People of older age are more likely to have long-term or fatal illnesses “In 1995, only 21% of all deaths were among the under-5s, 7% among those 5-19, 29% among those 20-64, and 43% among the over-65s. By 2025, 8% of all deaths will be in the under-5s, 3% among 5-19 year-olds, 27% among 20-64 year-olds and 63% among the over-65s.” WHO 2015. Cancer, Heart disease and more commonly related to the 70-75 age group and also people aged 75 and above have more chance of becoming impaired such as visually, mentally, mobility and hearing. Women with breast cancer deprives women of 10 years of their life expectancy making women that have/do have breast cancer not live as long. The risk of

Radiation therapy can be used anywhere in the body to treat any kind of cancer. Depending on what type of radiation therapy, it can have some side effects. The most common ones include fatigue, hair loss near the treated area, and skin darkening in the area exposed to a beam of radiation. ("Radiation Therapy for Cancer,” 1) There are also safety concerns that patients have when they are treated with radiation therapy. Many people that receive radiation therapy treatment, worry about exposing family and love ones to radiation, as well as the side effects. Radiation effects on the normal tissues are divided into acute and chronic effects (Schreiber). Acute effects occur during the course of therapy and during the post therapy period (approximately 2-3 weeks after the completion of a course of irradiation) (Schreiber).

The elderly population is growing with 35 million people who are age 65 years or older and half are between the ages of 65 to 74 and the other half are over the age of 75. The population age 85 years or older are the fastest growing population (Dubow, 2017). In 1991 the Institute of Medicine (IOM) reported that 8 out of 10 people over the age of 60 had one or more chronic diseases or impairments which included arthritis, hypertension, hearing impairment, heart disease, cataracts, deformity or orthopedic impairment, chronic sinusitis,

This ends up causing a disruption to internal hemostasis. You have special nerves (known as chemoreceptors) which will send a message to your brain when you have a lower pH level than you should. This causes your brain to send messages to your heart to increase the contractions. This also happens in your lungs. When these two things happen together it will cause your body to get rid of the CO2(which will take a longer amount of time if you are in bad shape, and a shorter time if you are in good

Though often effective, radiation therapy presents unique challenges with regard to early and late treatment toxicities, thought to develop as a response to vascular

A growing percentage of elderly people are starting to populate the world. With advances in modern medicine, the life expectancy has risen from

The geriatric population is a very vulnerable population, which needs great care. The main concerns are attributed to the age, educational background, medication experiences, living conditions and diet. All these contribute to factors which make it difficult to be adherent to their goals, which have been developed to improve their health.

Many people are living longer because of radiation therapy to treat cancer, but what happens after treatment is over? Most people go back to their normal life. However, some people will have their quality of life affected by late effects of radiation therapy. Late effects of radiation therapy can happen months or years after treatment and may be temporary or permanent. Some can be minor such as skin changes to the treated area, and some can be as serious as cardiovascular problems. As radiation therapy has become more advanced and more common in treating cancer, professionals in medicine have studied the treatments and late effects to decide what can be done to prevent late-effects from occurring.

Chemotherapy uses drugs that are designed to slow or stop the division of cancer cells. It targets cells that are in the process of dividing into two new cells and kills them, some drugs destroy the cell's control center and kills the cell, and some disrupts the chemical processes in cell division. Side effects of chemotherapy include nausea, vomiting, hair loss, and low red blood cell numbers. Because chemotherapy kills rapidly dividing cells like cancer, other normal cells that divide rapidly are also killed. Hair, bone marrow, and skin cells are constantly dividing to grow more hair, produce red blood cells, and replace dead skin cells. Radiation therapy uses targeted energy like x rays or radioactive substances to kill or shrink tumors. There are three types of radiation therapy delivery methods. External beam radiation therapy uses an external machine that directs radiation onto cancer cells. Internal radiation therapy uses radioactive material that is placed directly or near a tumor with a catheter. Systemic radiation therapy uses a radioactive substance that is swallowed or injected and travels through the bloodstream and locates and kills cancer cells. Side effects of radiation therapy depend on which part of the body the treatment is applied, some common general side effects are fatigue, and itching, blistering, or peeling of the skin. In the head and neck it can cause tooth decay, and mouth and gum sores, in the chest it can cause radiation pneumonitis, which causes a cough and fever, and radiation fibrosis, which is scarring of the lungs caused by untreated radiation pneumonitis. Radiation therapy causes side effects because high doses of radiation is applied to areas of the body which kill cancer cells, but also damages healthy cells near the treatment

From hair you will lose it quite quickly and it clumps around 200 rems. In the 5,000 rems of radiation it will start to kill nerve cells and a lot of small blood vessels causing seizures and immediate death. The thyroid gland is superbly susceptible to radioactive iodine in some cases destroying the whole thyroid which stores and produces hormones that affect the function of almost all organ in our bodies. Next is the blood system. The blood system, around 100 rems or so, make the bloods lymphocyte count extremely low making the person very susceptible to infection. This is considered minor radiation sickness. The early symptoms are very flu-like and will continue on until the blood count is almost completely gone, which can be extremely fatal for you. Your heart which at around 1,000 to 5,000 rems will do immediate damage to multiple small blood vessels and cause will probably cause heart failure or simply immediate direct death. Also radiation effects the gastrointestinal tract. The gastrointestinal tract, which includes the mouth, throat, and anus, helps digest food. With rad damage to the intestinal tract lining will cause nausea, bloody vomits and diarrhea above 200 rems. The intense amount of rads wil destroy cells that multiply very fast include the blood gastrointestinal tract reproductive and hair cells. This also harms the dna and rna of most of the

Radiation therapy is the use special machines to convey high-energy rays that damage cancer cells and stop them from growing. The radiation can be directed to a specific area of the body or the whole body. Some side effects that come from the therapy are fatigue, hair loss, nausea, or red, dry, itchy skin.

The incidence of radiation injuries is small compared with the number of procedures performed. More than 700,000 interventional procedures are being performed each year (Koenig). Any report that has been made about a skin injury has been reported to the FDA and has been investigated. The reports, usually received contain minimal information regarding the circumstances of the injury. The types of interventional procedures that resulted in reports of skin injuries were: cardiac catheter ablation, catheter placement and shunt placement (Shope). The injuries ranged by erythema to moist desquamation in others and to skin necrosis that required skin grafting.

Adequate perfusion supplies the entire body with necessary oxygen and nutrients to sustain life. The process of oxygenation and perfusion can be affected by a multitude of factors. A few examples are, a decreased oxygen carrying capacity, hypovolemia, neuromuscular disease, central nervous system alterations and chronic diseases (Potter, Perry, Stockert, & Hall, 2013, p. 826). Two specific examples of conditions affecting perfusion are cardiomyopathy and Raynaud’s phenomenon.

It is secondary to under-perfusion of otherwise normally functioning kidneys and if detected early can be reversible. In Mr Jones’s case, his kidney’s experienced hypo-perfusion during surgery. Hypo-perfusion consequently causes azotemia due to the excess nitrogenous wastes in the blood. Medications, such as high doses of dopamine, can cause prerenal kidney injury due to the production of intrarenal vasoconstriction, which can lead to hypo perfusion of the glomeruli (Nissenson, 1998). The kidneys have an enormous blood supply and account for 20-25% of cardiac output. This blood supply is needed for the removal of waste products and the management of fluid and electrolyte balances. If the blood flow to the kidneys is reduced, this has a decreasing effect on the GFR leading to a decreased urine output, filtration and reabsorption of filtered material through the glomerulus. This can lead to further issues and effect other organs in the body. Fredrick experienced a decreased urine output as a symptom of his reduced GFR. Fredrick’s increased respiration rate noted during assessment was an indicator of his deterioration and alerted the medical team that there was an underlying issue. During the nurse’s assessment, they observed that Frederic had very poor urine output, which is also linked with the drop in the GFR in the kidneys. Thus, encouraging the nursing staff to take immediate action with thereputic

Nevertheless, removing the most of the tumor in the affected area by the surgery, women tend to redevelop the disease that left still. For this reason, radiotherapy is applied after the breast conserving surgery. Understanding the mechanism of the radiation is that generating free radicals to destroy the cells by producing a large amount of energy that lead to breaking a single and double stranded DNA. A pregnant woman should avoid the radiotherapy, moreover the patients with previous cancer histories who was treated before (Buchholz, 2009). Chemotherapy is basically systemic therapy, yet has limited opportunity which depends on the affected number of lymph nodes, the size of the cancer, the presence of hormone receptors, and the amount of