Cancer, a leading cause of death worldwide, is a particular concern for the aging population. As the number of older adults continues to grow, the prevalence of cancer in gerontology also rises. Age-related changes in the body, such as a weakened immune system and increased inflammation, can contribute to the development and progression of cancer in older individuals. Approximately 60% of all cancer diagnoses and 70% of cancer-related deaths occur in individuals aged 65 and above. With the unique challenges that geriatric patients face, including age-related comorbidities and functional decline, it is crucial to develop tailored treatment strategies for this population. Integrative oncology, which combines conventional cancer treatments with evidence-based complementary therapies, offers a promising approach to managing cancer in gerontology.

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What is Integrative Oncology?

Integrative oncology focuses on the whole person, addressing the physical, emotional, and social aspects of cancer. This approach recognizes that cancer affects not only the body but also the mental and emotional well-being of the individual, which in turn can impact treatment outcomes. It combines conventional treatments such as surgery, radiation, and chemotherapy with complementary therapies like nutrition, mind-body practices, and supplements to improve overall health and well-being. Integrative oncology ensures that patients receive comprehensive care that addresses their unique needs and preferences by utilizing a multidisciplinary team of healthcare professionals. This patient-centered approach is particularly important for geriatric patients, who may face additional challenges related to aging and multiple comorbidities. By focusing on both prevention and healing, integrative oncology aims to improve cancer outcomes and enhance the quality of life for geriatric patients while empowering them to take an active role in their own care.

How Common Is Cancer In Gerontology?

As the global population continues to age, the number of geriatric cancer patients is expected to increase significantly. In the United States alone, it is estimated that by 2030, 70% of all cancer diagnoses will be in the geriatric population. This underscores the importance of addressing cancer in gerontology and exploring novel approaches like integrative oncology.

Signs & Symptoms of Cancer in Geriatric Patients

Common signs and symptoms of cancer include:

• Unintentional weight loss
• Persistent fatigue
• Unexplained pain
• Changes in skin color or texture
• Persistent cough or hoarseness
• Changes in bowel or bladder habits
• Difficulty swallowing or indigestion
• Unexplained bleeding
• A new lump or mass

Common Causes of Cancer in Gerontology

Lung cancer, breast cancer, prostate cancer, and colorectal cancer are some of the most common cancers among older adults. Factors such as genetics, exposure to environmental toxins, poor diet, sedentary lifestyle, and chronic inflammation contribute to the development of these cancers. Lung cancer, the leading cause of cancer-related deaths in this population, is primarily linked to smoking and exposure to secondhand smoke, asbestos, and arsenic. Geriatric patients may experience more aggressive lung cancer due to age-related decline in immune function. Furthermore, the incidence of breast cancer and prostate cancer increases with age, and is therefore common in the geriatric population. Colorectal cancer, the third most common cancer worldwide, primarily affects individuals aged 50 and above.

Genetics

Specific inherited genetic mutations can increase the risk of developing cancer in geriatric patients. For example, mutations in the BRCA1 and BRCA2 genes are associated with an increased risk of breast and ovarian cancers in women. In contrast, mutations in the HNPCC (Lynch syndrome) genes can lead to a higher risk of colorectal cancer.

Environmental Toxins

Exposure to environmental toxins, such as asbestos, radon, and certain chemicals, can increase the risk of cancer in older adults. Age-related declines in the body's detoxification systems and thinning of the skin can make geriatric patients more susceptible to the harmful effects of these toxins.

Poor Diet

A diet high in processed foods, refined sugars, and unhealthy fats can contribute to inflammation and increase cancer risk in older adults. Conversely, a nutrient-dense, anti-inflammatory diet rich in fruits, vegetables, whole grains, and healthy fats can help protect against cancer and support overall health. The gut microbiome is important in colorectal and breast cancer development and progression, affecting how the disease forms and how patients respond to treatment. Modifying the microbiome through promising new strategies may improve health, increase survival rates, and reduce the side effects of cancer treatment.

Sedentary Lifestyle

A sedentary lifestyle is a significant concern in geriatric health, as it contributes to obesity, inflammation, and hormonal imbalances. These elements, combined, exacerbate the risk of colon, endometrial, and lung cancer in older adults. Fortunately, regular physical activity serves as a powerful countermeasure, reducing cancer risk and fostering overall health and well-being in the elderly population.

Chronic Inflammation

Chronic inflammation has long been recognized as a contributing factor to the development of several cancer types, encompassing lung, prostate, and colorectal cancers. Within the geriatric patient population, age-related transformations in the immune system, coupled with exposure to inflammatory factors, amplify the risk of cancer.

Functional and Integrative Medicine Labs for Gerontology Oncology Patients

Geriatric oncology patients can benefit from functional and integrative medicine labs that provide comprehensive assessments to help detect early signs of cancer, monitor treatment progress, and address underlying health issues.

Cancer Panels

The Access Medical Labs Extended Cancer Panels for women and men provide a comprehensive assessment of various cancer biomarkers, including tumor markers and hormone levels. These panels can help detect early signs of cancer and monitor treatment progress in geriatric oncology patients. Identifying abnormal lab markers can aid healthcare professionals in developing targeted treatment plans for older adults, improving outcomes and overall quality of life.

While tumor markers are useful tools in cancer detection and monitoring, they have limitations. Tumor markers may not always be a definitive sign of cancer, as they can also be elevated due to non-cancerous conditions. In some cases, tumor markers may remain within the normal range even in the presence of cancer, leading to false-negative results. Additionally, some tumor markers are not specific to a particular type of cancer, making it challenging to pinpoint the exact cancer type based on tumor marker levels alone.

Hs-CRP

The hs-CRP test measures the levels of C-reactive protein, a marker of inflammation in the body. Elevated levels of CRP have been linked to an increased risk of cancer development and progression. In geriatric oncology, this test can help identify underlying inflammation that may contribute to cancer.

Comprehensive Stool Testing

The Diagnostic Solutions GI-MAP Stool Test provides valuable insights into the gut microbiome, digestive function, and inflammation within the gastrointestinal tract. Imbalances in the gut microbiome and digestive issues can contribute to chronic inflammation, which may increase cancer risk in geriatric patients.

GPL-TOX

The GPL-TOX Panel is a comprehensive test that evaluates the levels of toxins and chemicals present in the body, which can contribute to increased cancer risk in geriatric patients. This test assesses exposure to harmful chemicals from various sources, including environmental pollutants, food, and water. Identifying and reducing exposure to toxins can help prevent chronic inflammation and oxidative stress, reducing the risk of cancer in older adults.

Genetic Testing

BRCA1 and BRCA2 gene mutations play a significant role in the development of certain cancers, particularly breast and ovarian cancer in women and prostate cancer in men. However, it is important to note that only about 5-10% of all cancers are linked to inherited gene mutations.

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Conventional Treatment for Cancer in Gerontology

Conventional cancer treatments, such as surgery, chemotherapy, radiation therapy, and targeted therapies, are often used to treat cancer in geriatric patients. However, these treatments can come with significant side effects, such as fatigue, diarrhea, and hair loss, which could, in turn, be exacerbated further by age-related factors like comorbidities.

Functional and Integrative Medicine Treatment for Cancer in Gerontology

Functional and integrative medicine approaches to cancer treatment for geriatric patients focus on promoting overall health and well-being through lifestyle changes and a balanced and nutrient-rich diet, emphasizing whole foods, and reducing inflammation. This holistic approach addresses unique nutritional needs to support immune function, recovery, and overall health in older adults with cancer.

Balanced and Nutrient-Rich Diet

Cancer can trigger significant changes in metabolism and physiology, impacting nutritional requirements for various nutrients. Common cancer treatment side effects, such as appetite loss, taste changes, and gastrointestinal issues, can lead to poor nutrient intake and malnutrition. During treatment, nutrition goals for cancer patients should focus on addressing nutrient deficiencies, maintaining lean body mass, minimizing nutrition-related side effects, and enhancing overall quality of life.

Anti-Inflammatory Foods

Chronic inflammation can damage healthy cells and tissues, weaken the immune system, and increase the risk of cancer. To reduce inflammation and lower cancer risks for geriatric patients, incorporating an anti-inflammatory diet is crucial. This includes consuming more plant-based foods rich in phytonutrients, antioxidants, and fiber, limiting processed foods, and balancing omega-3 and omega-6 fatty acids. Moreover, reducing red meat intake, opting for pasture-raised and hormone-free animal products, and incorporating fermented foods like yogurt, kefir, sauerkraut, and kimchi can further help mitigate inflammation and promote overall health.

Lifestyle Changes

For geriatric cancer patients, recommended lifestyle changes include increasing physical activity and reducing sedentary behavior. These factors are associated with an increased risk of more than ten cancers, including colorectal, breast, and endometrial cancers. Emphasizing a diet rich in whole grains, fiber, fruits, and vegetables can help lower cancer risk while limiting alcohol consumption is crucial in reducing breast cancer risk. Maintaining a healthy weight is also important, as obesity is linked to increased cancer risk and mortality.

Supplements and Herbs Safe to Use With Cancer in Older Adults

Supplements and herbs like Vitamin D, curcumin, omega-3 fatty acids, and green tea extract can provide additional support for older adults with cancer. These supplements possess properties that help maintain overall health, reduce inflammation, and enhance the effectiveness of cancer treatments.

Vitamin D for Cancer in Older Adults

Studies suggest that sufficient vitamin D levels are associated with a lower risk of various cancers, including colon, breast, ovarian, and prostate cancer. Vitamin D deficiency is more common among residents of the northeastern United States and individuals with more skin pigmentation. Improving vitamin D status, such as through supplementation, could potentially reduce cancer incidence and mortality in the elderly with minimal adverse effects.

Curcumin for Cancer in Older Adults

Curcumin, a natural substance found in turmeric, has been studied for its numerous health benefits, including its potential to fight cancer. It works by targeting various cell pathways involved in cancer growth and spread. Curcumin can affect different proteins and molecules in the body, helping to promote cancer cell death and reduce inflammation. When used alone or with other treatments, curcumin could be a promising option for cancer therapy.

Omega-3 Fatty Acids for Cancer in Older Adults

Evidence suggests that long-chain omega-3 fatty acids, found in high levels in some fish oils, may have protective effects against common cancers like breast, colon, and possibly prostate cancer. Various mechanisms contribute to these protective effects, such as preventing cancerous transformation, inhibiting cell growth, promoting cell death, and reducing blood vessel formation in tumors. A key factor in many of these effects is the reduction of harmful substances produced from omega-6 fatty acids.

Green Tea Extract for Cancer in Older Adults

Green tea has become popular for its potential cancer-fighting properties. Its main component, EGCG, is found in various organs and has shown promising results in preventing cancer. Combining EGCG with other compounds can enhance its effectiveness in combating cancer cells.

Complementary and Integrative Medicine for Cancer in Gerontology

Complementary and integrative medicine approaches, such as acupuncture, yoga, and massage therapy, offer valuable support for older adults with cancer. These therapies can help alleviate cancer-related pain, nausea, and fatigue, as well as improve mental well-being, immune function, and overall quality of life.

Acupuncture

Acupuncture, an ancient Chinese medicine practice, involves the insertion of thin needles into specific points on the body to balance energy flow. A study involving 522 patients found that 69% were interested in receiving acupuncture for nausea during radiotherapy treatment. Results indicated that acupuncture-point stimulation reduced acute vomiting but not acute or delayed nausea severity compared to control. Electroacupuncture demonstrated benefits for chemotherapy-induced acute vomiting, while self-administered acupressure showed a protective effect for acute nausea.

Yoga and Meditation

Yoga is a feasible and beneficial intervention for a wide range of cancer patients, including those with differing cancer diagnoses and at various stages of disease and treatment. Yoga has shown positive effects on sleep quality, mood, stress, cancer-related distress, symptoms, and overall quality of life, as well as functional and physiological measures. Yoga can positively affect the mind-body connection of cancer patients by addressing various aspects of their mental and physical well-being. Research indicates that yoga may ease cancer-related fatigue, improve sleep quality, aid in recovery from cancer surgery, and reduce depression, anxiety, and distress. Through a combination of physical poses (asanas), breathing techniques, and meditation or mindfulness exercises, yoga helps promote relaxation and stress reduction. Less strenuous types of yoga, such as gentle hatha and restorative yoga, can be particularly beneficial in managing treatment side effects. Overall, yoga has the potential to enhance patients' quality of life by improving their physical flexibility, balance, self-esteem, and spiritual well-being, while also providing relief from pain and promoting relaxation.

Massage Therapy

Oncology massage is a specialized massage therapy approach tailored to support cancer patients in managing their experiences with the disease. It has been found to enhance the quality of life by promoting relaxation, improving sleep and immune function, and alleviating anxiety, pain, fatigue, and nausea. Therapists trained in oncology massage are equipped to address the wide-ranging physical, emotional, and psycho-social impacts of cancer and its treatments.

Individual goals for receiving oncology massage may vary, including seeking respite and relaxation, relief from symptoms such as nausea, pain, or peripheral neuropathy, or support in coping with ongoing cancer treatments. Oncology massage can be an integral part of a patient's healing process, as it is provided by therapists who understand the complexities of cancer and its treatments. While earlier concerns that massage could potentially spread cancer through increased circulation have been debunked, there are still precautions that need to be taken. Cancer patients and survivors should ensure their massage therapist has specialized oncology massage training in addition to being a licensed practitioner. This ensures that the therapist knows the unique contraindications and can safely provide massage therapy to cancer patients.

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Summary

Cancer in gerontology presents unique challenges due to age-related factors and comorbidities. Integrative oncology, which combines conventional and complementary therapies, offers a holistic approach to managing cancer in older adults. By focusing on nutrition, supplementation, and complementary therapies, integrative oncology aims to improve cancer outcomes and enhance the quality of life for geriatric patients. As the aging population continues to grow, the importance of addressing cancer in gerontology and exploring novel approaches like integrative oncology cannot be overstated.