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Chemotherapy effects on the elderly: Healthy patient vs patient with malnutrition

Dr Tira Tan, Consultant from the Division of Medical Oncology at National Cancer Centre Singapore (NCCS), a member of the SingHealth group, shared that elderly cancer patients who suffer from a lack of proper nutrition may benefit from simple interventions such as help with meals in the community, dental assessment or a referral to a medical social worker.

“Those who follow good nutrition and are healthier tolerate chemotherapy better, have a better quality of life and a better survival outcome. Patients with poor nutrition suffer more toxicity, complications and side effects from chemotherapy. By identifying those who may not benefit from chemotherapy, we can intervene early to treat them in other ways, like working with a dietitian to improve their oral intake, prescribing supplements, and making them more comfortable,” she said.

Dr Tan said there is a need for more information on how to treat elderly cancer patients. “Globally, the population is ageing and we’re treating patients who are older and older. We need more such data and other studies to help us treat them more effectively.”

She hopes that her study, which won a prestigious award from the American Society of Clinical Oncology Merit Awards in 2013, will raise greater awareness in patients and their caregivers of the risks of malnutrition. The geriatric oncology team at NCCS is working towards forming a dedicated multi-disciplinary team of physiotherapists, nutritionists, occupational therapists, oncologists and geriatricians to treat elderly cancer patients.

Elderly malnutrition: How to spot it

While caring for her late grandfather, Dr Tan found herself coping better when she was better informed. She has some advice for those who look after the elderly and are suffering from a lack of proper nutrition.

• Don’t assume that the old lose their appetite as they age
  “Many people assume it is common and all right for this to happen, but it is not always normal. Find out the causes and be aware of the risk factors commonly associated with malnutrition. Highlight any to the patient’s doctors so that they can intervene earlier and help the patient.”

• It is possible to be overweight yet malnourished
  “The elderly patients who took part in our study weighed between 21kg and 81.3kg. Malnutrition occurs when people don’t get the right nutrients in the right quantity. It’s possible for someone to be overweight, or even obese, yet suffer from a lack of proper nutrition, as he could be eating inappropriate or unhealthy food.”

How does nutrition affect chemotherapy in elderly patients? See previous page to find out.

Ref. K21