India is all set to become the youngest nation, with most number of youths in the world, by the year 2020. But it will have its fair share of the elderly population too. Thanks to the improved life expectancy and health care opportunities, 11% of the Indian population will belong to the age bracket of 60 years and above. Notably, there is a marked prevalence of cancer cases amongst this elderly population. As per the report published in the NCCP, 12-23% of all cancers are diagnosed after the age of 65. Yesteryear Bollywood actress Mumtaz was diagnosed with breast cancer at the age of 54. It took 35-radiation therapy and 6 chemotherapies to get rid of the deadly disease.
Dame Maggie Smith, famous for her role as Professor McGonagall in Harry Potter and the Half-Blood Prince was diagnosed with breast cancer in 2008. Being diagnosed with breast cancer at the age of 73 years did not deter this actor from completing her share of shooting in the movie. After having the lump removed, the actress is said to have had her chemotherapy and radiation sessions alongside her filming schedule.
What could be the link between cancerous growth and ageing? Could it possibly be the body’s self-defense mechanism losing its efficiency over the period of time?
Men and women age ≥ 60 years are at high risk for the major cancers. Data shows that for the men have been ≥ 60 years have a risk 15 times greater and in women 8 times greater than the persons having age < 60 years.2
Immune senescence, a medical term used to define decrease deficiency of the immune function could be the cause of increased risk of cancer in elderly. Let us understand in simple language, the biology behind cancerous growth and the role of immune system.
A strong immune system (read young) is constantly on guard, fighting and destroying any foreign or abnormal substances that does not belongs to the body. At any given time, there are billion of cell divisions taking place inside our body, and a wrong cell division (read gene mutation) is a very common occurrence. As part of its job, our immune system is programmed to recognize any such abnormality. It automatically destroys these abnormal, damaged cells, keeping chances of cancerous cells growth to minimal.
With ageing, the weakened immune system loses its efficiency and capacity to recognize these damaged cells. Moreover, in due course of time, the cancerous cells become smart enough to evade the immune system.An aged immune system might not be able to kill all cancerous cells, thus giving a chance to these abnormal cells to accumulate and grow into a tumor. This is exactly what happens to someone who is diagnosed with cancer later in life. Their immune system is notstrong enough to fight all kinds of abnormalities, thus succumbing to a complicated disease such as cancer.
Manisha Koirala, the Nepali beauty declared cancer free for the past two years says, “To be diagnosed of cancer was an unsettling experience for me at the age of 42. I shudder to imagine the condition of someone in their 60s to be diagnosed of cancer. It is physically and emotionally draining to be a cancer patient, let alone be a one with weak immunity and declining health.”
“Unhealthy lifestyle also poses a risk factor for cancer in old age. The amount of physical activity of an individual starts decreasing with age, people tend to get more lethargic, and also losing weight becomes an uphill task, thanks to the decrease in basic metabolic rate. Hence obesity combined with poor lifestyle habits such as smoking, drinking, lack of exercise, and poor eating,all expose an individual to high risk of cancer. Maintaining healthy lifestyle, especially in old age is very important to keep cancer at bay, more so during festive season, it becomes imperative to keep a check on diet and exercise as people are prone to be less conscious of their eatingand drinking habits during the celebration time,” says Dr. Meenu Walia, Director –Medical Oncology & Haematolgy, Max PPJ, Delhi.
“FDA Granting Keytruda® to be used for First-Line Treatment of Patients with Advanced Non-Small Cell Lung Cancer, a news that has created a stir in the medical fraternity and revived hopes for many cancer patients worldwide. Keytruda is a humanized monoclonal antibody that works by increasing the ability of the body’s immune system to help detect and fight tumor cells. Keytruda blocks the interaction between PD-1 and its ligands, PD-L1 and PD-L2, thereby activating T lymphocytes which may affect both tumor cells and healthy cells,” Meenu added.
Researchers worldwide have been trying to find out an effective solution to cancer treatment for the last four decades. Immunotherapy treatment aims to enable the immune system to fight off cancerous growth. Of late, there have been several successful trials that have finally set the stage for immunotherapy to become an important line of cancer treatment. The recent FDA grant to keytruda drug is a significant step in this direction says Dr. Sandeep Nayak, Laparoscopic and Robotic Onco-Surgen.
Going forward, immunotherapies could be used as single or combined treatment modalities, for any cancer patient, be it young or old. It certainly gives us a new frontier in cancer control. Moreover, it has the potential of being more effective by reviving the body’s self-defense mechanism.