Lung cancer in the elderly – increasing epidemiological problem of 21st century

Batura-Gabryel H, Foremska-Iciek J

Lung cancer is the second most common malignant neoplasm after prostate and breast cancers. It is the most frequent cause of death related to neoplasms. The elderly people over 65, are the most numerous population suffering from lung cancer. Risk of incidence and death increases with aging process. In majority of patients, diagnose is established in highly advanced neoplastic process. More than 80% of all types of lung cancers make non-small cell lung cancer (NSCLC) and less than 20% – small cell lung cancer (SCLC). The choice of the managment must be individually considered and should be based on the stage of cancer clinical advance, clinical and functional status, concomitant diseases, nutritional status, cognitive functions. The patients age is not a contradiction for the introducement of the treatment. Surgical treatment is a method by choice at the early stages of NSCLC. Radical radiotherapy should be introduced in the elderly disqualified from the operation. Single-agent chemotherapy seems to be benficial for the elderly with advanced NSCLC in good general condition, mainly due to less toxicity and satisfactory the survival rate. In the cases of SCLC polychemotherapy with prophylactic brain radiation is the first-line managment. Unfortunately, the effectivity of the therapy is occupied by its toxicity. Still frequent occurrence and late diagnosis of lung cancer, high mortality, low efficiency of chemo- and radiotherapy causes the necessity of newer research for more effective screening methods, more effective and safer lung cancer treatment schemes for the elderly.