This issue of InFo ONKOLOGIE & HÄMATOLOGIE is about tumors in pediatrics and geriatrics.
How to respond in acute childhood leukemias? We explore this question in our article. In doing so, we provide an update on the more common acute lymphocytic leukemia and the rarer but less treatable myeloid leukemia. While these diseases were almost always fatal in the past, they are now largely curable. However, an unclear cytopenia with further symptoms should be clarified in a specialized center in any case, since life-threatening complications are still a risk factor. An early response to therapy significantly improves the prognosis. Also important are other factors such as age, blast cytogenetics, initial leukocyte count, immunophenotype, or CNS involvement. Unfortunately, the risks for late effects of therapy or treatment remain high even in long-term survivors of childhood acute leukemia. The potential effects in older age are many and should be monitored.
Dr méd. Martial Coutaz of the Hôpital du Valais examines the treatment situation of another group in our society, namely oncological therapy in the elderly, i.e. in the geriatric field. He asks the question: In view of the high risk of developing a tumor in old age, is cancer treatment a luxury or a sign of a wealthy society that can afford such therapies despite an expensive medical system? With an appropriate individual application of the possible therapies, it certainly is not. The switch point that should decide on the sense of treatment is the accurate evaluation of the elderly patient (in collaboration with the primary care physician, the oncologist and the geriatrician). In the course of a global inventory, the following factors should be reviewed: functional abilities, the risks of comorbidities, medication use, nutritional, cognitive and, lastly, social status. Moreover, it is important to adjust the goals of a therapy: the reduction of mortality can rarely be seen as an end in old age; rather, the increase of quality of life is the focus.
With this in mind, I wish you an interesting read about young and old patients in oncology.
Prof. Dr. med. Nicolas von der Weid
InFo Oncology & Hematology 2014; 2(5): 3.
