As people live longer, the likelihood of developing chronic diseases, including cancer, increases. Advanced age is, in fact, the main risk factor for this disease. According to the U.S. National Cancer Institute, the average age of diagnosis is 66, 70% of deaths occur after age 65, and those over 65 are eleven times more likely to develop it than younger people. According to the Pan American Health Organization (PAHO), life expectancy in the Americas region reached 77.2 years in 2019, more than three years above the level recorded in 2000 and above the global average. United Nations projections show that population aging will continue to accelerate: in Latin America and the Caribbean, the population over 60 will triple by 2060, growing from 42 to over 220 million people. That is why it is crucial to evaluate each case comprehensively, Presman noted. Chronic diseases that often coexist at this stage can complicate both the diagnosis and treatment of cancer. Their presence is associated with lower survival rates and higher hospitalization rates, which is why doctors recommend an approach that considers not only the oncological disease but overall health. «Treatment in older adults requires a more careful balance: comorbidities like hypertension, diabetes, or heart failure can limit therapeutic options and make the risk-benefit balance more complex,» said Diego Kaen, Medical Director of Oncology at MSD Argentina. The link between aging and cancer has biological roots: over time, cells accumulate genetic alterations, and the body's natural repair mechanisms become less efficient, increasing the likelihood of tumor formation. However, the social dimension is equally determinant. Specialists emphasize that chronological age does not always reflect biological age and should not be the only factor in deciding on cancer treatment. «Each patient is different. Some are 80 years old with an excellent functional status, while others are 65 with multiple comorbidities,» Kaen noted. In this context, Comprehensive Geriatric Assessment (CGA) has become a key tool in oncology to comprehensively assess the health of older adults. This multidimensional approach allows for identifying vulnerabilities and defining functional and physiological age, which is more relevant than chronological age. It assesses functionality, cognition, nutrition, comorbidities, emotional state, social environment, and risks of treatment toxicity. Its application allows for designing personalized strategies and improving clinical outcomes. In addition to pharmacological treatments, Kaen highlighted the importance of supportive care: «Good nutrition, adapted exercise, hydration, and emotional support are as important as the therapy itself for improving quality of life».
