Geriatric Oncology

摘要

It was only in the early 1980s that Rosemary Yancik whonwas an epidemiologist in the USA identified that there werena growing number of older individuals with cancer [1]. Manynof the papers in the 1980s identified that older people werenless likely to be investigated, diagnosed or managed actively.nFew were entered into clinical trials andmany cases were onlynidentified on death certificates.nAs Geriatricians we are more than aware that ageing isnassociated with a permanent accumulation of damage at manyndifferent levels including molecules, cells, organs, tissues andnthe whole organism. Although in more sophisticated organismsntissues can replace damaged and lost cells, this has bothnpositive and negative effects. It increases the possibility fornmaintenance, repair and prolonged life but does bring withnit the risk that cells might acquire genetic changes that affectncell growth or differentiation thus increasing the risk of themnbeing transformed into a cancer cell. There are two majorncategories of tumour suppressor genes: gatekeepers andncaretakers.Whilst caretaker genes protect the genome againstndamage and mutations, gatekeeper genes induce cell death orncell cycle arrest of cells that have accumulated damage genesn[2].