Should the Elderly be Screened for Cancer?

A recent article in the New York Times is fueling the debate over cancer screening in the elderly - particularly breast cancer. Doctors recommend that women have yearly mammograms after the age of 40 but once a woman reaches the age of 85, that recommendation is often changed to every two to three years. Experts say this is due to lack of evidence that screening for the cancer in older patients increases their survival.

Other experts are balking at that apparent lack of evidence, citing patients they've treated with advanced cancer that could have been caught sooner, and treated less aggressively, if they would have had annual mammograms.

So, what gives? Should an elderly woman have annual mammograms or not?

Debate it all you want but the answer lies with the individual patient. A healthy, active octogenarian who can easily make it to a clinic to be screened should absolutely have a mammogram every year. A woman in her 80's who has multiple health problems that are under control and who has a life expectancy of at least several years should probably get a yearly mammogram as well, if she chooses to.

However, an elderly woman with chronic health problems who needs 24 hour care and is likely to succumb to her illness in the next few years probably won't benefit as much. A mammogram can, in fact, do more harm than good for this woman. The stress of being dragged into a clinic where her breast is squeezed into a machine might be too much for someone who has dementia or an unstable illness. The treatments that would likely follow if breast cancer was suspected or confirmed would be over-kill for someone who will likely die of another illness anyway.

As with any medical decision, the end goal always needs to be considered. Are we focusing on extending life as long as possible? Would we rather focus on maintaining quality of life for as long as possible? Regardless of what the experts spew back and forth, it's important to consider your own, or your loved ones individual situation and personal goals.

Read the New York Times article and share your thoughts below.

Making Health Care Decisions