Research by the American Academy of Family Physicians demonstrates that vulvar cancer occurs most frequently in women age 65 to 75 years of age. Thirty percent of patients with vulvar cancer are age 70 or older, and the rate increases with age, reaching a peak of 20 per 100,000 women by 75 years of age.
A team of researchers headed by Ashley Stuckey, MD, and Don Dizon, MD, of the Program in Women's Oncology at Women & Infants Hospital of Rhode Island, recently presented research to the International Gynecologic Cancer Society at a meeting in the Czech Republic, which concluded that the treatment for vulvar cancer in this age group was often more lethal than the disease itself.
"Many elderly women have multiple health care problems. This makes it complicated to administer radiation with sensitizing chemotherapy, which is the standard treatment for advanced vulvar cancer," Dr. Stuckey explained. "The goal of our study was to investigate whether elderly patients are more likely to die of intercurrent diseases that intervene during the course of treatment or of treatment-related complications."
Seventy women were identified from published data and a meta analysis was performed. The researchers compared the remission rates, death from intercurrent disease (ICD) or treatment complications, and rates of surgery. They collected such data as patient age, stage of cancer, treatment (chemotherapy, radiation and surgery), follow-up times, and whether death was disease-related, treatment-related or intercurrent.
"Three percent of the patients under 65 years of age died of ICD or treatment complications versus 11 percent of patients over the age of 65," Dr. Stuckey noted. "Death from ICD or treatment complications, therefore, was nearly four-fold higher for elderly patients.
"This is a small sample size but the data is still compelling" she said, adding that future research should focus on treatment with chemoradiation in the elderly with regard to survival benefit, toxicity, and death from ICD or treatment complications.
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