May 06, 2013
Meeting the geriatrician: A cancer diagnosis' silver lining
BY Deborah Thomas
I know it sounds really odd to say I'm glad my mom found out she has cancer, but in a strange kind of way I am. If my mother wasn't diagnosed and coming to MD Anderson, there is a good chance her other health issues would not have been discovered.
My mom went for her physicals every year and was told she was healthy. However, when she came to MD Anderson, doctors diagnosed another discernible issue besides her cancer - extreme hypertension.
Geriatrician fills in the gaps for seniors
So, Mom was sent to see Beatrice Edwards, M.D., a geriatrician here at MD Anderson. Mom thought she was just having her high blood pressure checked, but Dr. Edwards checked for every possible thing that could be a problem for a senior.
At her first visit, Dr. Edwards did a few cognitive tests and determined my mom needed to go through a complete neuropsychology exam. This is important to do before starting chemo, especially for an older person, to see what effects the chemotherapy has on the brain and try to alleviate side effects.
Dr. Edwards also had my mom walk around the room so she could observe her balance. Mom's gait is a bit off, plus she needs to get back into exercise, so Dr. Edwards prescribed physical therapy.
Is chemotherapy the right choice for the elderly?
At a follow-up visit, my mom and I asked Dr. Edwards if Mom should even be doing chemo at her age, especially since Mom thought she did awful during her cognitive testing.
It really made a difference to hear a geriatrician explain why my mother should go forward with the chemotherapy. After studying my mom's tests and scans -- including her cognitive tests, on which she actually did quite well -- Dr. Edwards said my mom is very healthy for her age. If it wasn't for the cancer, she would predict my mom living 14 years or more. The chemo, she explained, is the best way to shrink all the cancer, and if we don't do that, it will shorten my mother's life. That definitely helped us make up our minds!
If my mother suffered from dementia or another cognitive issue, had weak bones and was prone to falls, or had other health concerns, Dr. Edwards would have suggested we talk to Mom's oncologist about a less aggressive approach -- possibly one not involving chemotherapy.
Geriatricians complement oncologists
Oncologists specialize in spotting tumors in CT and MRI scans, but a geriatrician looks for other complications. Dr. Edwards looked for signs of mini-strokes in my mom's MRI and found none (yay!). She also could tell my mom has lost 40% of bone mass due to osteoporosis. She prescribed medicines that will combat bone loss since chemo may cause a 6% drop in bone density.
Dr. Edwards gave my mom some homework, and I love the assignments. I've been after Mom for years to get back into exercising, and now it is on her must-do list. Dr. Edwards said exercise, as well as intellectual activity, preserves brain function. She also prescribed participation in book clubs and weekly bridge card games.
Geriatricians are for the young at heart, too
People may be turned off by the word "geriatrician," thinking it's for "old" people. But even if you're a healthy person over 60 diagnosed with cancer, it is a great idea to see a geriatrician before, during and after your cancer treatment.
They specialize in problems that may arise in elderly patients. So, if you want to keep those issues at bay or under control, seeing a geriatrician is a must.
Even if you're a healthy person over 60 diagnosed with cancer, it is a great idea to see a geriatrician before, during and after your cancer treatment.
Caregiver and Employee