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A significant proportion of women diagnosed with breast cancer are over the age of 70 years and there is evidence that these patients frequently do not receive standard treatments, including surgical procedures and adjuvant therapies, which would be routine practice in younger age groups. The factors underlying this may include the physiological effects of ageing, differences in the biology and stage of the tumour at presentation, patient co-morbidities and patient and clinician preferences. The interaction of all these factors needs to be considered when individualising treatment plans for patients. For some patients this will need to be undertaken in the context of an extended multidisciplinary team setting with additional input from geriatricians, in addition to surgeons and oncologists, in defining a treatment plan. Little is known about the preferences of older patients in their choice of surgical treatment for breast cancer and further research is required to increase the evidence base for the rational management of older women with breast cancer. [ABSTRACT FROM AUTHOR]

A growing number of patients undergo surgical procedures with general anaesthesia soon after receiving chemotherapy; occasionally such treatment can be given during surgery. Therefore, it is worthwhile and prudent to consider the pharmacological interactions between anticancer and anaesthetic drugs. We review published data on the pharmacological interactions between antineoplastic and anaesthetic drugs, despite the fact that this specific topic is poorly represented in published work. This low coverage seems to be due more to a lack of knowledge and understanding rather than an absence of interactions between the two drug types. Since the number of individuals receiving chemotherapy in the perioperative period is rising, patients who might have potentially dangerous and unwanted effects are also due to increase in number. Thus, we should be vigilant in the careful surveillance of these interactions as well as broaden our knowledge of in-vivo and in-vitro findings and investigations. Classic cytostatic compounds and modern drugs should be extensively studied, and new anticancer therapies closely interacting with immunological responses need to be better understood, since their clinical effectiveness might be modified by anaesthetics that are currently used. More frequently, tumours are being managed in a multimodal integrated approach with medical, surgical, and radiotherapeutic aspects. [ABSTRACT FROM AUTHOR]

Lung cancer is a leading cause of cancer death and its cure depends on an adequate surgical approach. More than half of all lung cancers are diagnosed in patients aged 65 years or over. However, surgical risk increases in patients over 65 years old. Therefore, surgical procedures for lung cancer are far less frequent in elderly patients. Many clinicians avoid surgery, or minimise surgical procedures on the basis of age but recent advances in preoperative risk assessment and surgical and anaesthetic techniques have resulted in a significant decrease in operative mortality and morbidity for older patients. The treatment of lung cancer in elderly patients should no longer be based on the premise that surgery is too risky for elderly patients. Every effort should be made to assess risk and optimise treatment for this large and expanding proportion of the population. [ABSTRACT FROM AUTHOR]

An important demand for breast cancer susceptibility (BRCA) testing is anticipated not only in women at high risk of breast cancer but also in the general population. However, the benefits of this new technology may be substantially counterbalanced by the risks and limitations associated with it. BRCA testing offers the potential for early detection of breast cancer; however, it may lead to psycho-socially harmful consequences. Both carriers and non-carriers of a BRCA mutation may face tremendous emotional upheaval which may adversely impact on subsequent attitudes towards health care. This paper points to the need for empirical studies examining the psycho-social aspects of BRCA testing. These studies should be undertaken cross-culturally in order to take into account the variations due to different health care systems and cultural background on psycho-social correlates of cancer genetic testing. [ABSTRACT FROM AUTHOR]