Cancer research journal devotes special issue to radiation therapy and the elderly

In In The News by Barbara Jacoby

The International Journal of Radiation Oncology•Biology•Physics tackles the unique issues facing elderly cancer patients and their doctors as the U.S. population ages

In response to an aging U.S. population and the rise in cancer incidence rates, a new special edition of the International Journal of Radiation Oncology•Biology•Physics (Red Journal) explores trends, challenges and new approaches in treating cancer in elderly patients with radiation therapy. The issue, which includes more than 30 research articles and essays, is available online.

The elderly population in the U.S. is growing at an unprecedented rate. By 2050, Census estimates predict there will be as many Americans older than 85—the “super-elders”—as there are under the age of five. The elderly also represent a disproportionate share of cancer incidence; by 2030, the elderly will represent 20 percent of the American population but 70 percent of diagnosed cancers in the country.

As the number of elders and super-elders grows, so will the number of cancer patients—including those who warrant special consideration due to advanced age. Between half and two-thirds of all cancer patients will receive radiation therapy at some point during their course of treatment.

“The elderly, and particularly those older than 85, are the fastest-growing age demographic in most of the developed world. In medicine, we have an entire specialty—pediatrics—that is dedicated to children because of their distinctive biology and vulnerabilities. I believe that we need to think about the elderly differently, also,” said Anthony L. Zietman, MD, FASTRO, the editor-in-chief of the journal and a radiation oncologist at the Harvard Medical School and Massachusetts General Hospital Cancer Center.

“There are pressing questions involved in cancer care for elderly, including both biological and philosophical considerations,” continued Dr. Zietman. “Can we assess the elderly and tailor their cancer treatments in a way that saves their lives without ruining their lives? How little treatment can we give yet still be effective? How can we leverage new technologies to reduce the side effects of treatment?”

The issue addresses these concerns in a variety of ways, touching on themes including survivorship, treatment de-intensification and curative versus palliative approaches to treatment. Articles are grouped by four major topics:

Radiation therapy, also known as radiotherapy, may offer unique benefits for geriatric patients, particularly those who are not healthy enough or are unwilling to have surgery. Advanced techniques, such as stereotactic body radiation therapy (SBRT), stereotactic radiosurgery (SRS) and proton beam therapy, can provide non-invasive, curative-intent treatment options for patients who cannot undergo an operation. Emerging evidence also points to the role of radiation in combined modality treatments for elderly patients; the special issue examines radiation therapy used in conjunction with endocrine therapy, with systemic therapy and with androgen deprivation therapy.

ASTRO is the premier radiation oncology society in the world, with more than 10,000 members who are physicians, nurses, biologist, physicists, radiation therapists, dosimetrists and other health care professionals that specialize in treating patients with radiation therapies. As the leading organization in radiation oncology, the Society is dedicated to improving patient care through professional education and training, support for clinical practice and health policy standards, advancement of science and research, and advocacy. ASTRO publishes three medical journals, International Journal of Radiation Oncology • Biology • Physics (, Practical Radiation Oncology ( and Advances in Radiation Oncology (; developed and maintains an extensive patient website, RT Answers (; and created the Radiation Oncology Institute (, a nonprofit foundation to support research and education efforts around the world that enhance and confirm the critical role of radiation therapy in improving cancer treatment. To learn more about ASTRO, visit