Cancer in the Lives of Older Americans: Blessings and Battles

Cancer in the Lives of Older Americans: Blessings and Battles

Cancer in the Lives of Older Americans: Blessings and Battles

Cancer in the Lives of Older Americans: Blessings and Battles


The "oldest old," individuals aged 85 and above, are the most rapidly growing segment of American society. And although more than a third of cancer occurs in people over 75 years of age, their tumors are less fully diagnosed and often less fully treated than those in younger patients. Ageism may account for this discrepancy--why intervene if an older man or woman with cancer doesn't have long to live anyway? Yet older people often tolerate chemotherapy, surgery, and radiation as well as younger patients, while continuing to maintain their quality of life for years to come.

The lack of clinical trials among this age group results in a deficit of knowledge regarding how to treat cancer in older adults. Little has been written to guide clinicians, social scientists, families, and individuals. In Cancer in the Lives of Older Americans: Blessings and Battles, Sarah H. Kagan writes from the perspective of more than twenty years of practice, inquiry, and education as a nurse. She uses anecdotes and case studies to illustrate important points about cancer among older adults.

The book follows the story of Mrs. Eck, a woman in her 80s diagnosed with pancreatic cancer. Mrs. Eck's situation sets the stage for a discussion of cancer, which too often focuses on cells and drugs, diagnoses and prognoses without looking more closely at the people who are experiencing the disease. Chapters offer varied assessments of what it means to be old and have cancer in our society, as Kagan explores other real experiences of cancer for older adults alongside information that will prove essential to patients, their families, scholars, and clinicians.


Shortly after New Year’s Day of 2006, I found myself on a street in a small town in New Jersey, a quintessentially American street in a typical American town. Even though the town is a short drive from a big city—just off the main commercial thoroughfare—a bedroom suburb lost in an array of similar places across the sprawling American urban landscape, emotionally this street in this town is deeply and personally connected to an enduring image of the American dream. Single-family homes, neat front yards browned by winter, a few children’s toys visible in the snowless remains of Christmas celebrations marked this street that was quiet and absent of any traffic at midday. I came to this neighborhood, a neighborhood that seems familiar in the ubiquitous sense of attaining the suburban version of the American dream, to meet a woman who I think embodies what it means to be old and have cancer in America today. I am a nurse who specializes in helping older patients who have cancer understand and manage the experience of cancer. Mrs. Eck is as much everywoman as she is enduringly and impressively herself. Her story, as she tells it, reveals much of what I seek to dissect and analyze from a societal level in a personal odyssey that affirms relationships, values, and perspective. Mrs. Eck’s exploration of her family, her faith, and her outlook is centrally illustrative of the themes, concerns, conflicts, and paradox our society faces in understanding the increasingly common experience of what it means to be old and have cancer in America today.

I arrived at the house that Mrs. Eck has shared with her husband of sixty-one years since they purchased it from her parents. She and Mr. Eck moved in a few years after they married, the memory of World War II still fresh in their minds, the promise of family in their future. One of Mrs. Eck’s sons, Joe, and his partner, Wayne, were expecting me. Joe, Wayne, and I knew the same editor, a fact that brought me to meet with Mrs. Eck on this mild winter day. Our connection through this editor resulted in a far more common one: Advancing age is the single greatest risk factor for cancer. The older you are, the more likely you are to be diagnosed . . .

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