Ishikawa Yojiro, Ishikawa Eisaburo, Ishikawa Kazuhiro
Radiology, Tohoku Medical and Pharmaceutical University, Sendai, JPN.
Internal Medicine, Ishikawa Clinic, Hitachi, JPN.
Cureus. 2024 Jun 7;16(6):e61919. doi: 10.7759/cureus.61919. eCollection 2024 Jun.
In developed countries like Japan, the size of the older population is rapidly increasing. Malignant neoplasms rank as the leading cause of death among the geriatric population of Japan, emphasizing the rising demand for cancer care in this demographic. Older patients, besides facing physical and cognitive challenges, are also affected by their social environment, necessitating tailored interventions. Few case reports have detailed the progress of cancer treatment in nonagenarian patients. This study presents the progress of two very old patients with cancer. The first case, a 95-year-old female with chronic constipation underwent emergency surgery for a cecal tumor. Despite initial improvements, her mobility declined after surgery, leading to institutionalization. Recurrent hospitalizations ensued with complications culminating in her death approximately 20 months after surgery. In the second case, a 94-year-old male, initially declining aggressive treatment for a suspected ileocecal malignancy, later opted for supportive care. Despite stable conditions, he eventually died at home after experiencing progressive weakness, which was approximately 20 months after the initial diagnosis. These cases shed light on the management of elderly patients with ileocecal cancer, illustrating the divergent trajectories between surgical intervention and supportive care. The tumor did not recur in the patient who underwent surgery; however, the independence in performing daily living activities declined significantly. In the case managed with the best-supportive care, progression was slow; however, severe anemia became a concern toward the end of life.
在日本这样的发达国家,老年人口规模正在迅速增长。恶性肿瘤是日本老年人口中的首要死因,这凸显了该人群对癌症护理的需求不断上升。老年患者除了面临身体和认知方面的挑战外,还受到其社会环境的影响,因此需要量身定制的干预措施。很少有病例报告详细描述了九旬患者的癌症治疗进展。本研究介绍了两名高龄癌症患者的治疗进展。第一个病例是一名95岁患有慢性便秘的女性,因盲肠肿瘤接受了急诊手术。尽管术后初期有所改善,但她的行动能力在术后下降,最终住进了养老院。随后因并发症反复住院,最终在术后约20个月死亡。第二个病例是一名94岁男性,最初拒绝了对疑似回盲部恶性肿瘤的积极治疗,后来选择了支持性护理。尽管病情稳定,但他最终在出现进行性虚弱后在家中去世,这大约是在初次诊断后的20个月。这些病例揭示了老年回盲部癌症患者的管理情况,说明了手术干预和支持性护理之间的不同轨迹。接受手术的患者肿瘤没有复发;然而,其日常生活活动的独立性显著下降。在采用最佳支持性护理管理的病例中,病情进展缓慢;然而,在生命末期严重贫血成为一个问题。