By Frederick F. Holmes M.D. (auth.)

The lifetime of a individual is finite, and all people age (see Fries 1980). it's tricky to split the consequences of sickness on organs and tissues from these anticipated of getting older. this can be fairly precise for vascular and degenerative procedures, for which there are not any transparent obstacles among getting older and affliction. Morbidity and mortality from middle illness and stroke are most likely due either to affliction and to alterations of getting older. For melanoma, the second one best explanation for dying in the US, the location is sort of diversified; melanoma is obviously a sickness and isn't a metamorphosis anticipated with getting older. melanoma occurrence raises nearly logarithmically after age forty. within the usa approximately one-half of all situations of melanoma are clinically determined after age sixty five, even if these over sixty five include under one-eighth of the inhabitants. hence, melanoma is especially a lot a disorder of the aged. There are at the very least purposes for this: first, the lengthy publicity to cancer-inducing brokers, and moment, the waning strength of immune defenses opposed to cancer.

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The only screening mechanism is periodic pelvic examination. The most efficient diagnostic strategy is careful investigation of any patient with postmenopausal bleeding. During the past decade there have been many papers in the medical literature reporting increased incidence of endometrial cancer related to both premenopausal and postmenopausal estrogen use. Certainly, postmenopausal estrogen use is a very important subject when one thinks specifically of the health and well-being of older women.

Aggressive multidrug therapy has lengthened mean survival in acute lymphoblastic leukemia of children from 5 months in 1950 to more than 5 years in the 1970s (PinkeI1971). Indeed, it is believed that some children have been cured of this awful illness. By contrast, the response of the elderly has been very disappointing. Mean and median survivals are little changed in the same 3D-year period (Holmes et al. 1979). Death from treatment may be as common as death from the acute leukemia in elderly patients.

1979). Death from treatment may be as common as death from the acute leukemia in elderly patients. Even in carefully conducted drug trials it is difficult to determine who died from the disease and who died from the treatment, because the modes of death are the same - bleeding and/or infection. A few elderly people have had excellent response to chemotherapy, with remissions of months or even years, but the question must always be asked at what cost to those who did not respond to treament and who may even have had their lives shortened by it.

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