Health Essentials from Cleveland Clinic

By: Mikkael Sekeres, MD, MS

If you’re an older adult and your doctor tells you that you have leukemia, you may think the only thing you can do is to get your affairs in order. However, what many people don’t realize is that we can treat every person diagnosed with acute leukemia, no matter their age and medical condition.

Older adult leukemia

Leukemia is often considered a childhood illness. Even though it is one of the most common childhood cancers, the blood disorder cancer actually affects far more adults.

According to the National Cancer Institute, leukemia is most frequently diagnosed among people between the ages of 65 and 74 years. The median age at diagnosis is 66. Treatment options include chemotherapy and blood transfusions, and are viable for patients of all ages.

We often joke, though it is no joking matter, that leukemia needs a better press agent. The older patient is often pleasantly surprised to hear what we have to say about options for treating them. The oldest patient I treated was 99.

Talking about treatment options and life goals

A person in his 60s who undergoes intensive chemotherapy has a 55 to 60 percent chance of going into remission. This means that all signs and symptoms of cancer disappear, although the cancer may still be in the body.

There are risks with undergoing treatment, however, including infections and death. But those risks also exist without treatment: If a patient in his 70s declines treatment, life expectancy is three to four months, with a risk of infections and other complications.

I tell patients this is really their decision, not mine. We talk about life goals. I’m in my 40s and have young kids. My job is to get my children to adulthood, so I would say yes, yes, yes. Life goals is one of the most important discussions we have.

Living with disease, with a good quality of life

Older adults diagnosed with leukemia should partner with oncologists who focus on the disease. We have doctors and nurses — both inpatient and outpatient — who specialize in leukemia. In addition, we have protocols in place for treating older adults with leukemia.

Several years ago, I followed those protocols with 92-year-old baseball legend Bob Feller. The former Cleveland Indians pitcher had been in great health before a fall landed him in the hospital. While treating him for the fall, doctors diagnosed leukemia and he underwent chemotherapy.

I wrote an essay about our relationship a few years back. When I asked him about his symptoms related to chemotherapy, I always made sure to check how the Indians had played the previous night — if they lost, which occurred all too frequently that year — that magnified his medical complaints.

Ultimately, Feller decided to forgo further chemotherapy, saying, “I’ve lived a good life. I have no regrets.”

My 99-year-old patient walked three miles a day before undergoing treatment for leukemia and lived for another year after treatment.