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**15** 

*Canada* 

**Lung Cancer in Elderly** 

Anne Dagnault and Jean Archambault

*Radiation Oncology Department, CHUQ-Hôtel-Dieu de Québec,* 

Lung cancer is one of the leading causes of cancer in the population. The aging population is a reality. More and more, in oncology, we are facing challenges about management of cancer in this important population. In this chapter, we will review data on lung cancer and aging. We will explore how to evaluate this particular population to offer them the best treatment possible, bearing in mind that some adjustment may be necessary compared to younger

The cut-off point for an adult to be considered "elder" is not well defined. According to most of the literature, age 70 years is used as a chronologic marker for definition of elderly population. This is also the age most commonly used in the clinical trials in oncology as a

In fact, elderly should be referring to a state either than a chronological age. It is well known that with time, especially at or around 70 years of age, a number of age-related physiologic changes occur affecting the physiologic reserve of the person. Many of these changes may affect the tolerance to cancer treatment as; decreased renal and liver functions, decreased volume of distribution, immune response and intestinal absorption (Avery et al., 2009). Talking more specifically about lung function, age-related pulmonary changes include a decreased response to hypoxemia or hypercapnia, decreased elasticity of the lung tissue, increased ventilation-perfusion mismatch, and decreased forced expiratory volume

Population age is increasing in developed country. In the United States, in 2000, there were 35 million persons aged over 65 years old. This proportion is expected to continue to increase from 40 million in 2010 to 81 million in 2040 (U.S. Census Bureau). In Canada, the situation is similar. In 2036, Statistics Canada estimates the population of persons aged 70

**1. Introduction** 

population.

**2. Definition of the elderly** 

limit for recruitment (Balducci, 2000).

(Gonzalez-Aragoneses et al., 2009).

years and older to be situated between 10 and 10.8 million.

**3. The aging population** 

**2.1 Chronologic aging** 

**2.2 Physiologic aging** 

