Oncology Frontier:  Is the primary goal of treatment the same in older patients compared to younger patients?

　　《肿瘤瞭望》：老年患者的主要治疗目的和年轻患者相同吗？

　　Dr Muss: The goals of treatment can vary between older and younger patients. In younger patients， especially with early stage breast cancer， the goal is to increase the chances of cure. Younger women might tolerate more side effects to see their children graduate college and have a long and fulfilling life. An older person on the other hand， in order to achieve a small improvement in cure rate of a few percent， may not be willing to undergo chemotherapy side effects such as those that cause nerve damage and so on because it is not worth it to them. They don’t want to lose functionality. They don’t want to be a burden to their families. So the goals of treatment can vary greatly when comparing older and younger women with breast cancer.

　　Muss教授：老年癌症患者和年轻患者的治疗目的有所不同。对于年轻患者，特别是处于疾病早期的患者，治疗的目的是增加治愈的机会。为了看到自己的孩子大学毕业、年轻女性能耐受更多的副作用，她们也可能拥有漫长而丰富的一生。但老年患者却不然，她们可能并不愿意仅仅为了治愈率能提高寥寥几个百分点，而承受化疗带来的如神经损害等副作用，因为这对于她们来说并不值得。她们并不想变为废人，不愿意成为家庭的负担。

　　Oncology Frontier: What are the main issues for clinicians in treating older women with breast cancer?

　　《肿瘤瞭望》：对于临床医生而言，治疗老年乳腺癌患者的要点是什么？

　　Dr Muss: The issue for the clinician is factoring in not age per se， but how long the patient is going to live. There are a lot of tools to use. Are they generally healthy? Are they going to live another ten or twenty years or are they very frail? Breast cancer may not be a key illness in their life. You need to know their life expectancy; you need to know what their goals of treatment are. Do they want to increase their chance of cure? If so， are they willing to take more intensive treatment particularly chemotherapy? You need to really make sure they understand the issues， but if they are healthy and have a good life expectancy， I think you treat them with state-of-the-art treatment.

　　Muss教授：对于临床医生而言，所要关注的问题并不是年龄本身，而是患者的预期寿命。有很多工具可以帮助我们做到这一点，如一般健康状况如何？是预期存活十年二十年，还是情况极差？乳腺癌可能并不是夺去她们生命的主要疾病。医生还需要了解患者的治疗目标，她们是否希望增加治愈的机会，如果是，她们是否愿意接受强度较大的治疗，特别是化疗。医生必须确保患者真正理解以上涉及的问题。但只要患者身体机能较好、预期寿命较长，任何现有的先进方案都可以尝试使用。