Cancer in the Lives of Older Americans

Cancer in the Lives of Older Americans: Blessings and Battles

Sarah H. Kagan
Copyright Date: 2009
Pages: 120
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  • Book Info
    Cancer in the Lives of Older Americans
    Book Description:

    The "oldest old," individuals aged 85 and above, are the most rapidly growing segment of American society. And although more than a third of cancer occurs in people over 75 years of age, their tumors are less fully diagnosed and often less fully treated than those in younger patients. Ageism may account for this discrepancy-why intervene if an older man or woman with cancer doesn't have long to live anyway? Yet older people often tolerate chemotherapy, surgery, and radiation as well as younger patients, while continuing to maintain their quality of life for years to come. The lack of clinical trials among this age group results in a deficit of knowledge regarding how to treat cancer in older adults. Little has been written to guide clinicians, social scientists, families, and individuals. In Cancer in the Lives of Older Americans: Blessings and Battles, Sarah H. Kagan writes from the perspective of more than twenty years of practice, inquiry, and education as a nurse. She uses anecdotes and case studies to illustrate important points about cancer among older adults. The book follows the story of Mrs. Eck, a woman in her 80s diagnosed with pancreatic cancer. Mrs. Eck's situation sets the stage for a discussion of cancer, which too often focuses on cells and drugs, diagnoses and prognoses without looking more closely at the people who are experiencing the disease. Chapters offer varied assessments of what it means to be old and have cancer in our society, as Kagan explores other real experiences of cancer for older adults alongside information that will prove essential to patients, their families, scholars, and clinicians.

    eISBN: 978-0-8122-0240-3
    Subjects: Health Sciences

Table of Contents

  1. Front Matter
    (pp. [i]-[vi])
  2. Table of Contents
    (pp. [vii]-[viii])
  3. Introduction: Finding My Way
    (pp. 1-8)

    Shortly after New Year’s Day of 2006, I found myself on a street in a small town in New Jersey, a quintessentially American street in a typical American town. Even though the town is a short drive from a big city—just off the main commercial thoroughfare—a bedroom suburb lost in an array of similar places across the sprawling American urban landscape, emotionally this street in this town is deeply and personally connected to an enduring image of the American dream. Single-family homes, neat front yards browned by winter, a few children’s toys visible in the snowless remains of...

  4. Chapter 1 Champagne and Hot Dogs
    (pp. 9-24)

    Mrs. Eck is perched on a sofa across from a fire that crackles and smells somehow quintessentially of what this home in this neighborhood on this day should. She is tiny, and my first impression is of her lovely and carefully coiffed red hair and of her tasteful outfit—slacks and a cheerfully cozy sweater—as she greets me rather formally by today’s standards of etiquette. We are to have tea and cookies baked by one of her daughters. Mrs. Eck seems precarious and somewhat off balance in the small space she occupies on the sofa. She has a cane...

  5. Chapter 2 Being Old, Having Cancer
    (pp. 25-37)

    Current social meaning associated with being old and having cancer maintains a tension between culturally embedded impressions of this state of being and the reality of its demography and individual experience. The societal impression of what it is to be old and have cancer is, in the largest and most abstract sense, one of despair, suffering, and death. The topic of aging and cancer generally elicits responses that distance the listener from perceived specters of debility, despair, and death. Yet the demographics of cancer in American society and the stories of older people and their families point to a far...

  6. Chapter 3 Paradox: Cancer and Aging in America
    (pp. 38-48)

    Cancer and old age in America coalesce in an existential paradox. Human experience, the realities of aging, and proximate mortality play out against the reification of emerging science, investment in curative biomedicine, and the hopes of immortality. Our external objectification of personal health is supported by exalted belief in cellular and molecular biomedicine. Senescence, aging, and age-related disease are approached cognitively as if they collectively constitute a problem to be solved. Cancer has long been constituted as a cognitive puzzle, elevated to the level of national policy when Richard Nixon declared war on cancer (Sporn 1996). The virtue of the...

  7. Chapter 4 Scientific Import and Influence
    (pp. 49-64)

    Social understandings of being old and having a disease like cancer, embedded in our collective consciousness, seem at first to have little direct influence on basic and clinical sciences. The intellectual distance between a common or shared image, such as that of pain, suffering, and social isolation often conjured by the phrase “an old man with cancer,” and cellular and molecular science aimed at determining specific elements of carcinogenesis appears wide. Social science documents how we understand and what we construct to be common elements of collective human experience. That offers a vantage point from which cells and molecules are...

  8. Chapter 5 Language Lessons
    (pp. 65-75)

    The experience of older adults who have cancer is likely more deeply marked by conceptual commonalities of their own language and the daily living that comprises such experience than by any discrete, scientific indicators of physiological, psychological, or social aging (Kagan 2004). In my work, three concepts that emerged from my original research in the symptom experience of older adults being treated for cancer have manifested in innumerable clinical situations and in the observation of the work of colleagues (Kagan 1994, 1997). The concepts, labeled “integrating cancer into a life mostly lived,” an abstraction of the place cancer holds in...

  9. Chapter 6 Aesthetics of Being and Having
    (pp. 76-86)

    What it means to be old and have cancer is ultimately a very individual matter, a personal experience of self—a persona of identity, embodiment, and relationships in daily life. It is out of such experiences that collective sensibilities emerge and social thought on the state of being old and having cancer extends. The remnants of our society’s Protestant origins that I discussed earlier, in order to frame the modern stories of Mrs. Eck, Mr. Napolitano, and Mr. Cahn, remind us of a time when cancer could not be understood in any dimension as a biological phenomenon and was exclusively...

  10. Epilogue: Not a Denial of the Fact of Death, a Denial of Death Now
    (pp. 87-94)

    People—enthrallingly, I think—exist in a space that merges inner identity and personal aesthetic with socially perceived knowing. As much as we comprehend ourselves and our own existence, we are known by others, especially those who love us. The dialectical nature of being in and through knowing oneself and being known by others accretes as we age. Our lives become almost labyrinthine as we pass through decades of daily life with relationships and events that mark them. This layering of experience shapes identity, knowing, and a composite aesthetic, a sense of ourselves as physically embodied beings who function in...

  11. Postscript: Completed
    (pp. 95-98)

    At the very end of August 2006, as I pounded away—literally, with finger strikes that clattered on my computer keyboard—at what I hoped would be final edits to the manuscript for this book, I received an e-mail titled succinctly “Completed.” I was taken aback by the superficial coincidence. As I completed effortful writing incorporating what I had learned from her, Mrs. Eck had more momentously completed her life a few hours earlier. Joe’s partner, Wayne, had written the message, voicing memory and mourning, with an eloquence I could only hope to reach:

    That’s a bit of a dramatic...

  12. Notes
    (pp. 99-102)
  13. References
    (pp. 103-106)
  14. Index
    (pp. 107-110)
  15. Acknowledgments
    (pp. 111-111)