What To Do If You're 90 Years Old And Diagnosed With Esophageal Cancer

When it comes to treating esophageal cancer in patients over the age of 90, the decision-making process becomes more complex due to the natural decline in overall health and organ function that typically occurs with advanced age. Each case must be evaluated individually, taking into account the patient's general physical condition and comorbidities.

For elderly patients in relatively good health, surgical resection remains the most effective treatment option and should be considered as the first-line approach. However, for those who are not suitable candidates for surgery due to frailty or other medical conditions, alternative treatments such as chemotherapy, radiation therapy, immunotherapy, or targeted therapy can be explored. These options may help control the disease and improve quality of life.

In some cases, patients may be diagnosed at a more advanced stage of esophageal cancer. Neoadjuvant therapy—such as pre-surgery chemotherapy or immunotherapy—can be an effective strategy to shrink the tumor and reduce the stage of the cancer before attempting surgery. This approach has been shown to improve both progression-free survival (PFS) and overall survival (OS) in many patients.

If surgery is not immediately feasible, starting with immunotherapy or chemotherapy may help determine whether the patient can later tolerate surgical intervention. This stepwise approach allows doctors to assess the patient's response to treatment and overall resilience before proceeding with more aggressive options.

Ultimately, the goal is to balance the potential benefits of treatment with the risks and ensure that the patient's quality of life remains a top priority throughout the decision-making process.