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Margot A. Gosney, Geriatric Oncology, Age and Ageing, Volume 38, Issue 6, November 2009, Pages 644–645, https://doi.org/10.1093/ageing/afp182
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Extract
It was only in the early 1980s that Rosemary Yancik who was an epidemiologist in the USA identified that there were a growing number of older individuals with cancer [1]. Many of the papers in the 1980s identified that older people were less likely to be investigated, diagnosed or managed actively. Few were entered into clinical trials and many cases were only identified on death certificates.
As Geriatricians we are more than aware that ageing is associated with a permanent accumulation of damage at many different levels including molecules, cells, organs, tissues and the whole organism. Although in more sophisticated organisms tissues can replace damaged and lost cells, this has both positive and negative effects. It increases the possibility for maintenance, repair and prolonged life but does bring with it the risk that cells might acquire genetic changes that affect cell growth or differentiation thus increasing the risk of them being transformed into a cancer cell. There are two major categories of tumour suppressor genes: gatekeepers and caretakers. Whilst caretaker genes protect the genome against damage and mutations, gatekeeper genes induce cell death or cell cycle arrest of cells that have accumulated damage genes [2].
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