After receiving a $3.3 million grant from the National Cancer Institute, a Boston University professor has begun leading a research team studying the effectiveness of breast cancer treatments in elderly women, an age group she said has been ignored in past studies of the disease.
Rebecca Silliman, a professor in BU’s School of Medicine and School of Public Health, will survey 2,180 elderly women in the United States during the study, examining the effects of cancer treatments on women who were diagnosed with breast cancer between 1990 and 1994. The study will also rely partially on patients’ past medical records, she said.
Silliman, who is also the Chief of the Geriatrics Section at Boston Medical Center, said this week the issue concerning the elderly and the cancer treatments they receive is an important one.
‘As deaths due to cardiovascular disease continue to decline and longevity increases, the number of older persons with cancer is growing substantially,’ Silliman said.
The study will research the effectiveness of tamoxifen therapy, a hormonal therapy that prevents breast cancer from recurring, and post-therapy surveillance, which seeks to prevent mortality of cancer patients, according to Timothy Lash, assistant professor of epidemiology in SPH and research team member.
The purpose of the study is to determine whether previous studies actually apply to all women of different ages, Silliman said. Though more than half of new breast cancer diagnoses are in women older than 65, very few women in breast cancer research trials are actually in that age group, she said.
There is also less information available on cancer treatments for the elderly because their multiple health problems make them difficult to study and sometimes ineligible for clinical trials, she added.
Lash, who has been working with Silliman on similar studies since 1996, said the public does not really know as much about how accurate breast cancer studies have been before because people do not know enough about the backgrounds of people participating in the studies. Previous research results may not apply to elderly people because tests have simply not been done on the age group.
‘Patients invited to do clinical treatments are usually younger, healthier and more educated women,’ Lash says. ‘The next logical thing to do is to see if the studies researching women receiving treatment apply to women of all backgrounds.’
A cancer research network that provides health care and treatments for patients will be used for the study, according to Lash.
Greatly increased access to patient records will also allow the research team to study patients with a broader range in backgrounds because the team will not be limited to studying patients who agree to participate in the study, as the team has done in the past.
Because they are working through the research network, they will not have as much trouble accessing people’s records.
‘Past studies involved contacting patients and getting their permission,’ Lash said. ‘In the current study, we don’t need to contact as many patients because we have access to their records through the health care organizations.’
Still, the group will take privacy issues into consideration, he said.
‘We are still upholding the same confidentiality standards we have always had for every patient,’ he said.
Silliman said she became interested in cancer treatments for the elderly as a junior faculty member at Brown University researching early studies of cancer in older people in the mid-1980s, and has been a practicing geriatrician for almost 20 years.
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