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Cancer in Older Adults: Timothy O'Brien, MD, director of the MetroHealth Cancer Care Center and chief of the Division of Hematology/Oncology, along with clinical nurse manager Barbara Ruda, RN, review a patient's diagnosis and treatment plan. That percentage is expected to reach 20% — 1 in 5 Americans — by mid century. Because half of all cancers are diagnosed in older adults, the topic of cancer in older adults is of increasing concern. MD News asked Timothy O'Brien, A MD, director of the MetroHealth Cancer Care Center, MetroHealth's chief of the Division of Hematology/ Oncology and associate professor at Case Western Reserve University School of Medicine, to discuss cancer in older adults. MetroHealth this year received full accreditation with commendations from the Commission on Cancer (COC) of the American College of Surgeons which recognizes excellence in the care and follow-up of cancer patients. DULTS OLDER THAN 65 rep- resent more than 13% of the U.S. population, according to the U.S. Census Bureau. MetroHealth also recently received recognition for its breast health services from the COC's National Accreditation Program for Breast Centers. Dr. O'Brien is board certified in Internal Medicine/Medical Oncology and Hematology. His specialties include blood disorders, gastrointest inal malignancies, multiple myeloma and hematologic malignancies. Here's what he had to say about cancer in older adults. Breast, colorectal and prostate can- cer are the most predominant cancers that increase with advancing age. Of these, breast cancer and colorectal cancer have the most effective screen- ing programs. For breast cancer, particularly with older patients, screening mammogra- phy defi nitely has been shown to detect 34 | Cleveland-Akron-Canton MD NEWS MDNEWS.COM NOVEMBER-DECEMBER 2011 breast cancers at an earlier stage. And if it's caught in an earlier stage, it's curable. When it spreads, it's generally not curable. The best test for colorectal cancer screening is still colonoscopy. This test is unique because it can help prevent, as well as detect, cancer. That's because cancer goes through several precursor stages: hyperplastic polyps, which means 'growth of the cells', but they're not cancerous; adenomanous polyp, which is a more abnormal polyp, but it's still not cancer; and dysplastic polyp, which is close to cancer. Beyond that, there's early stage invasive cancer and then advancing stages of cancer. A screening colonoscopy is very use- ful, because if we can pick up one of these polyps in an early point of development, we can halt progression to invasive cancer. Perspectives from MetroHealth's Cancer Center Director PHOTOS © REBECCA COLLINS-KUNES, COURTESY OF METROHEALTH