← Return to Pancreatic lesion 89 yr old dad. Dr not sure if he can be treated.

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@stageivsurvivor

The vast majority of clinical trials have an upper age limit ranging between 75 to 85 years. It is extremely rare to find a trial today that accrues patients that are 89 years old which is the upper limit of any trial I have found on clinicaltrials.gov and those trials occurred more than a decade ago. Phase I and II trials accept healthier and younger patients and are the ones more likely to be open label trials where all patients receive the test drug. Some phase II trials are randomized and can be single or double blinded to mask knowing who is receiving the drug until the trial is concluded.

Phase III trials accept less healthy patients although with limits in age restriction and the co-morbidities that can result in exclusion. All phase III trials are randomized. A computer does the selection so the patient nor the oncologist has any say in who is in the test arm and who is in the control arm receiving standard of care.

There are surgical oncologists who will perform the Whipple and Distal Pancreatectomy with splenectomy on patients of advanced years. The criteria is not age but the ECOG health status of that patient, generally being 0 to 1 and no serious co-morbidities. The famous Whipple surgeon John Cameron who practiced at Johns Hopkins in Baltimore and now retired performed a Whipple on the oldest patient being 103 years old. Flavio Rocca MD in Portland, Oregon did a Whipple on a patient that was 94 years old. John Chabot MD of the Pancreas Center at Columbia Presbyterian also does Whipple surgery on patient of advanced years.

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Replies to "The vast majority of clinical trials have an upper age limit ranging between 75 to 85..."

@judithbramson12 had Whipple at Mayo/Jax (Dr. Stauffer) in 2022, which would have been age 82 if I read her post here https://connect.mayoclinic.org/discussion/bloathas-anyone-experienced-bloat/?pg=2 correctly. That's absolutely amazing.

My dad was 84 and in OK health when his pleural mesothelioma was discovered, but every surgery on the books was ruled out as too hard on him. He took an immunotherapy treatment for about 4 months, and that about killed him. Once off that, he survived about 7 months of up and down, mostly down.

My father-in-law was 83 and in so-so health when he needed a heart stent and treatment for kidney cancer. The surgeons in both camps didn't want to touch him, basically daring the other one to go first. He wound up eventually getting both a few months apart, but we almost lost him a couple times. He's still on an adjuvant immunotherapy from the kidney removal, but testing negative for his cancers. One tough SOB (and former USMC).

@stageivsurvivor is correct about performance status being a bigger eligibility determinant than age. A quick search of trials at https://clinicaltrials.gov/search?cond=cancer&locStr=USA&country=United%20States with generic criteria of Location=USA and Condition=Cancer for all ages returns 45,510 trials.

If you add a filter limiting age to 65+, it returns 42,233.

If you manually specify an age range from 65 to 85, 99, or 1000, it returns the same 42,233.

That may be a limitation of their search engine or how they specify age items in their database, but it reinforces the idea that age (outside of adulthood at 18 or senior status at 65) is not a strict criteria for many trials.

Unfortunately, I couldn't find a search filter for performance status in my brief trip through the site.