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Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
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Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
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Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
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Drug distribution in the human body is influenced by several factors, including plasma protein concentration, body composition, blood flow, tissue-protein concentration, and tissue fluid pH. Among these, changes in plasma protein concentration and body composition due to aging significantly affect how drugs are distributed within the body. Specifically, aging is associated with a decrease in albumin levels by about 10% and an increase in α1-acid glycoprotein levels. These alterations are...
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In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
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Geriatric patients show significant variation in how their bodies process medications, which can change how effective and safe treatments are. The liver is the primary organ where drug metabolism occurs, involving two main types of chemical reactions: phase I and II. Phase I metabolism is driven by the cytochrome P450 enzyme system, which includes key types such as CYP3A, CYP2D6, and CYP2C9. Research indicates that while aging doesn't notably alter the levels or activity of these enzymes, it...
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Geriatric oncology in Mexico.

Carolina Gomez-Moreno1, Haydeé Verduzco-Aguirre2, Enrique Soto-Perez-de-Celis1

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Cancer cases in Mexico

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Area of Science:

  • Geriatric oncology
  • Epidemiology of cancer in older adults
  • Healthcare systems analysis

Background:

  • Mexico faces a growing population of older adults, increasing cancer incidence.
  • Population aging and lifestyle changes present significant healthcare challenges.
  • Fragmented healthcare and lack of geriatric training impede geriatric oncology care.

Purpose of the Study:

  • To review cancer epidemiology in older Mexican adults.
  • To analyze the Mexican healthcare system's structure.
  • To outline current geriatric oncology initiatives and future priorities.

Main Methods:

  • Mini-review of existing literature and data.
  • Analysis of the Mexican healthcare system.
  • Identification of stakeholders and development priorities.

Main Results:

  • Cancer incidence in older adults is rising in Mexico.
  • Healthcare system fragmentation and workforce training are key barriers.
  • Several initiatives are underway to develop geriatric oncology programs.

Conclusions:

  • Addressing the challenges in geriatric oncology care is crucial for Mexico.
  • Future development requires collaboration among stakeholders.
  • Enhanced training and system integration are essential for improving care.