More than half of patients diagnosed with cancer are older than 65. Some of them are in great shape, others are frail. But with current standards, they are all treated the same way, which can have deadly consequences.
When it comes to cancer treatment, age is just a number.
At 91 years old, nothing slows Bill Owen down.
"I go out and work my garden, go out here and cut me some wood and stack it out here," said Owen.
He's an avid hunter, a world war two vet, a die-hard baseball fan, and now he has another title: cancer survivor.
"About scared me to death," Owen said.
Doctors diagnosed Bill with stage four lymphoma four years ago. Because of his age he and his wife were told not to assume he would survive.
"Go home and enjoy what time he had left," Barbara Owen, Bill's wife said.
Dr. Heidi Klepin said treatment decisions are difficult because most clinical trials only include younger patients.
"It's not clear exactly which older patients are going to benefit from any given therapy," Heidi Klepin, M.D., from Wake Forest Baptist Medical Center told Ivanhoe.
Treatment recommendations are often based on age alone, but take a fit 80-year-old versus a frail one.
"If you applied the same treatment to both of those patients, you would either under treat the fit 80-year-old patient or over treat and potentially harm the frail 80-year-old patient," Dr. Klepin said.
That's where a first of its kind assessment tool comes in. Klepin used it to evaluate seniors with leukemia. She measured everything from physical function to a patient's mental state. Her findings show those who scored poorly before chemo have a higher risk of death.
"People want to know what are the risks for me to go through this therapy, what are the benefits, with this type of assessment, we can start answering those questions," said Klepin.
For Owen, it meant finding another doctor and undergoing chemo.
"I still go all day long," he said.
Klepin hopes her study will help create a nationwide test for oncologists that can determine which seniors will benefit from aggressive treatment and which won't. Then they will be able to individualize treatment plans. She's also in the process of enrolling for a new study looking at whether factors like exercise can help improve outcomes for seniors who undergo cancer treatment.