Assessing the benefit of surgery for older patients


19 Apr 2020 | 1 | by kjh

12280login-checkAssessing the benefit of surgery for older patients

Dr. Rita F. Redberg is a cardiologist who practices general and preventive cardiology at UCSF Health. She is also interested in how to promote high-value health care, an approach that emphasizes delivering appropriate treatment while avoiding tests or therapies with no known benefit.

As editor of JAMA Internal Medicine, a journal of the American Medical Association, she has spearheaded the publication’s new focus on health care reform and less-is-more medicine, a movement to reduce unnecessary interventions.

Dr. Redberg said that doctors treated her mother for melanoma when she was 92 years old. Melanoma is the most serious type of skin cancer.  After the cancer was removed from her mother’s leg, the doctor urged her mother to undergo additional surgery to cut away more tissue and nearby lymph nodes, which can harbor cancerous cells.

Dr. Redberg said that every time her mother saw the dermatologist, he wanted to refer her to a surgeon.  But her mother had problems with wound healing and recovery would have likely taken three months. The surgeon said that the benefit of the surgery was that it could reduce the chances of cancer coming back within three to five years. Her mother laughed and said “I’m not interested in doing something that will help me in three to five years.  I doubt I’ll be here.”

Assessing the benefit of various procedures is important to older patients.  Many times Medicare will pay for the procedure but having an advocate for an elderly patient is important.  It might not be beneficial for the patient to undergo additional tests and surgery.  Some older patients are frailer than others so assessing the benefit is important for the quality of life in the elderly.



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10 months ago

I go with my mother to the doctor a lot and I agree. In her 80’s the doctors want her to have surgery even for things that aren’t necessary (in terms of life and death).

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