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"We always are working on ways of minimizing the complications of therapies," he says, although he agrees that managing comorbidities may complicate treatment.
Hawk says sustaining patient participation in clinical trials remains an NCI priority, and he recognizes the greater challenge of recruiting older individuals.
"Getting anyone to participate requires effort — all the more so, people with co-morbidities at advanced ages," he observes.
But research has shown that age alone is not a predictor of whether a cancer treatment will cause side effects or have a positive outcome, Johnson says. He advises older patients to insist on exploring all their options to avoid physician bias against aggressive cancer treatment.
"Their doctor decides they are too old or too frail," explains Johnson, director of Vanderbilt-Ingram's Division of Hematology/Oncology.
Regardless of any knowledge gap that remains to be closed, the experts expect help will come from the geriatric sub-specialties and centers that already are in place across the country. And the early detection and prevention efforts — particularly the push to stamp out smoking — which have helped keep cancer death rates from climbing, will continue to play an important role as more people enter the prime age range for developing the disease.
"One of my hopes is that we get much better at early detection," says DuBois. "That's one of the big missions of the Ayers Institute."
The Jim Ayers Institute for Precancer Detection and Diagnosis was established at Vanderbilt-Ingram in 2005 with a five-year,
$10 million gift from its namesake. One goal of the institute is to identify new markers to detect colorectal cancer at its earliest stages using new proteomics technologies developed
at Vanderbilt. DuBois says a breakthrough here — which he predicts may be five years away — could reduce colon cancer mortality by as much as 90 percent.
And the baby boomers themselves may play a more important part in their own health care than did patients in past generations. Armed with the Internet as a research tool, healthier from exercising more and eating better, and determined to stay active well into old age, this generation will expect — perhaps even demand — the best medical care for chronic diseases.
Musician Dave MacKenzie just feels lucky that Vanderbilt's Mathew Ninan, M.D., is considered one of the nation's experts in treating his rare lung condition, called a Pancoast Tumor.
"That was a real blessing," says MacKenzie, especially since that meant his wife and performance partner, singer Adie Grey, did not have to sleep in a hotel room away from home during his hospital stay.
Ninan and Kyle D. Weaver, M.D., removed the tumor that had impinged on MacKenzie's nerves, making playing guitar with his left hand more and more difficult. He has gone from being told he might lose the use of his arm, to accompanying his wife on a Louisville radio show publicly for the first time in September.
While his wife used the Internet to track down information after his cancer diagnosis, MacKenzie took a more introspective route to dealing with the disease doctors said could be fatal.
"I was trying to do a more Zen approach to the fear," he says.
At 57, he's not convinced his fellow baby boomers are more fit or more informed about health, but he does think this post-World-War II generation was raised with the expectation of having better lives than their parents did — an expectation that might very well end up in the doctor's office.
"We were, frankly, spoiled," he says.
MacKenzie observes this might be the first generation to get hit hard by the unknown effects of chemicals and other pollutants in food and the environment. And he thinks worry about bioterrorism — an area that has received increased federal funding — may be misplaced.
"You've probably got a lot better chance of dying from one of these diseases," he observes.
And in the cancer fight, federal funding is imperative, he says.
"The war on cancer is like the war on terrorism," says MacKenzie. "It's larger than any individual cancer doctor. It's larger than even a great institution like Vanderbilt...The national approach is the only logical answer."
For their part, cancer experts have mixed views about what to expect from this incoming wave of patients and the care they will need.
"I do think the boomers are a little more informed — not a whole lot more informed — about their options," says Johnson, who also was a member of MacKenzie's treatment team.
Eyre, of the ACS, believes new developments in information systems will translate to better health care for the baby boomers. Electronic medical records are one example, he observes. This generation will be the first to fully benefit from this technology, Eyre says, which should provide better information for the doctors who will provide the care.
"It's a different population than what was in the past," observes DuBois, "and that could be a good thing." 
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