Dr. Rodolfo C. Morice measures lung capacity for Pearley Brown, a patient from Orange, Texas.
	More than 15 percent of the approximately 1,000 neurosurgical procedures performed at M. D. Anderson during the past fiscal year were for patients 65 and older, reports Dr. Raymond E. Sawaya, chairman of the Department of Neurosurgery. “Our volume of older patients is increasing, too. Statistics show that in general older patients undergoing brain surgery have about the same neurological outcomes as younger ones,” says Dr. Sawaya, who holds the Mary Beth Pawelek Chair in Neurosurgery. One of the oldest patients was a 93-year-old attorney whose malignant skin cancer of the scalp was causing weakness and spreading into his brain. Dr. Franco DeMonte, an associate professor of neurosurgery, orchestrated the removal of the tumor and sent the patient home two days later to enjoy Thanksgiving. Dr. DeMonte, who specializes in skull base tumors, has removed large benign brain tumors from several patients 80 and older. In most cases, the tumors had been pressing on vital brain tissues and producing progressive weakness and inability to walk. One of those patients is an 84-year-old Louisiana man who regained his balance and walked out of the hospital following excision of a giant acoustic neuroma. Many patients of all ages — including those in their 80s and 90s — benefit from extensive rehabilitation following brain surgeries and other aggressive treatments. The Pennzoil Rehabilitation Services area provides a centralized location for both hospitalized patients and outpatients to work on overcoming mobility, strength and cognitive problems. “We are seeing an increasing number of senior patients, including some in their 90s, whose primary treating physicians want us to help restore physical function so they can enjoy a better quality of life. For the elderly, it is so essential to keep them up, mobile and participating in daily activities, such as personal grooming, cooking, household tasks and interacting with others,” observes Dr. Theresa A. Gillis, chief of the Section of Physical Medicine and Rehabilitation. Dr. Gillis and her colleagues frequently assess neurological function and physical mobility for older patients prior to undergoing surgery. “We also must be mindful of medications that the elderly take for underlying problems since those drugs may interact with chemotherapeutic agents, sedatives and anesthetics used during surgery. Older patients on chemo may develop loss of feeling in the extremities and/or muscle weakness, while some patients having radiation may experience generalized weakness and fatigue. Evaluating them prior to treatment allows us to prevent or at least minimize some of the problems,” Dr. Gillis says. Continued