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04/28/2017 06:02 pm ET Updated Apr 28, 2017

What Charlotte Rae's Cancer Plan Reveals About Medical Decisions Late In Life

At 91, it's less about how to treat cancer and more about whether you should.

Actress Charlotte Rae, 91, has revealed that she was just diagnosed with bone cancer. And like many who get a diagnosis of a serious illness at an advanced age, her first decision wasn’t what the best treatment plan might be but rather whether she should seek treatment at all.

“At the age of 91, I have to make up my mind,” she told People magazine. “I’m not in any pain right now. I’m feeling so terrific and so glad to be above ground.”

Rae, who was treated for pancreatic cancer several years ago, added, “Now I have to figure out whether I want to go have treatment again to opt for life. I love life. I’ve had a wonderful one already. I have this decision to make.”

Rae, best known for her role as Edna Garrett on “Diff’rent Strokes” and then on “The Facts of Life,” received six months of treatment at the UCLA Center for Pancreatic Disease. She described the side effects as “not too bad” but said she still wants to mull over whether to undertake treatment for bone cancer.

While time is generally considered to be of the essence in most cancer discoveries and treatments, Rae allowing herself some space to decide whether she wants to receive treatment at her age makes perfect sense.

Age alone, of course, should not be a barrier to cancer care for those who want it. But not everybody wants it. A study of 1,000 cancer patients in the U.K. found that 12 percent over age 75 declined treatment, a rate that wasn’t far from the 14 percent to 15 percent found with younger patients.

A smaller study of 112 older, newly diagnosed cancer patients put the rate of those who refused or stopped treatment at about 17 percent.  

Rae on the set of 'The Facts of Life'
NBC via Getty Images
Rae on the set of 'The Facts of Life'

Will the treatment be worse than the disease?

The question she is likely pondering is whether the treatments will provide more benefit than harm. And, given the anticipated progression of the disease, would she be wiser to make the most of her current pain-free life than experience the side effects of cancer treatment?

The American Cancer Society says that the five-year survival rate for bone cancer is 70 percent when you combine children and adults. Certain cancers tend to grow more slowly in the elderly, but bone cancer is not one of them.

While Rae did not say what type or stage cancer she has, the most common bone cancer in adults is chondrosarcoma, which has a five-year relative survival of about 80 percent. (A relative survival rate assumes that some people will die of other causes and compares the survival of people with cancer with that of people without the cancer.)

What’s more, cancer treatments improve considerably every five years, so many newly diagnosed patients may have a more favorable outcome than the survival rate implies.

Being treated for cancer as an older person also presents some heightened risks. Treatment could leave an older person dizzy and thus more prone to falls. Bones are more fragile and break more easily in the elderly. An older person undergoing cancer treatments might lose some independence and need assistance with the activities of daily living. And if other health issues are present, the cancer medications might interact with other drugs being taken. 

Rae has faced her fair share of adversity. In her 2015 memoir, The Facts of My Life, she chronicled how she maintained nearly 44 years of sobriety, how she discovered her loving husband, John Strauss, was cheating on her with men, and how she coped with the death of her son, who had autism and dementia.

As she counsels in her book, “I want to tell everybody to celebrate every day, to savor the day and be good to yourself, love yourself, and then you can be good to others and be of service to others.”

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