Older cancer patients miss out on care

Charity highlights under-treatment of over-75s

ELDERLY cancer patients are being “under-treated” because assumptions are being made about their ability to cope, a charity has warned.

Some are missing out on medicines and support that would give them the best chance of beating the disease, according to Macmillan Cancer Support.

Figures show older people are less likely to receive surgery, radiotherapy and chemotherapy than younger patients.

While this can often be medically justified, there is “growing evidence” that many older patients who could benefit from treatment are simply not being offered it, according to Macmillan’s report, The Age Old Excuse: The Under-treatment of Older Cancer Patients.

The charity said under-treatment is one of several factors contributing to around 14,000 avoidable cancer deaths among over-75s in the UK each year.

The others include late diagnosis and a higher incidence of cancer among older people.

The report said that recommendations on treatment are too often being made on the basis of age, regardless of the patient’s fitness.

Many patients also do not take up treatment because they do not have enough practical support to help them at home or with transport.

Furthermore, older people are under-represented in clinical trials for new treatments, so doctors lack evidence on the benefits and risks of treatment.

In the report, Ciaran Devane, chief executive of Macmillan Cancer Support, said: “Assumptions about someone’s ability to tolerate treatment, quality of life or personal preferences should never be based on their chronological age.

“Two people of the same age may have very different needs and will cope with cancer treatments differently.

“One 78-year-old may be bedbound, while another may take part in half-marathons. As such, they should be treated as individuals.

“In spite of this, chronological age is an all-too-common influencing factor in cancer treatment recommendations.

“The simple fact is that cancer mortality rates in our older population are not improving rapidly enough. If UK mortality rates matched those in the USA, we could prevent around 40 cancer deaths per day in people aged over 75.”

The report said a survey of 98 cancer specialist trainees found 60% had received no training in the particular needs of older people with cancer.

While cancer death rates are improving significantly for the under-75s, the rate is much slower rate in those aged 74 to 84 and is worsening for over-85s.

Half of all new cases of cancer in the UK are diagnosed in people aged 70 or over.

Mr Devane added: “To deny older patients treatment that could cure them based on ill-founded assumptions is a n u n a c c e p t a bl e act of discrimination.

“We have a moral duty to treat people as individuals and give them the best chance of beating cancer, regardless of their age.”