Survival rates for cancer in the UK are not as good as in some other countries.
One of the reasons for this is poorer outcomes among certain groups and including older patients aged 75 years and over. An international research study by the National Cancer Equality Initiative (NCEI) has now shown that in several countries older people are often not offered the treatment most likely to benefit them.
The study (www.dh.gov.uk/health/2012/02/age-oncology) explored the extent to which age influences treatment decisions across a range of cancers: breast cancer (non-HER2-positive); chronic myeloid leukaemia (CML); colorectal cancer (bowel cancer); non-Hodgkin lymphoma; and renal cell carcinoma (kidney cancer).
The findings revealed that while clinicians believe they do not discriminate against older people, there is a tendency for less intensive treatments to be prescribed according to the chronological age of the patient rather than their biological age. This means that more robust older patients are potentially denied potentially curative or life prolonging treatments.
Older people may also unwittingly collude in the process as they often have preconceptions about the side effects of chemotherapy or not report symptoms accurately or quickly enough.
Part of the problem is that clinical trials tend not to include older patients. Increased trial activity in this age group would provide clinicians with the information they need to better determine what approach is best for their patients.
Our Research Director Professor Chris Bunce says: “It’s time to revisit the options for older cancer patients. The advent of novel therapies and better care together with an increased understanding of these diseases is extending the opportunities for meaningful anticancer treatments over and above palliative care”.
The National Cancer Equality Initiative (NCEI) and the Pharmaceutical Oncology Initiative (POI) collaborated on this study, supported by the Department of Health.
The NCEI says more work needs to be done to provide guidance for clinicians so that they have accurate information about an older person’s ability to benefit from cancer treatment rather than making assumptions on the basis of age.
Sally Clark – Science Communications Team