A lack of treatment or insufficient treatment is contributing to 14,000 deaths a year in people over the age of 75, Macmillan Cancer Support has found, in what it called an ‘unacceptable act of discrimination’.
Deaths from cancer are reducing in most age groups but at a slower rate in those aged 74 to 84 and are increasing in people aged 85 and over, the report said.
The report, The Age Old Excuse: the under treatment of older cancer patients, said treatment options are too often recommended on the basis of age rather than how fit the patient is.
Professor Riccardo Audisio, Consultant Surgical Oncologist at St Helens Hospital, said: “It is despicable to neglect, not to offer, not to even go near to the best treatment option only on the simple basis of the patient’s age.
“This has been a horrible mistake that, particularly in the UK, we have suffered from.”
According to research published in the journal Cancer Epidemiology, there would be 14,000 fewer deaths from cancer in those aged over 75 per year if if mortality rates from cancer matched those in America.
Cancer is more common in the elderly and in many cases it is diagnosed late, further reducing the chances of successful treatment.
In addition, many older people decide not to be treated or refuse certain options because they do not have the support at home, or transport that would be needed for repeated radiotherapy sessions or a course of chemotherapy, for example.
Few clinical trials involve older people so clinicians are lacking evidence of how effective drugs may be in elderly people and few cancer specialists have had training in care of older people, the report said.
A survey found six in ten trainee oncologists had not received training in the additional care needs of the elderly such as preventing falls and incontinence management. This is despite half of all cancers occuring in the elderly, the report found.
There are around 310,000 cancer diagnoses and around 156,000 deaths every year in Britain.
Cancer is the single biggest killer of people age over 75, accounting for a quarter of all deaths in men and almost a fifth of deaths in women, data from Cancer Research UK shows.
Ciarán Devane, Chief Executive of Macmillan Cancer Support, said: “To deny older patients treatment that could cure them based on ill-founded assumptions is an unacceptable 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.
“As our population ages, and the number of people diagnosed with cancer grows, it is vital that steps are taken to ensure that the right people get the right treatment at the correct level of intensity, together with the practical support to enable them to take up and complete the treatment.
“Efforts are being made to increase early diagnosis and promote healthier lifestyles, but much more needs to be done to tackle under treatment.
“The NHS and social care providers must wake up to the specific issues older people face and ensure treatment decisions are based on their overall health not just their date of birth. Writing people off as too old for treatment is utterly shameful.”
Macmillan is calling for a more effective way of assessing older people for treatment, more short-term practical support to enable them to take up recommended treatment and training for professionals working with older people within the NHS to promote age equality.
Care Services Minister, Paul Burstow said: "Cancer patients, irrespective of their age, should expect the best care and that's what our dedicated NHS staff are delivering.
"However, we are under no illusions that there are unjustifiable variation in standards, which is why we have funded five pilots jointly with Macmillan to help us understand how older people with cancer are cared for.
“The learning from the pilots will help the NHS to ensure that all older patients with cancer have their needs properly met.
"Not only is the NHS under a moral obligation not to discriminate, but we sent a clear message that any age discrimination in the NHS is unacceptable when we did not ask for any exemptions on age in the Equality Act."
Article from Telegraph