Improving cancer treatment, assessment and support for older people
Macmillan is working in partnership with the Department of Health and Age UK on a project to improve access to treatment for older people with cancer.
Just over half of all people newly diagnosed with cancer in the UK are over 70 years old.
We're concerned that the UK has some of the worst survival rates in Europe for older people. Although late presentation and diagnosis plays a part, there is a growing body of evidence to suggest that older people with cancer are under-treated.
This may explain why, while mortality rates are improving significantly for the under-75s, they are improving at a much slower rate in those aged 74-84 and actually getting worse for those aged 85 and over.
The project has identified key areas of good practice. Age friendly cancer services will:
engage elderly care specialists as an active part of the cancer care team and adopt a multidisciplinary approach to the assessment and management of all patients
ensure an early and appropriate assessment of an older person is undertaken. The assessment should not only inform a dialogue about cancer treatment, but should identify and address unmet physical, psychological and social support needs. Follow up assessments should be undertaken at various stages throughout treatment to identify and address changes in need
ensure everyone gets the maximum benefit from cancer treatment and associated supporting therapies by effectively managing other health conditions and incorporating reasonable adjustments into care planning to address additional needs
establish services and clear referral pathways for both outpatients and inpatients to address needs identified by assessment. This includes establishing clear links with voluntary sector agencies, social services, and specialist teams such as falls prevention teams, continence specialists and dementia specialists.
ensure effective communications systems are in place to facilitate coordinated care and informed decision making
ensure clinical and non-clinical staff are supported with the training and access to resources required to conduct appropriate assessment and follow up care of all patients. In order to do this, it is vital systems allow sufficient clinic time to undertake this work in day-to-day practice.
The Age Old Excuse campaign (no longer running)
The Age Old Excuse campaign stressed that treatment recommendations should take into consideration biological age (i.e. health and fitness) as opposed to chronological age. We recognise that over-treatment is just as undesirable as under-treatment.
The campaign aimed to ensure that older people got the treatment and care that’s right for them.
For more information on patient age and oncology, download the Department of Health’s The Impact of Patient Age on Clinical Decision Making in Oncology report.
For more facts and figures on older people and cancer, read our older people’s rich picture [PDF 2.7MB].
Access All Ages was published in 2012 by Age UK and the Royal College of Surgeons. It looks at intervention rates for a number of surgical procedures, and discusses some of the reasons for variation by age.