The Older People's Project pilot sites
We are working in partnership with the Department of Health and Age UK on a project to address under - treatment of older people with cancer.
Read the project report Cancer Services Coming of Age [PDF2.6MB].
In 2011, 14 NHS Trusts throughout England began to test new models of care for older people aged 70 and over, including:
testing new methods of clinical assessment of older people with a diagnosis of cancer
coordinating and delivering short-term practical support packages for older people undergoing treatment
promoting age equality to address age discriminatory behaviour in cancer services.
A final report from the pilot sites will be available in December 2012.
Why do we need better assessment methods?
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Two older people with cancer may be the same chronological age but have different physiological ages.
One older person interviewed for the recent Macmillan Walking into the Unknown report [PDF] said:
'I asked my [specialist nurse] about the decision on my treatment to have the injections. She brought my file in and showed me a letter that had been signed by four consultants. It said that 'due to the patient being 85 we recommend hormone treatment.'
When it’s in black and white like that, and maybe I’m anticipating it, but I’m sure if I was 65 I’d be on a different treatment. I’ve always been really active; I’m not necessarily a typical 85 year old.'
It’s like she’d gone beyond her duty and was showing me something that maybe I shouldn’t have seen. It was like she was giving the game away, and it was at that point that I thought for the first time: this is palliative, not curative.’
What would better assessment methods achieve?
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Half of all cancers occur in people aged 70 or over. In the case of some older people with cancer, curative treatment won’t increase the quality or length of their life, and may be harmful. So, older people commonly receive less aggressive therapies.
We hope assessment methods routinely used in geriatric medicine will be adopted in cancer services to support clinicians and patients to make more appropriate treatment decisions.
This may lead to identifying more older people for whom curative treatment would be appropriate, and reduce the number of people denied treatment on the basis of their chronological age.
Furthermore, these assessments may identify health problems which can be managed in order to improve treatment tolerance.
What difference will practical support make?
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Our aim is to reduce the number of older people who refuse cancer treatment because they don’t feel they'll be able to maintain their independence and cope at home as a result of it. Practical support may include activities such as providing transport, housekeeping, shopping, dog-walking and befriending.
The pilot project will see greater collaboration between acute care, primary care, social services and the voluntary sector to ensure older people receive practical support during treatment.
Find out where pilots for the project are taking place: