19 December 2012
Ageism in the NHS is stopping some older cancer patients getting the best treatment according to a survey of oncologists, cancer clinical nurse specialists and GPs by Macmillan Cancer Support1.
The ICM research shows nearly half (48%) think stereotypes and assumptions about older people held by health professionals is resulting in some older cancer patients not getting the best treatment for their cancer and individual needs.
Nearly half of health professionals (45%) say they have dealt with a cancer patient who has been refused treatment on the grounds they were too old and nearly two in three (67%) said they have heard health professionals speak to older cancer patients in a condescending or dismissive way.
These findings echo those of recent reports published by the Royal College of Surgeons2 and the Department of Health3 which suggest that some health professionals make age-based assumptions about people’s ability to tolerate cancer treatment.
The UK has some of the worst cancer survival rates in Europe for older people4. Our older people are less like to receive treatment than their younger counterparts5,6.
Susan, 66, from Warwickshire, who was diagnosed with breast cancer five years ago, says:
“I’d signed the chemotherapy consent form but when I went to see the consultant he threw every negative at me about maybe never being the same again and anyway it may not work. I came out of the appointment and burst into tears.
“I asked him later why he’d not pushed it and was told, “You’re 60 not 30. At 30 you’d have more life in front of you”. I’m still alive but I just wish I’d had proper support to make an informed decision.”
Today, Macmillan is launching a new report outlining what health and social care providers in England must do to improve the treatment and care of older people with cancer. The report, Cancer Services Coming of Age, summarises the findings of five pilot projects set up in England with Age UK and Department of Health to improve the quality of cancer care for older people. Based on these findings, Macmillan is calling on healthcare providers in England to:
• Adopt assessment methods that test a patient’s overall physical and mental wellbeing – including cognition, mental wellbeing, nutrition, and social and financial circumstances - to ensure treatment decisions aren’t based on age alone.
• Give health professionals the time and resources to complete specialist training in elderly care to reduce age discrimination in the NHS.
• Establish strong links with the voluntary sector, social services and teams specialising in dementia, falls and continence and address any medical, social or financial issues that maybe preventing an older patient taking up treatment.
Ciarán Devane, Chief Executive at Macmillan Cancer Support, said:
“Health professionals’ concerns about the prevalence of age discrimination in cancer care mustn’t be ignored.
“Unless staff are given the time and training to carry out a proper assessment of a patient’s overall physical and mental wellbeing, some patients will be unfairly written-off as “too old” for treatment. The right practical support, whether it’s transport or help with caring responsibilities must also be put in place so older people needing treatment can actually take it up.
“The number of older people (aged 65 and over) living with cancer in the UK is set to rocket in the next 20 years from 1.3 million to 4.1 million.7 Unless the barriers to timely treatment are tackled now, many older people could die unnecessarily from cancer and services will become unaffordable.”
To read the pilot report, and for more information on Macmillan’s Age Old Excuse campaign, visit www.macmillan.org.uk/ageoldexcuse
***CASE STUDIES AND IMAGES AVAILABLE***
For further information, please contact:
Rebecca Openshaw, Media & PR Officer, Macmillan Cancer Support
020 7840 4699 (out of hours 07801 307068)
Notes to Editors:
1Macmillan/ICM online survey of 155 UK healthcare professionals involved in the treatment of cancer patients (55 GPs, 50 Oncologists, and 50 Cancer Clinical Nurse Specialists). Fieldwork undertaken September 2012. Survey results are not weighted. Results can be broken down as follows:
Country of Origin Count of Respondent
Northern Ireland 2
Grand Total 155
2 Royal College Surgeons of England (2012) Access all ages: Assessing the impact of age on access to surgical treatment
3 Department of Health (2012) The impact of patient age on clinical decision-making in oncology http://www.dh.gov.uk/health/2012/02/age-oncology/
4 Europe survival comparison: Eurocare 4 survival analysis 5 year survival rates 1995-1999.
(Accessed February 2012)
5 Turner N et al (1999) Cancer in old age – is it inadequately investigated and treated? BMJ 1999; 319:309
6 National Cancer Intelligence Network (2010) NHS treated cancer patients receiving major surgical resections – NCIN Data Briefing (Accessed December 2012)
7 The number of older people (aged 65 and over) living with cancer in the UK is set to rocket in the next 20 years from 1.3 million to 4.1 million according to Maddams J, Utley M and Møller H. 2012. Projections of cancer prevalence in the United Kingdom, 2010–2040. Br J Cancer 2012; 107: 1195-1202
• The Cancer Services Coming of Age report is jointly published with Age UK and the Department of Health
• A copy of Macmillan’s report – The Age Old Excuse: the under treatment of older cancer patients - is available here.
• For more facts and figures read, The rich picture on older people with cancer – available here
• To view Macmillan’s campaign film starring Sir Patrick Stewart, go to www.macmillan.org.uk/ageoldexcuse
About Macmillan Cancer Support
Cancer is the toughest fight most of us will ever face. But you don’t have to go through it alone. The Macmillan team is with you every step of the way.
We are the nurses and therapists helping you through treatment. The experts on the end of the phone. The advisers telling you which benefits you’re entitled to. The volunteers giving you a hand with the everyday things. The campaigners improving cancer care. The fundraisers who make it all possible.
We are Macmillan Cancer Support.