Treatment issues for older people with cancer

Which treatment? Back to top

It’s important that doctors personalise treatment and take into account a person’s physical health, rather than just their age, when deciding which treatment is the most appropriate for them. The National Service Framework for Older People, which was produced by the Department of Health, gives guidance on this. It states that NHS services should be provided equally to everyone, regardless of age, based on their medical situation only.

You can view the National Service Framework for Older People| on the Department of Health website.

Cost of treatment Back to top

You or your family may be concerned that you won’t be offered the best or more expensive treatments if you are older. But your age shouldn’t influence the treatment you are offered. If your doctors say that a specific type of treatment is not suitable for you, you are entitled to ask why. Most specialists are very approachable and, when discussing treatment options with you, will be happy to explain their preferred choice of treatment. If you aren’t satisfied with their answer, or if you don’t feel able to talk easily to your doctor, you can ask for a second opinion| from another specialist. Your GP or current specialist can refer you.

Side effects Back to top

Some doctors are reluctant to give treatments that may cause severe side effects| to older people. If you feel that this is happening, you can ask why a particular treatment is not being offered to you. You may find it helpful to take someone for support. You could also ask for a second opinion.

Talking to your doctor and specialist nurse Back to top

If you’re worried that you may not be having the best treatment for your cancer it’s best to discuss this with your doctor or specialist nurse. They can then explain why they feel that the treatment they have recommended is best for you.

Respecting your needs Back to top

All medical discussions, and the way treatments are given, should aim to maintain your dignity and freedom of choice, whatever your age.

The National Service Framework for Older People (produced by the Department of Health) provides guidance on this. You have a right to expect the people caring for you will respect your privacy and be sensitive to your needs. This may be as simple as asking what you would like to be called, rather than assuming that they can call you by your first name.

Respect by medical and nursing staff should extend to providing privacy when parts of your body are exposed for examinations. If you find a situation embarrassing or distressing, then let your doctor or nurse know so that they can help to make things more comfortable and less embarrassing for you. You will probably have had experience of being assertive in different situations during your life, and you can use this skill, if necessary, to maintain your dignity while you are having medical care. You may find it helpful to take a relative or friend with you to appointments for extra support.

Information Back to top

You are entitled to have as much information as you need to help you understand your diagnosis and the treatments that are proposed, so that you can make informed choices.

Consenting to treatment Back to top

Before you have any treatment your doctor will explain its aims to you. They will usually ask you to sign a form saying that you give your permission (consent) for the hospital staff to give you the treatment.

No medical treatment can be given without your consent, and before you are asked to sign the form, you should have been given full information about:

• the type and extent of the treatment you are advised to have
• the advantages and disadvantages
• any other treatments that may be available
• any significant risks or side effects (both short and long term)
• what the treatment aims to achieve.

If you don’t understand what you have been told, let the staff know straight away so that they can explain again. Some cancer treatments are complex, so it’s not unusual for people to need things explained more than once.

It’s often a good idea to have a relative or friend with you when the treatment is explained, to help you remember the discussion more fully. You may also find it useful to write down a list of questions before your appointment.

You are also free to choose not to have the treatment. The staff can explain what may happen if you don’t have it. It’s important to tell a doctor or your nurse in charge, so that they can record your decision in your medical notes. You don’t have to give a reason for not wanting to have treatment, but it can help to let the staff know your concerns so they can give you the best advice.

You might find our information on making treatment decisions| useful.