Treatment issues for older people with cancer

Surgical| techniques and anaesthetics have improved greatly over the past years so that surgery may not be a problem for older people. Radiotherapy| techniques and chemotherapy drugs have also improved so that the side effects are lessened. Often, treatment can be given which can control the symptoms of cancer without causing unpleasant side effects.

Tiredness (fatigue) Back to top

Tiredness or fatigue| can occur due to any of the cancer treatments mentioned in the previous section (except for watchful waiting). All patients having radiotherapy and chemotherapy are encouraged to rest as much as possible, but if you are looking after a partner, relative or friend, then fatigue may be a major problem. (See the carers section|)

Which treatment? Back to top

There is no one treatment that is right for everyone, and it can be difficult for both yourself and your doctors to decide which is the best treatment for you.

Since older people are generally fitter and healthier than a generation ago, it is important that doctors personalise treatment and take into consideration a person's individual physical state, rather than just their age, when deciding which treatment is the most appropriate for them.

Cost of treatment Back to top

You or your family may be concerned that if you are older you will not be offered the best or more expensive treatments. This should not be the case - your age should not influence the treatment that 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 will be willing to explain their choice of treatment.

If you are not satisfied with their answer, or if you do not 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.

Unfortunately some expensive treatments are only available in certain parts of the country and not in others. However, this should not be related to age.

Side effects Back to top

Some doctors are reluctant to give treatments that may cause severe side effects in older people. If you feel that this is happening to you, and you would like to have the stronger treatment, it can be helpful to get a relative to go with you so that you can ask why a particular treatment is not being offered. You could also ask for a second opinion.

Talking to your doctor Back to top

If you are worried that you may not be having the best treatment for your cancer it is best to ask your doctor, rather than just worrying. Your doctor can then explain why they feel that the treatment they have chosen is best for you.

Respecting your needs Back to top

All medical discussions, and the way treatments are provided, 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) has recently given guidance on this. You have a right to expect that 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 have had experience of being assertive in many situations during your life, and you can use this skill, if necessary, to ensure that you maintain your dignity while you are receiving medical care.

Information Back to top

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

Confidentiality Back to top

Doctors or other health professionals should respect your wishes if you do not want details of your diagnosis to be shared with other members of your family. It is important to tell your doctors and nurses if you do not want certain people to be told about your condition, as they may assume that you will want your relatives to know what is going on. They may share information with your relatives if you do not make your wishes known.

Your family members may need to know what your situation is, in order to provide appropriate help and support. You may also need to remind the staff that you want to be personally involved in all discussions about your future care rather than these discussions taking place with your family or partner.