20 August 2015
Charity calls for health system to assess patients on individual need and circumstance, rather than ‘making assumptions around age’
Older people are no more likely to refuse cancer treatment than younger people , according to a new study of over 1,500 people commissioned by Macmillan Cancer Support and carried out by Ipsos MORI.
Currently, older cancer patients (aged 65 and over) are far less likely to be given life-saving treatment than younger cancer patients (aged 55 to 64) . One reason previously put forward for this is that older people may be more likely to turn down treatment  but today’s research challenges this view.
While older people are confident in pursuing treatment, the research also finds that they are less likely to question decisions about which treatment might be best for them, than those aged 55-64. Macmillan is concerned that older people are therefore missing out on the full range of different treatments available.
Jagtar Dhanda, Head of Inclusion at Macmillan Cancer Support says:
“Older people are simply not getting a fair deal when it comes to cancer care. We know they do not currently have the same access to cancer treatments or the same rates of survival as younger people. This research reveals, for the first time, that we would be wrong to assume that the reason for this is down to older people refusing cancer treatment more than younger patients.
“So the question now is – why are older people not getting the cancer treatment they need? We are worried judgements about older people are being made on the basis of their age rather than their actual capacity or preference to receive treatment. And we hope that this research will help to challenge this.
“We know the NHS is serious about addressing the gaps in survival between older and younger patients through the commitments made in the recently published ‘Cancer Strategy for England’. This research will support them to bridge this gap. Cancer care needs to remain patient-centred and healthcare professionals must be supported to adopt assessment methods which test a patient’s overall physical and mental wellbeing to ensure treatment decisions are not based on age alone.”
Macmillan is calling for urgent action from the government and NHS to implement and fully fund the recommendations in the recently published ‘Achieving world-class cancer outcomes - A strategy for England 2015-2020’ which seeks to address some of the issues faced by older people living with the disease.
Barry Worthington, 74, from Cheshire, was diagnosed with prostate cancer in 2014. Barry says:
“I never thought about my age when deciding on treatment. I’ve always kept active so there was no reason to think I wouldn’t take any treatment offered to me. I was told that without surgery I could be in a wheelchair in three months, so there was never any doubt that I would have the operation. The cancer is incurable but stable thanks to regular hormone therapy and, although I’m not able to be as active as I was, the important thing is that I’m still here.”
Macmillan advises that anyone living with cancer should aim to have open conversations with their healthcare professionals about treatment options. The charity’s support line is free to call and callers can discuss options and raise any questions or concerns with trained professionals.
The full report Exploring the attitudes and behaviours of older people living with cancer
is available here
If you’re living with or looking after someone with cancer and need information or support, call 0808 808 00 00 or visit www.macmillan.org.uk
For further information, please contact:
Charlotte Morris, Media and PR Officer, Macmillan Cancer Support
0207 091 2467 (out of hours 07801 307068)
Notes to Editors:
1.Twelve per cent of those aged 75 or over say they opted not to have certain types of treatment, compared with 15% of those aged 55 to 64 and 14% of those aged 65 to 74. Macmillan Cancer Support/ Ipsos MORI online surveys of 1,004 GB adults aged 55 and over living with cancer and 500 adults of the same age range who have never had a cancer diagnosis. Fieldwork undertaken 6th – 13th May 2015. Survey results are weighted by gender, nation, and age. The findings refer to the group who have been diagnosed with cancer unless otherwise stated.
2. Previous Macmillan research shows that otherwise healthy lung cancer patients at 75 or over, whose cancer hasn’t spread, are five times less likely to be given life-saving surgery than younger patients. J Shield, J Flynn, T Welchman, E Drage, M Gibbs, C Edson, M Lind. Surgery Rates in Older Lung Cancer Patients with Low Pre-Diagnosis Mortality Risk (2014) NCIN Cancer Outcomes Conference 2014 - The power of information. Poster presented at the Cancer Outcomes Conference. Defined as not having any of the health conditions listed in the Charlson co-morbidity index (adapted to remove cancer and metastatic cancer) mentioned in their hospital inpatient medical record for the period 30 to 3 months prior to being diagnosed with cancer. The conditions listed in the index include diabetes, heart disease, liver disease, kidney disease and stroke.
3. NHS England. Are older people receiving cancer drugs? An analysis of patterns in cancer drug delivery according to the age of patient. December 2013. http://www.england.nhs.uk/wp-content/uploads/2013/12/old-people-rec-cancer-drugs.pdf
. Page 10 of the report says: "...there may well be good reasons for some decline in chemotherapy rates with age, including co-morbidity and frailty, patient preference and, in some cases, alternative forms of treatment."
4. Around two in three (68%) of those aged 65 or over agree that healthcare staff know what’s best for them, when it comes to decisions about cancer care compared to around three in five (58%) of those aged 55-64.
About Macmillan Cancer Support
When you have cancer, you don’t just worry about what will happen to your body, you worry about what will happen to your life. Whether it’s concerns about who you can talk to, planning for the extra costs or what to do about work, at Macmillan we understand how a cancer diagnosis can take over everything.
That’s why we’re here. We provide support that helps people take back control of their lives. But right now, we can’t reach everyone who needs us. We need your help to make sure that people affected by cancer get the support they need to face the toughest fight of their life. No one should face cancer alone, and with your support no one will.
To get involved, call 0300 1000 200
today. And please remember, we’re here for you too. If you’d like support, information or just to chat, call us free on 0808 808 00 00
(Monday to Friday, 9am–8pm) or visit macmillan.org.uk