Understanding your rights as an older person

Making decisions about treatment

Cancer treatments

Your age should not stop you from being offered many of the available treatments for cancer. If your doctor does not recommend a particular treatment, it should be because the treatment is unlikely to be helpful and not because of your age.

The aim of cancer treatment may be to cure the cancer. Or it may be to control the cancer and relieve your symptoms.

Treatments can include:

  • surgery
  • radiotherapy
  • chemotherapy
  • hormonal therapy
  • targeted (biological) therapy.

Asking questions

It is important to talk to your doctor about your treatment options. You might want to ask some of the following questions:

  • What will treatment involve?
  • Where will I have treatment?
  • How often will I need to have treatment?
  • How long will the course of treatment last?
  • What will happen if I do not have treatment?

Some people find that learning more about their treatment helps them feel prepared. It can also make it easier to plan ahead. You could ask about how you may feel during and after treatment.

If you are a carer, you and the person you care for might need extra help during and after your treatment. Asking questions can help you plan for this. We have more information for carers. This is aimed at people who look after someone with cancer, but has useful information for all carers.


Research – clinical trials

Cancer research trials are carried out to try to find new and better treatments for cancer. Trials that are carried out on patients are known as clinical trials.

Trials are the only reliable way to find out if a different type of surgery, chemotherapy, hormone therapy, radiotherapy or other treatment is better than what is available already.

You may be asked to take part in a research trial. If you choose to take part, you will be carefully monitored during and after the study. If you decide not to take part, your decision will be respected and you won’t have to give a reason. There will be no change in the way you’re treated by the hospital staff, and you’ll be offered the standard treatment for your situation.


Your rights as an older person

Like all patients, you have the right to:

  • be treated with dignity and respect
  • see your medical records (this can take up to 40 days and may involve a fee)
  • be given information about any proposed treatment, including its aims and side effects
  • expect confidentiality
  • ask for a second opinion
  • refuse treatment
  • make a complaint.


Personalised treatment

Not all treatments work for everyone. It may be difficult for you and your doctors to decide which treatment is best for you. Doctors should plan your treatment to suit your individual situation. This is called personalising your treatment. They should consider:

  • your general health
  • your biological age (how well your body is working).

It is important that your doctor looks at your biological age, not just how old you are in years.

They should also be sensitive towards any religious or spiritual beliefs that you tell them about. For example, this could mean giving you information about therapies that may improve your spiritual well-being, such as meditation.


Treatment guidelines

There are official national guidelines and standards that explain what should happen when someone receives cancer treatment. These guidelines and standards may differ depending on where you live in the UK. You can ask your healthcare team to show you these documents.


Respecting your dignity

You have a right to expect that the people caring for you will respect your privacy. They should also be sensitive to your needs.

This may be as simple as them asking what you would like to be called, rather than assuming they can call you by your first name. It also means giving you privacy during physical examinations. If you find a situation embarrassing or distressing, tell the doctor or nurse so they can help to make things more comfortable for you.

You can ask for a chaperone if you want one, or take a family member with you for examinations. A chaperone is a trained person who can:

  • provide reassurance
  • protect your dignity and confidentiality
  • offer emotional support
  • help with communication between you and the healthcare professional.


If a drug is not available

The NHS offers most treatments and services that patients need. But sometimes treatment is not available for patients with a particular need.

If a treatment that could be an option for you is not available on the NHS, talk to your cancer doctor. It is important to understand the treatment and whether it is right for you.

We have more information about what you can do if a drug is not available.


Accessing cancer information

Your healthcare team should give you as much information as you need to understand your diagnosis, treatment and possible side effects. This can help you to make informed choices.

We have more information about different types of treatment and tests you may have. We also have information about making treatment decisions.

Some people may need information in a different format. If your eyesight is poor, Macmillan and many other organisations produce information in large print. We can also produce Braille versions of our information on request. Some of our information is available as audiobooks.

If you have hearing difficulties or are deaf, some of the videos on our website have British Sign Language translation. We also have information in other languages.

You can call our support line on 0808 808 00 00 to ask about different formats.


Consent

Before you have any tests or treatment, your doctor will explain the aims of that test or treatment to you. They will ask you to sign a form saying that you give your permission (consent) for the hospital staff to give you the treatment. Nobody can give you medical treatment without your consent. Before you sign the form, you should be given full information about:

  • the type of treatment
  • how long the treatment will take
  • advantages and disadvantages of the treatment
  • any significant risks or side effects
  • any other treatments that may be available.

If you do not understand what your doctor has told you, tell them straight away. Some cancer treatments are complicated, so you may need them to repeat the information.

You can choose not to have the treatment. You should be told what will happen if you choose this option. You also have the right to suggest a treatment that you think is the best option for you, even if the people treating you disagree. But your doctor does not have to provide a treatment if they do not think it is suitable for you.

Tips for talking to your doctor

Find out how to get the most out of your appointments with a GP or doctor.

About our cancer information videos

Tips for talking to your doctor

Find out how to get the most out of your appointments with a GP or doctor.

About our cancer information videos


Mental capacity

Mental capacity is the ability to:

  • understand and retain information
  • make decisions based on that information
  • communicate the decision.

A person may not be able to make a particular decision at a specific time about a treatment, even with support, because they do not have mental capacity. In this situation, a doctor must act in that person’s best interests. To do this, they must try to find out what the person would want. They may ask people who are close to the person about what they believe that person would want.

You can find out more about mental capacity on the NHS Choices website.


Confidentiality

Healthcare professionals are not allowed to share details of your diagnosis and treatment with your family, friends or carers without your permission. They also have to involve you in any discussion about your care. Discussions can only happen without you if you have given permission.


Advanced decisions and lasting power of attorney

Some people write down, while they have capacity, what treatments they would refuse and under what circumstances they would refuse them. This can be helpful in case a time comes when they can’t make or communicate treatment decisions. This is called an Advance Decision to Refuse Treatment. It can also be called an Advance Directive or Living Will.

If you want to allow someone to make decisions about your care on your behalf, you can set up a Lasting Power of Attorney (health and welfare) if you live in England, Scotland or Wales. There is no Power of Attorney to give someone the right to make welfare decisions on your behalf in Northern Ireland, but you can say how you would like to be cared for using documents like an Advance Care Plan.

In every country in the UK, you can set up a Long Term Power of Attorney that allows someone to make decisions about your finances and property on your behalf.

Our booklet Your life and your choices: plan ahead gives more information about planning your future care. There is one version for England and Wales, and two others for Scotland and Northern Ireland. We also have a booklet called Sorting out your affairs, which has more details about planning you financial affairs.


Making a complaint

Most of the time, people are happy with the treatment and care they get from healthcare professionals. But sometimes people make mistakes and this can be very upsetting. You can often sort out a problem by talking to the healthcare professionals involved. Or you may be able to talk to another person in the team. But if this does not work, or if you feel it won’t help, you may want to make a formal complaint. Someone can also make a complaint on your behalf, if you agree to this.

Back to Coming to your decision

Making a decision

If you’re struggling to come to a decision about treatment, try following these five steps.