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Senior Citizen Health & Medicine
Cancer Care for Growing Elderly Population Poses
International Time Bomb
Well educated, internet savvy elderly will be more
capable of demanding optimal care
 Sept.
26, 2007 – It is impossible to predict how many older people will have
cancer in 2020, according to the editor of Cancer World, but there will
be many more elderly with cancer than there are today; and she warned an
international conference there is too much “complacency about this time
bomb.”
In her keynote lecture to the European Cancer
Conference (ECCO 14) in Barcelona, Spain, Monday, Kathy Redmond, who is
editor of the magazine Cancer World and also a nurse, will say that
these are “huge issues” that need to be addressed now pertaining to the
healthcare of a greater number of elderly with cancer over the years
ahead.
Chief among these will be ensuring that healthcare
professionals have the skills and knowledge to treat the elderly people
with cancer, that current inappropriate attitudes towards the elderly
cease, and that advances are made in ensuring that cancer patients are
able to comply with their treatment.
“It is almost impossible to predict what the
reality will be in 2020,” she will say. “But one thing is certain: there
will be many more elderly people living with cancer. There is still far
too much complacency about this time bomb.”
Problem dealing with cancer plus other ailments
in elderly
She says that one problem is that as people get
older they may develop a number of different conditions, only one of
which might be cancer. However, there are not enough healthcare
professionals who have skills and knowledge in both cancer and the best
care and treatment of the elderly.
This is important because an elderly person could
be receiving treatment for several different conditions and it is
necessary to know what impact those treatments are likely to have on the
elderly and also how they might interact.
“I hope that ageism will be less prevalent by
then,” Ms Redmond says.
“At present there is a problem with persistent
negative attitudes to the elderly.
“Such attitudes mean that many elderly cancer
patients receive sub-optimal cancer care. In fact, there is an inverse
relationship between increasing age and the likelihood of proper
treatment despite evidence that otherwise healthy elderly cancer
patients can benefit from treatment to the same degree as their younger
counterparts.
“Under-treatment and sub-optimal practices mean
that older patients are dying unnecessarily from cancer.”
Non-adherence to oral, long-term cancer therapies
is emerging as a significant problem in oncology and is set to increase
over the next decade because of the increasing availability of oral
targeted therapies. Redmond says.
Elderly not following treatment a major problem
“There’s an enormous lack of awareness about the
scope of non-compliance in cancer and the fact that this problem will
become more prevalent in the coming years. Patients do not comply with
treatment for many different reasons – key factors are poor patient
education and ineffective side effect management,” she says.
“There is a need to train health professionals how
best to promote treatment adherence and to recognize when patients are
not complying with their treatment. Otherwise, cancer outcomes will be
compromised.
“The elderly are at higher risk of treatment
non-compliance because they are less likely to receive comprehensive
information about their treatment, are more likely to have literacy and
memory problems, and often lack the social networks that can help
promote adherence to treatment.”
Redmond says cancer professionals can learn a lot
from specialties that have already had to deal with treatment
non-compliance in an increasing elderly patient population. An important
first step is for cancer professionals to recognize that a problem
exists so they can identify successful strategies and adopt them into
everyday clinical practice.
Improved technology may come to the rescue for some
of these issues.
“Over the next two decades innovations in
technology, techniques and targeted medicines will revolutionize
approaches to cancer care. These advances will enable more cancers to be
eradicated and others to be controlled,” Ms Redmond said.
“Remote monitoring of patients via their mobile
phones may become standard, robotics may provide solutions to care in
the home and there may be other developments that we can’t even imagine
at present.
“Advances in communication and information
technologies (ICT) will help address communication and information gaps
for those who are ICT literate, however, a digital divide will persist.
There will be much greater awareness of the importance of cancer being
managed by a multi-disciplinary team composed of competent professionals
working in a centre of excellence. ICT advances will help bring
specialist care closer to the patient’s home. Where this is not
possible, informed patients will seek out specialist care and be willing
to travel across European borders to access this care.
“Demographic changes will mean that greater numbers
of cancer patients will live alone without social support. As the
prevalence of cancer increases, the cost of delivering cancer care will
escalate rapidly and may grow beyond what most socialized health care
systems can bear. Expenditure on cancer services will have to be
strictly rationed according to agreed priorities.
What are the implications of these developments
for cancer patients?
“Most cancer patients in 2020 will be elderly –
some very healthy, others extremely frail,” Redmond said.
“It is likely that there will be greater
disparities between those that have and those that have not – equity in
access to cancer treatment will be difficult to guarantee.
“Well educated, internet savvy elderly cancer
patients with good social support will be much more capable of demanding
access to optimal care.
“Policy makers need to plan and invest today to
ensure that there will be an adequate infrastructure in place to care
for the vastly increased numbers of cancer patients in 2020. Patients
should have a voice in policy discussions to make sure that future
cancer services address disparities and guarantee a minimum quality of
care for all,” she concludes.
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