Cancer in the older person
In 2012 it is estimated that 75 per cent of new cancer cases will be diagnosed in men aged 60 years and over, and 65 per cent in women aged 60 years and over. The prevalence of a previous cancer diagnosis increases with age, with the highest prevalence among those aged 80 and over. Almost one fifth (19%) of all Australians aged 80 and over had had a diagnosis of cancer within the previous 26 years (26 year prevalence). This represents approximately 3.3% of the Australian population.18
Psychosocial changes associated with ageing and multiple co-morbidities in older people can influence the type of treatment and support required.19 The unique treatment and care needs of older people with cancer have been described as a new specialty termed 'geriatric oncology'.19
Studies suggest that changes associated with ageing can sometimes lead to older people receiving suboptimal treatment, or treatment that is not consistent with their personal preferences.19, 20 Some studies report that older people with aggressive lymphoma are less likely to be treated for cure than younger people with the same disease and are less likely to survive for five years due to limited access to clinical trials.21
Beneficent ageism refers to a neglect of an older person's wishes. The older person's social role is distorted and health professionals assume an ability to represent the older person’s best interests without endorsement from them.22
Additional complications can arise in the older person due to co-morbidity factors. Comprehensive geriatric assessments can help to support decision making in relation to treatment plans for older people.23 The following factors should be taken into account when assessing the older person with cancer:24-26
- functional status
- social support
- psychological state
- concomitant medications
- carer support.
Cancer Australia. (2018) EdCaN module: Lymphoma.
Watch Arthur’s story: meet Arthur. You may also wish to access the NCCN clinical practice guidelines for oncology – senior adult oncology.26 Complete the following learning activity:
- Describe the issues Arthur may experience across all domains of health related to a diagnosis of cancer.