Better care needed for elderly cancer patients |
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August 10, 2009
Cancer patients should not be treated on age alone and better systems of health care need to be developed to treat elderly cancer patients, according to Dr Christopher Steer, who is visiting Perth as part of the Cancer Council Update series.
Dr Steer, a consultant medical oncologist at Border Medical Oncology in Albury Wodonga, is at the forefront of a push to improve services for elderly cancer patients in Australia.
Issues around cancer and the elderly will be discussed by Dr Steer at a free public talk in Perth today, including some of the common myths around treating this group of patients.
“It is relatively common practice that elderly cancer patients are not offered certain treatments because it is assumed they will not be able to tolerate them” said Dr Steer.
“If we treat patients on the basis of age alone, then we run the risk of under treating them.”
The median age of cancer diagnosis in Australia is 67 years, which means that approximately half of the cancer patients in Australia fit into this group (70 is considered elderly).
“Being elderly doesn’t mean that your “time is up”, because we know that if a patient lives to 80 they have a 50 percent chance of living at least another 8 years. Our older patients should not be denied potentially life-saving treatments just because we assume they will die soon from other causes.
“We are talking about a huge number of patients that is increasing because of our aging population.
“The simple fact is we’re seeing more elderly people diagnosed with cancer so I’m trying to generate discussion about how we can treat them better.”
Dr Steer said appropriate assessment was the key to improving well being and survival rates for elderly cancer patients, as well as developing more specialised and integrated services that encouraged collaboration between different medical specialists.
Dr Steer wants to see formal models of assessment developed in oncology practice such as an initial screening test, which might alert an oncologist to certain conditions a patient may have and would help to prevent problems in the patient before they arise.
“If the initial screening test reveals problems, a further, more comprehensive geriatric assessment is then required, looking at every aspect of the patient including their cognitive function, their ability to perform daily tasks and how likely they are to die from some other medical condition.
Dr Steer said it was vitally important for clinicians to then intervene and act on the findings of an assessment. Such an assessment can also help determine if a patient is fit for anticancer treatment and enable individualised treatment that will minimise side effects.
At present there is only one clinic specialising in cancer in the elderly in Australia and there are only three doctors training in geriatric oncology, one of whom is based in Perth.
The Clinical Oncology Society of Australia (COSA) has recently formed a cancer in the elderly interest group, chaired by Dr Steer, to develop ideas for research and services to help improve the treatment of this group of patients.
Dr Steer said Australia is not alone in confronting these issues and this was a growing problem around the world.
“Internationally there is a need for better, more appropriate treatment of this older age group as medical experts come to terms with the scale of this growing problem,” said Dr Steer.
