You received an award for your research on geriatric cancer at the American Society of Clinical Oncology (ASCO) Congress in Chicago. Do we need to effectively protect against the ‘grey cancer tsunami’ as it has been said?
“The problem is that the population is aging rapidly and cancer is mainly a disease of old age. Half of cancers now occur in people over 65. Fifty years ago it was a fraction of the current figures. This will continue to increase as more people age. In the UK, the number of cancer cases will rise by a third by 2040.” It is projected to increase from 384,000 new cancers per year now to 506,000 by 2040. Such an increase is unsustainable.”
What problems does it cause?
“Care for older people with cancer is more complicated because they often have not only cancer problems, but also heart or cognitive problems. This means that the oncologist has to make a lot of compromises in finding the best treatment for each older person. Treatments are usually only tested in fitter, younger people. Some treatments are practically impossible for older people, But it’s rarely been researched. Others that are routinely given to young people are impossible for older people because they’re too heavy. Often times, changes in treatment schedules are needed.”
So are older patients’ needs somewhere different than younger ones?
“Needs and preferences. Young patients want to live as long as possible, and they happily accept some of the side effects for that. For example, they can see their children grow up. For someone in their 80s, it’s less about how long they live, but about how much quality of life they still have.” .
“Sometimes that quality of life is achieved by doing nothing, sometimes with adaptive or very aggressive treatment. So we can’t treat every elderly patient the same way, and that’s where the shoe pinches. Because we don’t have a way to follow older patients individually.
“For optimal care of older people with cancer, a good assessment of general health status independent of cancer is important. Such ‘geriatric assessment’ has been clearly shown to improve care, lead to less aggressive treatments, fewer side effects of treatment and better quality of life.”
“Our federal government created a cancer program in 2009, which freed up resources for geriatric assessment. As a result, large projects and studies were launched in Belgium to expand geriatric assessment and integrate it into care. But in 2015, our government suddenly decided not to renew this support, which As a result geriatric assessment in Belgium largely stagnated.
Why is it so important?
“There are many studies that show that geriatric care of cancer patients has real benefits. For example, there was a Belgian study presented yesterday at ASCO in which half of the cancer patients received usual care and the other half were assisted by a geriatric nurse. And what was the result? If older people with cancer were assisted by a geriatric nurse, six Quality of life improved significantly after months.
