Are We Keeping the Elderly From Seeking Cancer Cures?

Age is a tricky factor when it comes to health. There are so many different processes that are unique to the aging body that an entire field of medicine exists to study them. While a cancer diagnosis is not an age-specific event, however, it seems that many doctors are prescribing treatment plans as if it were.

Too Little, Too Late?  In a 2006 study published in the Journal of Gerontology, primary care physicians were surveyed about what type of cancer screening they would give to a hypothetical 70, 80, or 90 year-old female patient. Interestingly, physicians tended to “over screen” older, frail patients who were within five years of their median life expectancy and “under screen” healthier patients who were over ten years away from their median life expectancy.

Surviving the Fight For the Cure:  Another study published this year in Critical Reviews of Oncology / Hematology tracked 200 elderly cancer patients and found that while their physicians judged only 64% of them fit enough to undergo chemotherapy, a comprehensive geriatric assessment found nearly 98% of them to do so.

Furthermore, a 2004 article entitled “The Opinion of General Practitioners on the Treatment of Prostate and Breast Cancer in Elderly People” stated that physicians were more likely to seek non-curative cancer management plans in elderly patients regardless of his or her actual performance status or medical history.

How does the patient feel about this? A Family Practice paper entitled “Who Decides about Prostate Cancer Treatment?” found that elderly patients were more likely to follow treatment plans prescribed by their physicians — often set forth in the same conversation when they were first given their diagnoses — than seek a second opinion or become a more active participant in the decision-making process. When asked why, many stated that they feared offending their doctor or looking like a “bad patient.”

I do not write this because I wish to condemn physicians for their reluctance to seek curative measures in the mature cancer patient, but to urge all patients to find the treatment plans that are right for them. Doctors know first-hand that cancer treatment is not only physically but emotionally draining, and I believe that their bias has more to do with wanting to shield these individuals from having to go through such a demanding process than anything else.

Cancer is the second leading cause of death in Americans aged 65+ and over, and in light of these findings, I wonder if part of this is due to human nature wanting to “protect” our loved ones from such an exhausting process in their later years. Are we helping our hurting elderly cancer patients by making decisions for them? Let me know what you think in the comments!

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