Over 50% of newly diagnosed cancers occur in the over 65s and the percentage of this population is steadily increasing, with an estimated 30% of the population over the age of 65 years by 2025. However, there is clear evidence that older patients with haematological cancers are undertreated, frequently being offered suboptimal therapy or best supportive care, and are frequently excluded from clinical trials. This is largely fuelled by the misperception that older patients are too frail or unwilling to undergo active treatment.

It is recognised that the treatment of elderly patients with cancer brings its own challenges. Better education of both the clinical community and their patients, the development of policies and guidelines to guide care and the communication within multidisciplinary teams to develop appropriate assessment tools to tailor treatment to individual patients are needed. Biological and not chronological age of the patient should be a key deciding factor. Appropriate screening tools including assessment of comorbidities, as well as functional, nutritional, cognitive social and biochemical factors will address this. Many of the newer, less toxic agents available also offer the opportunity to treat all categories of elderly patients with haematological cancer. Their reduced toxicity combined with the ability to administered at home, will result in reduced hospitalisation costs and will improve patient willingness to take medicines, so improving outcomes. With the ever increasing elderly population, who make up the majority of patients seen with cancer, there is now an urgent need to rethink cancer care in this population.

By Vanessa Lane

You can watch the of proceedings of our EHA Media Briefing to address ageism in cancer here