Older Cancer Patients Need Better Care

In an alarming presentation at the 11th bi-annual conference of the Federation of European Cancer Societies (ECCO 11) in Lisbon, an Italian researcher warned European cancer services that they must rethink their attitude toward older patients-and soon.

Professor Silvio Monfardini of Azienda Ospedale-Universita de Padova told attendees that patients over age 70 face discrimination in treatment, lack social support services, and face far too many barriers to entering specific clinical trials that focus on treatment options for older patients.

Monfardini noted that more than half of all tumors occur in patients older than age 65. And with the progressively increasing age of the global population, there will be a further rise in the total number of cancer incidences. The consequent burden this will place on the global healthcare community could be catastrophic.

"After age 70, combination chemotherapy regimens designed for young adult patients cannot be automatically applied to the older populations," he said. For example, he noted that researchers still don't know exactly if adjuvant chemotherapy should be applied in breast and colon cancers after 70, "and we know even less what to do in patients over 75."

"We urgently need to enroll older patients in clinical trials," he emphasized. "We simply don't know enough about the best way to treat them."

Monfardini believes that a lack of family and social support is an obstacle to older patients entering trials. But he said such obstacles are not insurmountable-and must be addressed immediately because of the progressively aging population.

He said another problem is the high cost of some drugs particularly suitable for older patients. He specifically cited Gemcitabine, Carboplatin, Oxaliplatin, Herceptin and Transtuzumab-and the costs of the hematopoietic growth factors useful in the elderly because of their reduced bone marrow tolerance to chemotherapy.

SOURCES:
ECCO 11, October 23, 2001, Lisbon, Portugal
Federation of European Cancer Societies (http://www.fecs.be)

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