Managing breast cancer in elderly patients presents particularly difficult challenges, a scientist reported at the 4th European Breast Cancer Conference in Hamburg, Germany. Professor Lars Holmberg, from the Regional Oncologic Center, Uppsala, Sweden, said that, with about 25% of all breast cancer patients being 75 or older, health policies in most countries were badly in need of developing strategies to meet this growing problem.

"It is commonly believed that elderly people have a better prognosis in cancer", he said, "but from looking at data from cancer registries we can see that this is not the case. In fact, the prognosis for older people seems to be worse, and this, together with the demographic changes which mean that the people will continue to live longer, means that there is an urgent need to deal with this problem."

The prognosis for older people did not seem to be explained by the tumor factor, he said. It used to be believed that it was related to less developed resistance - but many people now think that it is simply that treatment for the elderly is not as good as for younger people. "Of course older people can't take the really tough treatments - they are just not robust enough", he said, "but increasingly we believe that doctors just don't try hard enough to find suitable treatments for this group."

"We don't know enough about attitudes among physicians; we don't ask elderly patients what they want; and we don't do enough specific trials for them", he said. "The combination means that older people lose out all round."

Health policymakers should look urgently at developing a strategy for treating cancer in the elderly, he said. "And older women should not be afraid to ask to go into trials, and to discuss all treatment options with their doctor."

SOURCE:
4th European Breast Cancer Conference, March 18, 2004, Hamburg, Germany