Deciding the best way to treat a cancer diagnosis can be more challenging and complicated for older adults; they are more likely to have underlying health conditions, such as diabetes or heart disease, and they may take medications that could impact treatment.
While considering treatment options, older cancer patients should consider other factors such as their physical comfort, nutritional needs, and their ability to take care of themselves financially and physically.
Perhaps the most important factor to consider is the patient’s ideas about a dignified or peaceful death. Depending on age and health status, physically feeling well may be more important than treating the cancer. This might be especially true if a spouse or partner has already passed, or if a chronic health condition is already reducing the quality of life. For others who are very healthy and enjoy many activities, aggressive treatment may be the choice.
It was a common practice in the past for doctors to make treatment recommendations without considering the patient’s priorities. Today, health care teams seek to know the patient’s concerns about treatment and believe that the patient has the right to make their own decisions.
Health care teams also need to have more research available to help them and their patients make informed decisions about cancer care options. Nearly 60% of people diagnosed with cancer are older than 65, but research on that age group is limited. More cancer research studies should include older adults to show how treatment differs from standard treatment options that include surgery, chemotherapy, and radiation.
Relieving the symptoms and the treatment side effects of cancer is an important part of care. A complete continuum of palliative care for older cancer patients includes getting support for the patient and family during the different stages of cancer diagnosis and treatment.
Older cancer patients and their families may be challenged sorting through choices on the kind of care they want or need. Options may vary from receiving care at home or in a residential treatment setting. In addition, family members trying to manage their parents or relative’s cancer care often ignore their own needs and can benefit from home care options.
According to research from the Cancer Support Community (CSC), an international nonprofit organization, family caregivers of cancer patients experienced substantial anxiety (48 percent of respondents) and elevated fatigue (37 percent). Caregivers who experience more unmet needs reported less knowledge about the patient’s cancer and treatment plan. They felt less prepared and experienced greater burden.
Patients may need to choose the degree of family involvement desired in caregiving and decision-making as well. Each of these decisions should ideally be considered in terms of how it helps to relieve suffering and to support the values and beliefs of the diagnosed individual and his or her family — especially if a cancer diagnosis leads to end-of-life care.
Sources: American Society of Clinical Oncology, www.cancer.net; American Cancer Society, www.cancer.org; American Psychological Association, www.apa.org