As someone who now qualifies as an older person (over 65 years old), there are a number of things that strike me.
- The proximity of the doctor, dentist and optician becomes more important than the locality of the nearest dress shop.
- People stand up and offer me a seat…and I look round to see who they mean…
- When buying furniture, I wonder if it’ll see me out.
- I can say things and get away with it – as age allows me a freer tongue.
If you’re reading my blog, you may be an older person yourself, or a partner/carer of someone over 65. It may be that you’re having tests for cancer, or living with a cancer diagnosis.
Last year my father died of cancer, aged 91. He was very put out, as his intention was to perish at 100, overcome with excitement of the England Cricket team winning the Ashes. However, I’d like to focus on the positives – he lived to a good age, by changing the things that he could, health wise, and accepting the things he couldn’t change with good grace.
The truth is that aging is the biggest cancer risk for all of us. GOV.UK notes that ‘Nearly two thirds of cancer diagnoses occur in the over 65s and one third in people aged 75, with over half of all cancer deaths occurring in people aged 75 and over. By 2020 there will be nearly two million people aged 65 and over with a cancer diagnosis.’
How to reduce cancer risk
It’s not possible to stop the aging process, but there are things we can do to reduce our cancer risk.
- Eating healthily, taking exercise, keeping active, cutting out alcohol and stopping smoking can help – and are beneficial for other health conditions too.
- Keeping your weight within healthy limits.
- Looking after your health – checking symptoms you’re worried about with your doctor, and not ignoring health problems hoping they’ll go away. Late diagnosis is more common in the elderly.
- If you were in a breast screening programme, and are now over 70, you can still request a screening mammogram. (Invitations are no longer sent out, after the age of 70).
If it is cancer
If you’re having tests for, or have been diagnosed with cancer, you may wonder how you’ll be treated. People sometimes worry that because they’re older, they’ll be less likely to be offered treatment.
However, the NHS aims to look at the person’s biological age, rather than the number/years. The Equality Act (2010) – (Age exceptions) was brought in 2012. This means that public services (including NHS) should not be inferior, or refused, purely because of age. A number of factors are taken into consideration:-
- How fit you are – if you’re frail, or physically active.
- Other health conditions that affect your physical wellbeing, and how your body might tolerate some cancer treatments.
- How advanced the cancer is.
- Weighing up the risks of treatment side effects versus the person’s quality of life.
- The person’s wishes.
Questions to ask
When you meet the specialist doctor to talk through your diagnosis, you may have many questions. Often older people’s cancers are diagnosed as the result of a hospital admission, so you may not always feel you get the chance to ask everything you’d like.
It can help if you have an idea of the things you’d like to know:-
- What type of cancer you have, and if it has spread
- What treatments are available, and the possible side effects
- How might your health be affected during treatment – who will be providing care and support
- If you have other health conditions, how will they impact on treatment options.
- Quality of life issues – treatment length and how they may impact on how you feel over time.
The doctors and nurses, in turn, should be checking who you have at home to care for you (if needed), who is around generally for support – and how you manage currently. They will check how you feel too – your opinions count. There are a number of things to weigh up. The mutual aim will be to treat the cancer, cure it if possible, keep the cancer under control or ensure that your symptoms are relieved, and you’re comfortable.
Family and friends
Taking someone along for support to your appointments makes good sense. The other person can take notes, and may ask questions you hadn’t thought of.
If you’re the carer, you may want to both support the person with cancer, but also be emotionally affected yourself. There can occasionally be tough decisions being made, and sometimes what the elderly person wants, may be different to how you would like things to be. If the cancer is advanced, for example, the person with cancer may decide not to have treatment – and this can be hard to hear. Talking through the issues between yourselves and with the healthcare team can ensure that the decisions reached feel comfortable for you all.
Cancer and dementia
As half the people developing cancer are over 70 – 75 years of age, there is a chance that they have dementia too. You may be reading this as someone with dementia, or more likely, your family member or carer is checking the information for you.
Cancer treatment will depend on a number of factors, and how the treatment might impact on your life. It depends how advanced both the cancer and dementia is, and each case will be determined individually. Some treatments can help treat the cancer, without having too much impact physically. (Hormone therapy, for example). Other treatments strength could be reduced or fewer treatments given.
Getting consent for treatment for someone with advanced dementia can be difficult. The doctors will need to check that the person with cancer has enough mental capacity to understand. If the person with dementia cannot make the decision, it doesn’t stop treatment being given, if appropriate. However the specialists will want to include the carer and family in the decision making, making sure that the person’s best interests are being met.
If the cancer is not curable
Sometimes cancer is not curable, and you may have concerns about what happens next. In many cases, cancer can be suppressed, or shrunk down. This can maintain and improve your health for some time. In other cases, particularly if the cancer is advanced when diagnosed, treatment will be palliative. Palliative does not mean that treatment stops – but that the goals may change.
The aim of the healthcare team will be to ensure you are supported, symptoms treated and that your quality of life is maintained. You should be offered the support of a palliative care specialist nurse, and your GP and district nurses will work closely with your hospital team to ensure you have the care you need.
Things you and your family may wish to think and talk about, is where you’d like to be cared for, and by whom. These conversations may feel difficult, but being open and honest with each other can help make the time you have left (be it weeks, months or years), feel in your control.
Maggie’s centres offer support, encouragement and information. You may have questions, or wonder what you can do to help yourself. You’ll also have the opportunity to talk with others, or have a one to one conversation with a cancer support specialist. Whether you’ve just been diagnosed, or are living with cancer, or are a family/friend – you’re welcome to drop in one of our Maggie’s Centres and have a word.
Often, there are other worries that accompany being diagnosed with cancer. Financially, you may have more costs to deal with, just at a time when your income may be more limited. Older people are often reluctant to apply for any grants/benefits that they may be entitled to. Maggie’s benefits advisors can help you find out what you’re entitled to, how to claim, and assist with other financial information.
Finally, you can carry on looking through our webpages for information, support and contact with other people in a similar situation.
Cancer Support Specialist
Older people Macmillan Cancer Support
Age and cancer Cancer Research UK
Cancer care decisions for older adults Cancer.Net
Cancer in later life Age UK
Cancer and dementia: a guide for carers Dementia UK
Age: the biggest cancer risk factor Cancer Research UK