Older Cancer Patients Often Excluded From Research

Posted on Nov 23, 2008 in Cancer

The majority of people diagnosed with cancer are over 65, but most major cancer studies exclude them, leaving a wide gap in knowledge about how best to treat older patients.The knowledge gap about older cancer patients was highlighted recently by researchers from Barcelona who studied the role that age played in the prognosis of 224 cancer patients.

According to the National Cancer Institute, 60 percent of newly diagnosed cancers are found in people over the age of 65. Overall, people in this age group are 10 times more likely to get cancer, and 15 times more likely to die from the disease, than are people under the age of 65.

But even though most cancer patients are older, age is typically not the deciding factor in whether someone survives the illness, the Spanish researchers showed. In their study, cancer survival was most affected by how much the cancer had spread at the time of diagnosis. Other issues, like the patient’s overall quality of life, also influenced survival. The research was published this month in The International Journal of Clinical Practice.

“We found that there were a number of factors that influence survival rates – including physical quality of life and how far the cancer had spread – but age was not one of them” said lead researcher Dr. Eva Domingo from Hospital Vall d’Hebron, in a press release. “Despite this fact, and the challenges that clinicians face from an aging population, there has been little research into how to treat older cancer patients, who often have complex medical needs because of other health issues.”

Dr. Domingo notes that older people are “systematically excluded” from many clinical trials. Among cancer patients who participate in clinical trials, only about one in four is over 65, she said.

As a result, doctors know very little about how drug therapies affect older patients. In addition, many doctors lean toward less aggressive treatment for older patients, based on the fact that they have shorter life expectancies or other health problems. But the Barcelona researchers found that whether a person has a high quality of life and functions well are more predictive of cancer survival than issues associated with normal aging.

“Older people tend to have more complex health needs, such as other illnesses, and that is one of the reasons that has frequently been put forward for not treating their cancers aggressively,” Dr. Domingo noted. But those factors were “much less significant” than factors like quality of life for predicting survival, she said.

“We would like to see fewer decisions taken on the basis of age and more research that explores the complex needs of older people, so that they can be treated more effectively and enjoy a better quality of life,” Dr. Domingo said