The Christie Hospital in Manchester is pioneering a specialist cancer service for elderly patients under plans to tackle a “silver tsunami” of cases.
More than 200 patients have been treated by the new team, which was set up to meet the more complex care needs of an ageing population.
The service has nearly halved the number of unplanned hospital admissions among older cancer patients, improving survival and quality of life.
Half of all cancer cases in the UK are in people over the age of 70, but they have worse outcomes. They often have many other health conditions and may not be offered or complete courses of radiotherapy or chemotherapy, because of concerns they cannot tolerate it.
The Senior Adult Oncology Service, launched at the Christie last summer, provides frail patients with exercises and nutrition advice to build up their strength.
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Treatment is adapted to take into account other common age-related illnesses, such as heart disease, diabetes and dementia, ensuring different medications do not interact and cause side effects.
As well as helping them to withstand side effects, this reduces the risk of falls and helps them to stay at home so they can spend time with grandchildren and stay independent.
A similar scheme has been launched at the Royal Marsden in London and it could now be expanded across the NHS.
The new service means older cancer patients can get all their care at a “one-stop shop”, reducing the time they need to spend in hospital. They no longer require several appointments with GPs, geriatricians, oncologists and physiotherapists, as all the specialists are brought together under one roof.
Fabio Gomes, the consultant who leads the service, said: “We want to keep the patients as active as is safely possible. It means elderly patients can spend more time at home with their families instead of being in a hospital bed.
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“Cancer treatment can be toxic, but supporting older patients throughout the treatments — with specialist nurses, physios, dieticians and pharmacists — means they hopefully don’t deteriorate.
“Having the added input from the specialist team can be the difference between someone being able to continue on treatment, or having it discontinued. It has huge implications for improving survival, reducing complications and improving quality of life.”
Gomes added that the specialist service has huge cost-saving benefits for the NHS, by reducing complications and hospital stays, and similar services could be rolled out across the country.
He said: “Half of our patients are already over 70, and that is the group of patients that is increasing the fastest. What is called the ‘silver tsunami’ is already here.
“These older patients have more complex needs and need targeted support. Patients won’t be getting any younger, so cancer services need to adapt for it.”
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Cancer becomes more common with age, because cell damage builds up over time, and Cancer Research UK estimates that 60 per cent of patients will be over 70 by 2040.
In June experts at a cancer conference in Chicago urged governments to urgently adapt services to prepare for a “global oncologic tsunami” of millions more older patients.
Case study
When Jean Riding, 75, had lung cancer diagnosed in September last year doctors were concerned that she would be too frail to tolerate intense treatment.
But she has now successfully completed courses of chemotherapy and radiotherapy, under the care of the Senior Adult Oncology Service at the Christie.
The specialist care meant she was able to avoid any prolonged hospital admissions, spending more time with her four children and seven grandchildren.
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Riding, a retired machinist from Dukinfield, six miles east of Manchester, was given exercises to help build up bone and muscle strength during treatment to reduce the risk of falls or complications.
She said: “The team has been great. I lost weight during treatment as some food tasted horrible because of the chemotherapy, and my calve muscles weren’t as strong as the team would have liked, so they arranged a bone density scan, gave me some exercises and provided me with dietary advice.
“Thanks to them, I am now 2.5kg heavier, and my muscles are a bit stronger. I’m lactose intolerant, so the pharmacist found me liquid versions of all the medications I need, so I don’t have to take solid versions with lactose.
“I was worried about the side effects of chemotherapy and radiotherapy. They gave me a lot of reassurance and emotional support.”
