The care of older cancer patients in the United Kingdom

Abstract

The ageing population poses new challenges globally. Cancer care for older patients is one of these challenges, and it has a significant impact on societies. In the United Kingdom (UK), as the number of older cancer patients increases, the management of this group has become part of daily practice for most oncology teams in every geographical area. Older cancer patients are at a higher risk of both under- and over-treatment. Therefore, the assessment of a patient's biological age and effective organ functional reserve becomes paramount. This may then guide treatment decisions by better estimating a prognosis and the risk-to-benefit ratio of a given therapy to anticipate and mitigate against potential toxicities/difficulties. Moreover, older cancer patients are often affected by geriatric syndromes and other issues that impact their overall health, function and quality of life. Comprehensive geriatric assessments offer an opportunity to identify and address health problems which may then optimise one's fitness and well-being. Whilst it is widely accepted that older cancer patients may benefit from such an approach, resources are often scarce, and access to dedicated services and research remains limited to specific centres across the UK. The aim of this project is to map the current services and projects in the UK to learn from each other and shape the future direction of care of older patients with cancer.

Keywords: United Kingdom; cancer; geriatric oncology; older patients.

Figure 1.. Geographic representation of key services and projects. 1—Brighton (Sussex Cancer Centre—Brighton and Sussex University Hospitals NHS Trust). 2—London (Guy’s and St. Thomas’ NHS Foundation Trust, University College London Hospitals NHS Foundation Trust). 3—Cambridge (Cambridge University Hospitals NHS Foundation Trust). 4—Nottingham (Nottingham University Hospitals NHS Trust). 5—Sheffield (Sheffield Teaching Hospitals NHS Foundation Trust). 6—Manchester (The Christie NHS Foundation Trust; Manchester University NHS Foundation Trust). 7—Leeds (Leeds Teaching Hospitals NHS Trust). 8—Hull (Queen’s Centre for Oncology and Haematology—Hull University Teaching Hospitals NHS Trust). 9—Newcastle upon Tyne (Newcastle upon Tyne Hospitals NHS Foundation Trust). 10—Dundee (Ninewells Hospital—NHS Tayside). 11—Glasgow (Beatson West of Scotland Cancer Centre). 12—Belfast (Belfast Health and Social Care Trust—NHS Greater Glasgow and Clyde). 13—Swansea (South West Wales Cancer Centre, Swansea Bay University Health Board). 14—Cardiff (Cardiff and Vale University Health Board).