Age Discrimination In Cancer Treatment

gp10:09 Friday 24th January 2014
BBC Radio Cambridgeshire

[A]NDIE HARPER: You might have seen in the papers today that the cancer charities are warning that some patients are being written off as being too old for treatment. MacMillan Cancer Support say that too many older people with a disease are being assessed on their age, rather than their individual fitness and condition. It says its research shows that many older cancer patients can live for a long time, and even be cured. Well I’m delighted to say that joining me is Jagtar Dhanda, Head of Inclusion at MacMillan. Jag, good morning to you.
JAGTAR DHANDA: Good morning.
ANDIE HARPER: I suppose the first question to ask Jag is when is too old. What sort of age group of people are we talking about here?

JAGTAR DHANDA: Well the first thing I’d challenge is that I don’t think there is such a thing as too old. I think that what we need to do is ensure that each person is treated on an individual basis, which is informed by a number of factors, such as their physical and mental well being, rather than grouping people together and saying, actually, you know, if you’re over six .. eighty five, then you’re just too old to undergo treatment.
ANDIE HARPER: You see, whatever age people are, they have contributed to the National Health Service. And I would have thought that whatever their age, then they are entitled to the best possible medical treatment, whether they’re eighty five or twenty five.
JAGTAR DHANDA: Absolutely, and that is something that MacMillan very much is supporting. All people, irrespective of their age, are entitled to good quality care and treatment and support.
ANDIE HARPER: But do you have evidence that this is the practice? And I suppose if you do, it’s very difficult to prove, none the less.
JAGTAR DHANDA: Well let’s start with the headline figure from the research that we commissioned. What it told us is that more than 130,000 people in the UK have survived for at least ten years after being diagnosed with cancer at the age of 65 or over. So that’s something to celebrate. However, if you look at the overall survival outcomes for older people affected by cancer, over 65, you see that it’s not as great as say as it is with our European counterparts. So that’s quite worrying, that on on level those people who have had access to treatment who are over 65 plus have actually lived very well with the consequences of treatment, and were able to undergo the treatment in the first place. Yet the survival outcomes themselves tell us something slightly different. So what we really need to do is understand why that variation emerges.
ANDIE HARPER: So what that demonstrates in effect is that it’s not the age that counts against you, it’s the treatment that you get, and that you can live for quite a long time when you are over 65, if you get the right treatment.
JAGTAR DHANDA: If you get the right treatment, and also if there is a proper assessment in place to ensure that all the variables that matter are taken into account. So a 50 year old might not be able to undergo treatment because they have four or five other conditions, whereas the 75 year old might have cancer, it might have been detected early, and as a result can undergo treatment and live very well.
ANDIE HARPER: A couple of questions spring to mind. First of all, is it a postcode lottery? Is where you live liable to have an influence on the sort of treatment you get, if any at all?
JAGTAR DHANDA: There is absolute evidence that health inequalities emerge, based on the area you live. And that might have an impact on whether an older person living in an area of high levels of deprivation compared to an affluent area might also play a part in whether they have access to treatment. So absolutely. But I guess what this research is initially telling us is that age cannot be the overruling or contributing factor to whether someone is given access to treatment or not.
ANDIE HARPER: And what about the particular cancer? Because we all know that some cancers are eminently treatable and recoverable from, others not so.
JAGTAR DHANDA: Yes, so we all know that there are a range of rarer cancers, where the treatment regimes and the technology to improve outcomes for those tumour types are not as advanced as some of the more common cancers. So that also equally would have an impact. But I think again what the research is telling us is that we need to ensure that we have those right assessments in place in the first place, to make those decisions and a much more informed opinion on whether someone can undergo treatment or not.
ANDIE HARPER: And I suppose the counter-argument is that there is a finite amount of money in the pot, and if various hospitals or indeed the wider health service feels that they don’t have the money, well then would they not be justified in saying we’re better to spend it on a 25 year old than a 65 year old?
JAGTAR DHANDA: No, absolutely not. It’s a false economy to think that this is about rationing based on whether it’s a 15 year old or a 40 year old, a 60 year old. Actually if you don’t make the right .. if you don’t give the right treatment and support early on to, say, someone over 65, then actually later on they might present with a multitude of other conditions which will actually cost a lot more.
ANDIE HARPER: It’s been really good to talk to you. Thank you very much indeed.