Surge in older cancer survivors expected as baby boomers age

December 10, 2008

STORRS, CT - The United States could be faced with a national health care crisis in the coming decades as the country's baby boomer population ages and a growing number of older adults find themselves diagnosed with and living longer with cancer.

That is the position of a team of researchers from across the country who believe current prevention measures, screening, treatments, and supportive care for older patients at risk of or dealing with cancer are lacking in the US.

In a special supplement issue of the international journal Cancer being released this month - Aging in the Context of Cancer Prevention and Control: Perspectives from Behavioral Health Medicine - the researchers say there is an urgent need for clear, evidence-based practice guidelines to assist physicians, oncologists and others who provide short- and long-term care management to older adults with cancer.

Only with more immediate research will proper prevention efforts, screening, treatment approaches, post-treatment survivorship and end of life care be put in place to serve this rapidly growing population, the experts say.

Consider these facts:"The coalescence of three factors has the potential to create one of the biggest public health problems our country has faced in decades," said Keith M. Bellizzi, a cancer survivorship researcher and assistant professor of human development and family studies at the University of Connecticut. "These are: the aging of the baby boomers, the age sensitive nature of cancer, and the increased survival for those diagnosed with cancer."

There is growing consensus, Bellizzi said, that researchers and clinicians will need to take a multidisciplinary approach to address this challenge incorporating perspectives from geriatrics, oncology, behavioral medicine, and public health.

"Further alarming are two recent reports which warn of a looming shortage of adult oncologists and geriatricians in the coming decades," said Bellizzi, one of the Cancer supplement's lead authors and a former scientist with the National Cancer Institute in Bethesda, MD. "Two pressing questions that need to be addressed are: 1) Who and how will we care for the growing population of older individuals with cancer, many of whom also will have competing health conditions, and 2) what are the unique physical, mental and social issues that they face. Regrettably, research has not kept pace with this growing population."

Here are some of the critical issues facing the country's growing population of older cancer survivors as presented in the special supplement:

Prevention - There is a prevalent bias in the medical community and the general public that believes since many older people suffer from chronic disease, the focus should be on illness management rather than prevention. (Smoking cessation programs being one example) Since little evidence based prevention research exists in older populations, physicians are often forced to make their own judgment calls.

Screening - In general, older adults are less likely to be screened for cancer and are more likely to receive incomplete diagnostic workups. Future research in cancer screening should be devoted to developing or updating screening guidelines for older adults based on clinical trials that actually include older adults, decreasing barriers to screening when screening is found to be beneficial and leveraging volunteer organizations to enhance the participation of older adults in screening trials.

Treatment - Older adults are less likely to receive optimal doses of chemotherapy compared with younger patients due to toxicities and perceived complications. Age alone is inadequate in determining the vulnerability or response to treatment. When carefully selected, older patients can benefit from treatment or palliation. Use of a Comprehensive Geriatric Assessment (CGA) is recommended to determine which older cancer patients can benefit from treatment and which patients may benefit more from palliative care. Importantly, the patient's and family's values and preferences need to be taken into account in deciding on an appropriate treatment approach.

Survivorship - Is it my cancer or am I just getting older? Trying to disentangle the effects of cancer and its treatment from competing health conditions like cardiovascular disease, diabetes and osteoporosis on health outcomes is complex. Some studies suggest that older cancer survivors may be doing worse physically and psychologically than non-cancer comparison groups. More research is needed in this phase of the cancer care continuum which will ultimately lead to interventions to prevent or mitigate these adverse outcomes.

End of Life - Although preparation of living wills and designation of a Health Care Proxy are mandated by Federal Law, studies have identified numerous barriers to their implementation. We believe more effective and efficient communication regarding prognosis among patients, families and practitioners will improve decision making and help patients with terminal disease gain better control over their financial and health care decisions at end of life.
-end-
A full copy of the supplement can be found on the Internet at: http://www3.interscience.wiley.com/journal/121542601/issue

The print publication will be available Dec. 15.

Lead Authors/Editors Contact Information:

Keith M. Bellizzi, Ph.D, MPH
Assistant Professor
Human Development and Family Studies
University of Connecticut
Storrs, Connecticut 06269-2058
Telephone: (860) 486-0663 Fax: (860) 486-3452
Email: Keith.M.Bellizzi@uconn.edu

Suzanne M. Miller, Ph.D
Director of Behavioral Research and the Psychosocial and Behavioral Medicine Program
Fox Chase Cancer Center
Philadelphia, PA 19111-2497
Phone: (215) 728-4069 Fax: (215) 214-2178
Suzanne.Miller@fccc.edu

Deborah J. Bowen, Ph.D
Clinical Professor
Boston University
Cancer Prevention Research Program
Fred Hutchinson Cancer Research Center
Seattle, Washington 98109
Phone: (860) 667-5977
Dbowen@fhcrc.org

Karen M. Mustian, Ph.D
Research Assistant Professor
NCI Biobehavioral Cancer Control Research Fellow
University of Rochester Cancer Center
Behavioral Medicine Unit
Rochester, NY 14642
Phone: (585) 273-1796 Fax: (585) 461-5601
Karen_mustian@urmc.rochester.edu

University of Connecticut

Related Cancer Articles from Brightsurf:

New blood cancer treatment works by selectively interfering with cancer cell signalling
University of Alberta scientists have identified the mechanism of action behind a new type of precision cancer drug for blood cancers that is set for human trials, according to research published in Nature Communications.

UCI researchers uncover cancer cell vulnerabilities; may lead to better cancer therapies
A new University of California, Irvine-led study reveals a protein responsible for genetic changes resulting in a variety of cancers, may also be the key to more effective, targeted cancer therapy.

Breast cancer treatment costs highest among young women with metastic cancer
In a fight for their lives, young women, age 18-44, spend double the amount of older women to survive metastatic breast cancer, according to a large statewide study by the University of North Carolina at Chapel Hill.

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.

Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.

Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.

Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.

More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.

New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.

American Cancer Society outlines blueprint for cancer control in the 21st century
The American Cancer Society is outlining its vision for cancer control in the decades ahead in a series of articles that forms the basis of a national cancer control plan.

Read More: Cancer News and Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.