A new report highlights the need for clinicians to be more willing to treat older women with breast cancer with chemotherapy to ensure they experience the best possible health outcomes.
The “Breast Cancer in the Elderly” report published in the journal, Future Oncology, says elderly patients are often not treated with chemotherapy or are treated less aggressively.
BCAC chair, Libby Burgess, says anecdotally BCAC is aware of healthy elderly women who have not received the same level of care as their younger counterparts.
“We know that some elderly women are missing out on the most effective treatments simply because of their chronological age. This is not acceptable and it’s something that needs to be addressed.”
This latest report notes that when chemotherapy treatment is not given or is less aggressive it can lead to poorer breast cancer outcomes. It also says that age has been shown to be an independent risk factor for receiving less than the standard treatment.
The report authors state that many elderly women may have other health issues that may impact on decisions to treat with chemotherapy. However, they point out that many women over 75 are also very healthy.
They say, “Chronological age itself is not an appropriate criterion on which to decide appropriateness of adjuvant therapy. Instead, biological age, which refers to the presence of comorbidities and the general fitness or health of a patient, should be used. Little benefit from adjuvant treatment is expected in a woman with multiple competing illnesses, while conversely, in a woman of 75 years in good health, breast cancer poses her greatest risk to life, and as such standard adjuvant treatment should ideally be recommended.”
In conclusion, the authors state that older women with biologically aggressive breast cancer stand to gain as much benefit from adjuvant chemotherapy as younger women and that decisions regarding treatment should be made based on tumour biology and biological age, rather than chronological age.
They also say there’s a critical need for further research into the appropriate management of elderly breast cancer patients.
Libby agrees that further research into the care and treatment of elderly women is crucial, especially given New Zealand’s ageing population. She says this is an issue BCAC has been very concerned about and is something the organistion raised with the Minister of Health last year.
BCAC hopes that New Zealand clinicians will take this latest report as a reminder to base treatment decisions on a patient’s biological health rather than their chronological age.
