Unveiling the Surprising Cancer Risk Factor: Ageing
It's a common misconception that cancer is primarily caused by lifestyle choices like smoking, drinking, or sun exposure. However, a groundbreaking revelation challenges this notion, pointing to ageing as the leading risk factor. This shift in perspective is crucial, especially as we witness a global demographic transformation, with older adults becoming the fastest-growing population in Canada and worldwide.
The Aging Population and Cancer Care
By 2068, nearly a third of Canadians will be over 65, emphasizing the urgent need for specialized cancer care for this demographic. International guidelines, including those from the American Society of Clinical Oncology, advocate for geriatric assessments before determining cancer treatment. These assessments, ideally conducted by geriatricians, provide valuable insights into how treatment may impact cognition, functionality, pre-existing conditions, and life expectancy.
What makes this approach truly remarkable is its patient-centric nature. Geriatricians focus on understanding what matters most to patients, ensuring that treatment decisions are aligned with the wishes and support systems of older adults. This personalized approach is not just about treating cancer but enhancing the overall quality of life for these individuals.
The Canadian Context
Canada currently has a limited number of specialized geriatric oncology clinics, with notable ones in Montreal and Toronto. These clinics offer significant benefits, as evidenced by a study demonstrating cost savings of $7,000 per older adult treated. Despite this, such clinics are not yet standard practice, and regions like British Columbia lack specialized services for older cancer patients.
Barriers to Specialized Care
The expansion of specialized geriatric oncology services faces several obstacles. While cost is an apparent concern, the potential for cost savings through improved care models should outweigh this barrier. The scarcity of geriatricians is another challenge, but nurse-led models have shown promise, particularly with the expanding role of nurse practitioners in Canada.
The inertia of the traditional oncology care model also plays a role. Despite rapid advancements in cancer therapies, changing the established care model is difficult. Implementing geriatric assessments, for instance, is more complex than introducing new drugs or surgical techniques.
Ageism: A Hidden Barrier
Perhaps the most insidious barrier is ageism, a pervasive form of discrimination based on age. It's astonishing that we accept age-based discrimination in healthcare when we would vehemently oppose similar treatment for children. This double standard highlights a critical need for societal and systemic change.
Innovating for the Future
Given the increasing number of older adults with cancer, providing specialized geriatric services to all is impractical. However, this presents an opportunity to develop innovative care models targeting the most vulnerable. By focusing on frail individuals who can benefit significantly from tailored care, we can improve quality of life and achieve substantial financial savings.
In conclusion, recognizing ageing as the primary cancer risk factor is a wake-up call for healthcare systems worldwide. It demands a shift towards patient-centric, geriatric-informed care, especially for older adults. Overcoming barriers like ageism and traditional care models is essential to ensure that cancer treatment is not only effective but also aligned with the unique needs and preferences of our aging population.
