Elderly women denied cancer drugs

Doctors say better clinical trials are needed

Elderly women with cancer are being denied potentially life-saving drugs because of their age, according to doctors.

An international conference in France has heard that many women over the age of 70 are not routinely given medication if they have advanced ovarian or breast cancer.

This is because there is no clinical evidence to suggest the drugs work in older women and because doctors are unsure about the possible side-effects.

Clinical trials often exclude patients over the age of 70

Dr Gilles Freyer

Clinical trials of most drugs do not generally include women over the age of 70.

But doctors at the European Society for Medical Oncology Congress in Nice, said that many patients were suitable for treatment.

Dr Gilles Freyer, from Centre Hospitalier Lyon Sud in France, carried out a study of 83 women aged over 70.

Side-effects

He found those who were depressed or lacked independence may be vulnerable to the side effects from powerful chemotherapy.

However, those older women who still had independent lives may be able to tolerate the treatment and so cancer specialists should not assume all elderly women with advanced cancer cannot cope with the drugs.

Dr Freyer said: "We simply do not know if elderly patients can tolerate these powerful drugs because clinical trials often exclude patients over the age of 70 years so the results that emerge are not fully representative of the age range of patients we have to treat."

Another study by Dr Anne Chantal Braud and colleagues at the Institute Calmettes in Marseilles, France, studied the effects of surgery, radiotherapy, chemotherapy and hormone therapy in 179 women aged over 70.

They found that the treatment given was usually influenced by the physician's choice and patient's age, instead of standard factors such as the size of the tumour.

Dr Braud called for a standardisation in the treatment of the elderly.

Ageing population

Professor Silvio Monfardini, President of the International Society of Geriatric Oncology, said cancer services needed to rethink their attitudes to older people.

He said there were more difficulties in treating elderly patients, such as getting informed consent before treatment and arranging transport for attendance at cancer centres.

However, in light of the progressively ageing population, he said: "This increasing burden for caregivers - but also for clinical trialists - cannot be avoided and must be foreseen and calculated for Europe in the near future."