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Last Updated: Wednesday, 29 October, 2003, 11:46 GMT
Elderly 'denied cancer surgery'
The attitudes of some doctors may be to blame
Elderly women are still being denied potentially life-saving surgery for breast cancer because of their age.

The claims will be made by senior doctors and other leading experts at a conference in London on Wednesday.

They come two years after ministers published a national service framework for older people and pledged to stamp out age discrimination in the NHS.

However, experts say the problem still exists and in many cases is resulting in women dying needlessly.

The conference is being organised by the charities Cancer Research UK and Help the Aged to highlight the problem of age discrimination in breast cancer care.

'Too old'

It will hear that women over the age of 70 are most likely to miss out on surgery, largely because doctors believe they are too old to have an operation.

"There is a myth that women over 70 will not live long because they are too frail," said Ian Fentiman, professor of oncology at Guy's and St Thomas's Medical School in London.

"There is a myth that women over 70 will not live long because they are too frail,
Professor Ian Fentiman
"There is a deeply entrenched age bias. We still make decisions on age alone. The first thing a doctor asks a patient is how old they are."

According to Professor Fentiman, many of these women are given the breast cancer drug Tamoxifen instead of surgery.

Studies have suggested that women with breast cancer who are given Tamoxifen without also having surgery are less likely to survive than those who have both.

He said the situation is compounded by the fact that many elderly women do not realise they have a higher risk of developing breast cancer compared to other women.

"Opinion polls have found that 60% of women over the age of 70 believe they have no risk or are at a reduced risk of developing breast cancer," he told BBC News Online.

"However, age is a major risk factor for the development of most cancers and certainly for breast cancer. This means that 50% of breast cancers occur in women over the age of 65 and 60% of deaths from breast cancer occur in that age group."

Professor Fentiman said this message was not getting through to older women.

"We as a profession have some blame. We may not have informed people well enough."

He said women over 70 should be offered the same treatment as all other women with breast cancer.

"How we treat older people is a test of our civilisation," he said.

Doctors' attitudes

Dr Richard Sullivan, head of clinical programmes at Cancer Research UK, said changing the attitude of doctors is key to ensuring elderly women get the care they need.

"Women over 70 are not getting the best treatment they should be getting for a variety of reasons," he told BBC News Online.

"One of these is because of the attitude of the medical profession to treating women over 70. This is something we need to change.

"We need to get doctors to offer standard treatment to all women. It is really important that they take biology rather than chronology into account. Some women of 70 are very fit."

The Department of Health said more elderly women have had surgery for breast cancer since its national service framewrok was published two years ago.

"The Older People's National Service Framework sets out our commitment to address age discrimination and provide treatment and care on the basis of clinical need, and not age," said a spokeswoman.

"This applies to the treatment of breast cancer and since the framework's publication in March 2001 significant progress has been made.

"For example between 2000 and 2002 breast cancer surgery for patients aged 85 and over rose by 13%."


SEE ALSO:
Cancer care 'ageist'
20 Mar 02  |  Health


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