In a world where we often associate cancer with factors like smoking, alcohol, or sun exposure, it's time to shine a light on a different, yet crucial, aspect. Ageing, an inevitable part of life, is the leading risk factor for cancer. This revelation is especially significant given the demographic shift we're witnessing, with older adults becoming an increasingly larger portion of the population. By 2068, nearly a third of Canadians will be over 65, and cancer, one of the most common diseases in this age group, will pose a significant challenge to our healthcare system.
What makes this particularly fascinating is the opportunity it presents for innovation in cancer care. International guidelines recommend geriatric assessments for all older adults before deciding on cancer treatment, yet this practice is not routine in many places. These assessments, led by geriatricians, provide a comprehensive understanding of an older adult's health, including their existing illnesses and the potential impact of treatment on their overall well-being.
In Canada, specialized geriatric oncology clinics are few and far between. However, the potential for cost savings and improved patient outcomes is significant. A study led by Shabbir Alibhai, one of the authors of this article, demonstrated a savings of approximately $7,000 per older adult seen in these clinics. Despite this, specialized services for older adults with cancer are still lacking, especially in British Columbia.
The barriers to implementing these services are multifaceted. Cost is a factor, but the evidence suggests that the long-term savings outweigh the initial investment. The shortage of geriatricians is another challenge, but nurse-led models have shown promise and could be a cost-effective solution with the expanding role of nurse practitioners.
One of the most intriguing, yet difficult to address, barriers is ageism. It's a form of discrimination that is often overlooked, yet deeply ingrained in our systems. We must ask ourselves, why do we accept a lack of specialized care for older adults with cancer when we would never tolerate the same for children?
While it may not be feasible to provide specialized geriatric services to all older adults with cancer, there is an opportunity to develop targeted models of care for those who need it most. By focusing on the most vulnerable and those who stand to benefit the most, we can improve quality of life and have a significant financial impact.
In conclusion, the leading risk factor for cancer is not what we often assume. Ageing, an unavoidable part of life, presents a unique challenge and an opportunity for innovation in cancer care. By addressing the barriers and implementing targeted models, we can ensure that older adults receive the specialized care they deserve and improve their overall well-being.
