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There are two key issues facing those of us involved in cancer care in these early years of the 21st century. They are separate but linked. As ageing is a key risk factor for cancer, and the proportion of the elderly in the population is rising steadily, then clearly there will be greater incidence of cancer and increasing the number of elderly cancer patients. At the same time the rate of growth in the number of those in the caring professions is failing to keep pace. This presents a scenario for the future when elderly people with elderly and frail partners and minimal family support will be grappling with the implications of a cancer diagnosis, comorbidities, effects of treatment as well as the normal effects of ageing. Currently in UK more than one in three people will be affected by cancer at some point in their lifetime. Our cancer services now are stretched and in spite of many developments and improvements the level of care needed is not always available. Unless changes are made this situation will become worse compounded by the fact that in the future frail partners will not necessarily be able to provide the informal care that currently forms a large proportion of support. We have too few nurses now to provide the specialist care that is needed. In 10–20 years the number will be even lower, relative to the increase in the number of the elderly with cancer. We may need to create new types of carers and re‐think the boundaries of some of our well‐established professions. Change is inherently threatening but without change there would be no progress. It is not so very many years ago that auxiliary nurses or health care workers began taking on some of the tasks previously the domain of nurses. Much longer ago stethoscopes and sphygmomanometers were the exclusive tools of the doctor. At the time these were major changes. We need to make some equally major changes now. Professions must clarify exactly what it is that epitomizes their unique contribution to cancer care. The shape of care in future is likely to look different too. As more treatments are delivered on an outpatient basis or in the community support needs will change. Elderly people with cancer will have complex care needs which may be unrelated to their cancer, and requiring a quite different workforce to deliver them. Our future may need increased number of people to provide practical help in the home, cleaning, cooking and gardening. Information and support needs will need to be geared towards an elderly population with sensory loss – hearing or sight for example. Much closer working between health and social care will be crucial with better communication, knowledge‐sharing and more robust partnerships between patients, professions and carers. In an uncertain world there is one thing that is certain. The number of elderly people with cancer will increase, but, in relative terms, the number of those in the caring professions will not. New ways of working will have to be found. There are two key issues facing those of us involved in cancer care in these early years of the 21st century. They are separate but linked. As ageing is a key risk factor for cancer, and the proportion of elderly in the population is rising steadily, then clearly there will be greater incidence of cancer and increasing number of elderly cancer patients. At the same time the rate of growth in the number of those in the care professions is failing to keep pace. This presents a scenario for the future when elderly people with elderly and frail partners and minimal family support will be grappling with the implications of a cancer diagnosis, comorbidities, effects of treatment as well as the normal effects of ageing. Unless radical action is taken now the divide between care needs and care availability will be too wide to bridge with the inevitable consequences.
European Journal of Cancer Care – Wiley
Published: Dec 1, 2004
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