Tag Archives: cancer diagnosis

Cancer in the UK a ticking timebomb

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Head of Macmillan Cancer Support warns of a ‘ticking timebomb’ for society if NHS and social care systems are unprepared.

The number of older people living with cancer will more than treble by 2040, say experts, who warn of a “ticking timebomb” for society if the NHS and social care systems are not geared up to help them in time.

Macmillan Cancer Support says the number of over-65s who have received a cancer diagnosis will go up from 1.3 million in 2010 to 4.1 million in 2040.

Its estimates – based on research from Kings College London, which it funded – mean that nearly a quarter of all older people (23%) will be living with cancer within 30 years. At the moment, the figure is 13%.

The biggest increase, according to the study – published online by the British Journal of Cancer – will be in lung cancer in women, which is expected to more than double from 319 to 813 per 100,000 people. While the number of men smoking has declined markedly since the 1970s, women have not quit in the same numbers.

Professor Henrik Møller, one of the study’s authors at King’s College London, said: “The aim of this research is to provide long-term projections of cancer prevalence in the UK.

“The research shows that large increases can be expected in the oldest age groups in the coming decades and, with this, an increased demand upon health services,” he said.

Cancer is predominantly a disease of older age. More than 60% of people living with cancer are over the age of 65 and half are over 70. The numbers of older people with cancer are rising sharply because the population is living longer, but also because cancer rates are increasing and treatments are improving so that more patients are surviving for longer or are cured altogether.

Cancer Research UK

Cancer Research UK

But in spite of this, Macmillan argues that older people who are diagnosed do not always get the best care. Decisions about which treatments to give people are too often based on age, rather than on fitness, says the charity.


Older patients are less likely to have radical surgery or radiotherapy and some studies suggest that their survival is less likely because of it. Older people are also more likely to find it harder to recover after their treatment and more likely to feel abandoned by the health service than younger people.

Ciarán Devane, chief executive of Macmillan Cancer Support, said: “The care of older cancer patients is the ticking timebomb for society.

“These stark predictions should act as a warning to the NHS and social care providers of the problems ahead if older cancer patients are not offered the best treatment and support.

“We have a moral duty to give people the best chance of beating cancer, regardless of their age. For cancer survival to improve, older people must be given the right treatment at the correct level of intensity, together with the practical support to enable them to take it up.

“The barriers to older people getting treatment must be tackled. If we don’t get this right now, many older people will be dying unnecessarily from cancer in the future,” he said.

A Department of Health spokesperson said: “It’s good news that improvements in cancer treatment mean more people are surviving after cancer.

“We know more can be done to improve cancer care for older people, which is why we are working with Macmillan Cancer Support and Age UK on a £1m programme to ensure that older people’s needs are properly assessed and met.

“From 1 October 2012, it will be unlawful to discriminate in health and social care on the basis of age. Adults of all ages will benefit from better access to services, and for the first time people will have a legal right to redress from the courts if they are unjustifiably discriminated against because of their age.”

Avodart may treat prostate cancer

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New research suggests that Avodart, a drug used to treat an enlarged prostate gland, may help slow the progression of early stage prostate cancer, reducing the need for aggressive treatment in some men.

Prostate cancer can grow and spread slowly, which is why some men are urged to engage in so-called watchful waiting when the cancer is first diagnosed. Avodart (dutasteride) may help such men feel comfortable with surveillance as opposed to radical treatment, the researchers noted.

“The concept of active surveillance is gaining traction in most parts of the world,” said study author Dr. Neil E. Fleshner, head of the division of urology at the Princess Margaret Hospital in Toronto. Still, some men are uncomfortable with doing nothing in the face of a cancer diagnosis, he said. “By using this drug, we can improve the proportion of men who remain committed to the surveillance.”

According to the U.S. National Cancer Institute, one out of every six men in the United States will develop prostate cancer in his lifetime. But because many of those cancers are low-grade, most will die of something else.

Avodart belongs to a class of drugs called 5-alpha reductase inhibitors. These drugs work by interfering with the effects of certain male hormones on the prostate. In the three-year study, prostate cancer progressed in 38 percent of 144 men with early prostate cancer who were treated with Avodart and 48 percent of the 145 men who received a placebo.

Prostate cancer cells

Prostate cancer cells

Men seem less anxious about the cancer diagnosis when they are doing something more proactive, Fleshner said. “The drug augments active surveillance and avoids most of the side effects associated with surgery and radiation,” he said. Prostate removal surgery and/or radiation can lead to impotence and incontinence, he said.

The medication does have side effects, however, including reversible breast enlargement and tenderness and some sexual dysfunction.


“We know that we are over-treating prostate cancer,” said Dr. Louis Potters, chairman of radiation medicine at North Shore University Hospital and Long Island Jewish Medical Center in Manhasset, N.Y.

“In the U.S., patients have a tendency to hear the word ‘cancer,’ and want to treat it right away,” he said. “In these men with early prostate cancer, we can now say, ‘Let’s put you on this medication, and see what happens over the next couple of months.’”

However, some experts have concerns about 5-alpha reductase inhibitors. The U.S. Food and Drug Administration recently issued a warning that men who take these drugs to treat enlarged prostate glands may be at increased risk for high-grade prostate cancer.

Dr. Ryan Terlecki, an assistant professor of urology at Wake Forest Baptist Medical Center in Winston-Salem, N.C., said this may dampen enthusiasm for use of the drug to treat cancer.

“The overall role that these medications will play for urologists will decrease,” Terlecki said. Doctors will likely begin looking toward noninvasive and/or non-medical treatments such as the use of thermal heat to cope with some of the symptoms of prostate conditions, he added.