Ageing world urged to prepare for ‘tsunami’ of cancer cases

A surge of ‘millions’ of cases risks overwhelming health services unless urgent action is taken to prepare for patients with more complex needs.

The world is set to be hit by a ‘tsunami’ of cancer cases.

A “tsunami” of millions of cancer cases in older adults is approaching, a conference of global cancer specialists has been told.

The surge in cases risks overwhelming unprepared health services unless urgent action is taken to prepare for patients with more complex needs.

Governments must boost the cancer workforce, and drugs and treatments should be specifically assessed for use in older patients where they are likely to be taken alongside other medicines, specialists urged.

The number of people in the UK diagnosed with cancer is expected to rise by a third by 2040, taking the number of new cases annually to more than half a million for the first time.

Analysis by Cancer Research UK predicts there will be 208,000 cancer deaths in the UK each year. The trend is echoed internationally and Andrew Chapman, a cancer specialist at Thomas Jefferson University Hospital, told the annual conference of the American Society for Clinical Oncology (Asco) in Chicago it represented a “silver oncologic tsunami”.

“The population globally is ageing. As we age, the potential to develop cancer increases. Because people are living longer, there’s going to be more cancer incidence which means there is going to be a higher volume of people that we need to take care of,” he said. “Globally, we’re not prepared.”

He said there was a risk people would be either over or under treated, without recognising the patient’s personal goals.

“Most of the time, older adults care more about maintaining their function than they necessarily care about the cancer. They want to go to weddings, they want to see their grandkids, they want to play golf,” he said. “If you’re going to give somebody treatment that’s going to take that away, they may not want it – much different than somebody who’s 45 who wants to live for another 40 years. It’s a different game.”

Dr Tina Hsu of The Ottawa Hospital in Ontario, said there was “an urgency” to develop specialist services for older patients. “We already are seeing more and more older adults with cancer,” she said. “I feel like sometimes we wait until the crisis … We should do something now [not] wait until it arrives.”

Speaking in Chicago, Cancer Research UK’s chief clinician, Professor Charles Swanton, said: “If we’re dealing with 30 per cent more cancer diagnoses, and those diagnoses are more complex, [we will] need 30 per cent more oncologists, surgeons and pathologists to cope with the caseload. Given that it takes 15 years to train them, we need to start thinking about increasing medical school places now and making the health service more attractive to work in so that we can retain the staff we do train.”

Caroline Abrahams, charity director at Age UK, called for more geriatricians, who could “understand older people’s health in the round”.

Julie Gralow, Asco’s chief medical officer and executive vice-president, said clinical trials should include older patients “so that we can understand the toxicities and efficacies of therapies on this population”.

An NHS spokesman said: “We have a growing and ageing population, which inevitably increases the number of people needing NHS care and [more intense] support, and as set out in the NHS long-term plan we are working with partners to ensure doctors are trained with the skills needed to meet the needs of an ageing population, alongside the development of specialist knowledge and skill.”

The Times