A better deal for those ageing with cancer

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Copyright: International Society of Geriatric Oncology (SIOG). This image has been cropped.

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  • Many countries are unprepared for the rise in cancer cases among the aged
  • Enabling environments related to policy, training and infrastructure are missing
  • Policies on cancer in elderly are lacking making treatment and support difficult

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Increasing life expectancy brings with it a rise in cancer cases among the elderly — in an unprepared world.

[GENEVA] Thanks to efforts in development and progress in healthcare, human life expectancy is increasing worldwide. The downside to this, however, is the significant rise in cancer cases among the elderly.

As cancer incidence increases sharply with age, it will translate into a worldwide epidemic in the decades to come. This will affect both developed and developing countries alike. Asia Pacific is, for example, emerging as a key region witnessing the growth of an elderly population with cancer.

“As cancer incidence increases sharply with age, it will translate into a worldwide epidemic in the decades to come. This will affect both developed and developing countries alike. Asia Pacific is, for example, emerging as a key region witnessing the growth of an elderly population with cancer.”

Najia Musolino, International Society of Geriatric Oncology (SIOG)

In light of these demographic changes, governments and other coordinated bodies must prepare for this reality. Although some countries have effective health service delivery models, most have difficulty implementing such models for the elderly living with cancer especially among developing countries. In many contexts, the problem has its roots in the lack of effective coordinating mechanisms and enabling environments related to policy, training and infrastructure, which include shortages of human resources.

While these deficiencies are well recognised by countries, the response to these challenges has clearly been insufficient. There are a few institutions, however, in various settings that have invested in dedicated personnel and dedicated units responsible for geriatric oncology services.

Meeting SDG 3

There is a need for the development of human resources dedicated to the area. Clearly articulated policies on cancer in ageing is lacking in many contexts. This most likely challenges countries to effectively translate research outputs and knowledge into healthcare practices, which address not only health issues of the elderly with cancer but also their access to treatment, equity and financial protection.

Universal Health Coverage (UHC) and the United Nations Sustainable Development Goal 3 (SDG3 – Good health and well-being for all) provide the foundations to address the societal challenges related to cancer in ageing. Mapping of the health systems addressing the quality of life and the needs of older patients living with cancer is only the first step in overcoming these challenges in an ongoing assessment process.

A stepwise approach will be required to subsequently assess the capability of health services. In other words, they will be evaluated according to the following: what their systems can and could do; their current performance compared to what they should be doing; and the effectiveness of improvement interventions to the systems. The baseline findings of such situational analysis will help develop more robust and resilient health systems that can respond to the dynamic needs and quality of life of the growing older population living with cancer.

In recognition of these challenges, the International Society of Geriatric Oncology (SIOG) works with institutions around the globe to improve outcomes for the elderly with cancer. In South-East Asia, for example, SIOG’s efforts with country partners are focused on trained health workers and quality healthcare management at different levels of the health system.

Partnerships to improve expertise

A recently agreed collaboration between SIOG and the Philippine Red Cross, the Philippine Cancer Society and the Philippine College of Geriatric Medicine is the first of a number of regional partnerships aimed at improving access to expertise in geriatric oncology. On 15th May this year, SIOG and the SEAMEO TROPMED and Public Health Network have invited countries to discuss current policies for the strengthening of human resources for health in Geriatric Oncology in South-East Asia. SIOG is currently completing a major study to underpin success stories, challenges, funding, and new care initiatives culminating with a policy meeting taking place at the United Nations in Geneva, Switzerland on 14 November this year.

The chair of the initiative, Martine Extermann, senior adult oncology, Moffitt Cancer Centre, adds that the SIOG report due in 2019 will consolidate country recommendations to generate and communicate knowledge to the stakeholders of cancer in ageing, thus contributing directly or indirectly to equitable health development in country settings; adapting and applying knowledge generated elsewhere for the achievement of international health development; and contributing to the global knowledge database.

The development of elderly cancer care models must embrace and incorporate the fundamental principles of geriatric oncology, says the president of SIOG, Hans Wildiers, a medical oncologist from UZ Leuven, Belgium.

The SIOG community and its country partners will continue to push the boundaries worldwide for better patient outcomes for those in the ageing population that are afflicted by cancer—both scientifically and through policy thought leadership. By doing this, it is contributing to the vision of Kofi Annan for the promotion of solidarity between generations in combating discrimination against older patients and in building a future of security, opportunity for treatment and dignity for them. 
Najia Musolino is the CEO of SIOG. She is widely recognised for synthesising evidence for policy options and integrating cross-cutting issues into analyses and flagship products. A former fellow of the Ludwig Institute for Cancer Research in Switzerland, she has served in various leadership roles in global health.
This piece was produced by SciDev.Net’s Asia & Pacific desk.