Monday, 15 October 2012

The increase will be partly caused by our ageing population, with breast cancer far more common in the over-50s.
But better treatment and diagnosis also mean that more women are now surviving the disease and living with it for many years – presenting new challenges for the NHS when it comes to practical support and after-care.
Experts say that unless the health service makes major changes, it will be unable to cope with the surge.
They fear it will not have the resources to help growing numbers of women deal with breast cancer treatment, side effects and living with the disease. 
Campaigners are particularly concerned that the NHS will not be able to handle the rise in elderly breast cancer patients. The numbers of sufferers aged over 65 is expected to quadruple by 2040.
Critics say the health service is not doing enough to help women cope with the long-term effects of cancer and treatment, which include heart problems, loss of energy and emotional trauma.
Mike Hobday, of Macmillan Cancer Support, said: ‘The NHS is not going to be able to cope unless it learns new ways to provide treatment and support for women with breast cancer. The really big concern is around older people with cancer. That’s what’s going to challenge the NHS.
‘I think it’s a potential crisis, it’s a growing crisis. It’s not a crisis now but it will be unless the NHS learns to provide treatment and support more effectively.
‘The NHS doesn’t provide the support that enables women to cope with the side effects of cancer.
‘Radiotherapy for breast cancer will affect the heart. Similarly, if they have had surgery, that will affect their upper body strength.
‘Having any form of cancer is a very emotionally traumatic experience for a woman to go through and the NHS needs to provide the right support.’
In a study published today in the British Journal of Cancer, academics from King’s College London calculate that by 2040 there will be 1.68million women living with breast cancer.
This figure includes those receiving treatment for the illness at the time, as well as anyone diagnosed within the past ten years. Of these, 1.2million will be aged over 65, marking a four-fold increase on present figures.
There is widespread concern that elderly women are often diagnosed with breast cancer too late and are not always offered the best treatment.
Many are unwilling to go to their GP if they have symptoms as they don’t want to be seen as a burden.
Campaigners say that while doctors are good at diagnosing and treating middle-aged and younger women with breast cancer, they are failing older victims.
They worry there is a lack of awareness amongst the over-65s and they are less likely to spot lumps or seek help from GPs if they find them.
Some doctors are reluctant to offer surgery to remove tumours for women in their 70s and 80s as they think they are too frail.
Studies have shown that some will simply look at a woman’s date of birth when deciding whether to offer her surgery to remove tumours.
Ciarán Devane, chief executive of Macmillan Cancer Support, said: ‘We need to change the way we care for older breast cancer patients now, so that we are prepared for such a dramatic increase in numbers.
‘Older people must be provided with the right treatment at the right time at the correct level of intensity.
‘We can never assume that because a woman is older that she will not cope with surgery or that she is less interested in body image than a younger woman.
‘It is our duty to ensure that every cancer patient has access to the best possible care. We can no longer tolerate the present situation where too many cancer doctors are making assumptions based on age which often result in older women receiving inadequate care for their breast cancer.’ 
Dr Rachel Greig, senior policy officer at Breakthrough Breast Cancer, said: ‘It is startling to think that we could have a million older women living with breast cancer within a generation. It shows that we have a rapidly ageing population, but also that we are getting much better at treating women with breast cancer.
‘However, increasingly we should think less about the age of patients, and more about their individual need. This will ensure the best standards of care for women living with the disease.’
Breast cancer is now the most common type of cancer among women, and one in eight is likely to develop it at some point in her life.
There are just over 48,400 new cases a year, but 95 per cent will survive longer than ten years. By comparison, in the early 1970s just over 80 per cent could be expected to live for this long after diagnosis.
However, as the prognosis improves, experts say the NHS is not offering enough support to help women deal with the long-term effects of breast cancer.
Treatments such as radiotherapy can leave women more susceptible to heart disease, while chemotherapy can cause long-term symptoms of fatigue.
Critics say doctors should also be providing more emotional support to help women cope with the trauma of the disease.
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