Like many forms of cancer, the risk of developing breast cancer increases with age: 30 percent of breast cancer patients in the United States are age 70 or older. For many older patients, the issues and challenges associated with the disease are quite different from those that arise in younger women.
Older women are more likely to have other health conditions that can complicate their treatment for breast cancer, and may have particular challenges involving finances, support networks, and the logistics of receiving treatment.
Here are some of the particular issues older patients face, along with suggestions for dealing with them, from Rachel Freedman, MD, MPH, a breast cancer specialist in the Dana-Farber’s Susan F. Smith Center for Women’s Cancers whose research focuses on improving the treatment of the disease in older women.
Social support, finances, and transportation
Older patients may have difficulty traveling to medical appointments and may lack a large network for emotional and physical support, especially if family members live far away. Financial issues can also be particularly acute for people on fixed incomes. Freedman notes that hospitals and treatment centers can connect patients with a variety of resources, both within the hospital and the broader community, to alleviate these challenges. Visiting nurses, elder services, and other community-based programs can be of assistance as well. Many hospitals have clinical social workers, psychotherapists, and patient navigators to counsel patients about the emotional aspects of a cancer diagnosis and treatment. Many also offer financial assistance or have advisors who can put patients in touch with assistance organizations and programs.
As of May 2022, the Program for Older Adults with Breast Cancer at Dana-Farber supports older adults throughout their breast cancer journey and acts as a single point of contact to help connect them to the many supportive care resources that are available throughout the Institute.
Co-existing medical issues
Patients being treated for other health conditions should make sure that all of their clinicians are in communication so their care can be fully coordinated. This will help ensure that treatment for one condition doesn’t interfere—or interferes as little as possible—with treatment for another.
Research has shown that older patients may know less about their cancer than younger patients do and may be more likely to defer treatment decisions to others, Freedman remarks. She encourages older patients to ask questions and learn about their disease so they can make well-informed decisions about their care. “If you don’t understand something, if you’re not feeling well, if you’re struggling with something, it’s important to let your care team—your physician, nurse, or other clinician—know,” she comments.
Adherence with treatment
Studies have shown that older patients may be less likely to adhere to treatment plans—less likely to take medicines on schedule, more likely to have large copay burdens because of having to take multiple medications, and potentially less likely to come for follow-up appointments—than younger patients. Freedman urges patients to follow their treatment plan as prescribed and to call their care team if any difficulties or side effects arise.