Purpose: Elderly (>65 years) cancer patients are perceived to be under-served in oncology care but will become majority users of future services. Research is needed to clarify how, or whether, their service needs differ from a younger cohort. Study questions: (i) Do psychosocial/informational/support care needs in the elderly differ from younger patients: (ii) Are older patients’ psychosocial/supportive/informational needs met?
Method: Using a prospective design, patients were assessed 3 and 9 months post-diagnosis using the Support Care Needs Survey and the Information Satisfaction Questionnaires. EORTC QLQ Functional Status scale provided co-morbidity data. Comparisons were between non-seniors (< 64) and seniors (>65) in the major diagnostics groups (Breast, Colo-rectal, GU, Lung).
Results: 394/713 (55%) patients completed baseline and 254/367 (69%) follow-up questionnaires;190 seniors and 204 non seniors (baseline) and 115 seniors and 139 non-seniors (follow-up). Commonly reported needs across the total baseline sample: “psychological support” (77%), “health systems and information” (63%) and “physical and daily living” (64%). 44% overall reported a need for easier access to services. More commonly reported concerns were “fears about cancer spreading” (51%), “concerns about the worries of those close to you” (51%), “fears about cancer returning” (45%) and “uncertainty about the future” (42%). Seniors/non-seniors did not differ significantly in terms of either desire for access to information about cancer (p>1) or preferences relating to involvement in treatment decision-making ( p>1). Contrary to predictions 27% of seniors reported high needs for psychological care. Areas of difference and similarity, according to age, will be reported in detail.
Conclusions: The findings reinforce a requirement for clinicians to provide supportive and psychosocial care in a way that avoids age stereotypes and the data point to areas in oncology care that might be improved. Functional status rather than age per se needs to be a guideline criterion for management.