Cassie Kingswell is a Clinical Nurse Specialist at Breast Cancer Now. She has worked in cancer services for over a decade, first as a chemotherapy nurse and then a breast cancer clinical nurse specialist at Guy’s and St Thomas’ NHS Foundation Trust in London.
It is currently estimated that by 2040 there will be over 1 million older people living with breast cancer in the UK.
Research shows that older adults have specific and complex needs, including:
- Significant co-morbidities.
- Being less physically active or mobile.
- Higher rates of polypharmacy.
- Having less social support and higher levels of loneliness.
- Living with mental health conditions such as anxiety and depression which often go undiagnosed.
- Potential cognitive impairment.
- Higher levels of nutrition problems and an increased risk of treatment-related side effects.
Older people with breast cancer are also at risk of:
- Assumptions about fitness for treatment, treatment options or treatment preferences based on age alone.
- Being either over- or under-treated.
- Underrepresentation in clinical trials.
- Being less involved in decision-making and being offered and/or taking up less support.
At Breast Cancer Now, we have designed a set of standards of care to give older adults and their support networks the information and tools to help them understand the care they should expect, ask questions and access the support services that are right for them. You can find the standards on the Breast Cancer Now website.
The standards have been created using research from comprehensive literature searches, information from national and international guidelines (including those from SOIG) as well as insight data from Breast Cancer Now’s patient experience ‘The Big Breast Survey’.
Importantly, we have also sought collaboration from geriatric oncology and breast cancer specialists, and from older people with a lived experience of breast cancer, via our Breast Cancer Voices network. This was to ensure the standards are both reflective of the needs and experiences of older people, but also realistic for what is achievable in the current clinical climate.
We held a focus group with our lived-experience volunteers which was the highlight of the process. The insights and experiences they shared illustrated the challenges they faced both during and after treatment, which really showed the importance of this piece of work.
So, what next? The standards are available on the Breast Cancer Now website to read and to download or print, with the hope that they will be used in breast clinics across the UK to help ensure everyone gets access to the right care and support for them.
We have a healthcare professional webinar planned in September, alongside the geriatric oncology team from The Royal Marsden Hospital, to highlight the importance of a multidisciplinary team (MDT) approach to care for older adults with breast cancer and to introduce the standards to our healthcare professional (HCP) network. Webinars can be accessed by any HCP hub members, please see the website for more details.
We hope to follow this work up with a supporting resource for healthcare professionals. We appreciate any feedback or comments on the standards, which can be given via the feedback box on the webpage, or by email to cassie.kingswell@breastcancernow.org.
