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Hospitals found to be less likely to give elderly cancer patients aggressive care

The Yomiuri Shimbun

The Yomiuri ShimbunThe proportion of cancer patients who do not undergo aggressive care exceeded 60 percent for a particular type of the disease among those aged 85 or older in the most advanced stage of their ailment, according to data released by the National Cancer Center on Wednesday.

In such cases, medical institutions chose to conduct such activities as follow-up checks instead of surgeries and chemotherapy.

Against a backdrop of elderly people making up an increasing share of cancer patients, the medical institutions are believed to have prioritized the patients’ quality of life, based on the fact that a complete cure is difficult for aged patients at this stage of cancer, and the low five-year survival rates for some cancers.

The government plans to advance research regarding treatments for the elderly patients with the aim of helping them make the best choice.

Cancers are categorized depending on how advanced they are. Stage 1 is an early stage, while Stage 4 is the most advanced condition, in which tumors are spreading to other organs. According to the center, among people who developed cancer in 2012, those aged 75 or older accounted for 42 percent, up seven percentage points from 2002. The figure is expected to rise as aging of the population advances.

On Wednesday, the center publicized the aggregated data of about 700,000 patients who were diagnosed with cancer in 2015 at 427 medical institutions across the nation, including the designated cancer hub hospitals. For the first time, it disclosed the data of treatments for the elderly aged 75 or older, categorized by the stage of the cancer.

According to the data, 58.0 percent of patients aged 85 or older who were diagnosed as being at Stage 4 of non-small cell lung cancer received “no treatment.” For patients of that age with other cancers at the same stage, the figure was 56.0 percent for stomach cancer patients. The figure was 36.1 percent for large intestine cancer patients, rising incrementally from 2012. The figure for pancreas cancer, which is said to be particularly difficult to treat, was 60.0 percent, and that for uterine corpus cancer, which rarely develops among the elderly, was 66.7 percent.

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  • The Yomiuri Shimbun

Many elderly cancer patients suffer also from such conditions as cardiac diseases and diabetes. In many such cases, it is likely to be decided that it would be difficult for them to undergo surgery or chemotherapy. Additionally, some observers say that medical institutions sometimes consider patients’ declining cognitive abilities in deciding to withhold treatment.

“We need to move faster to establish standards to help the medical institution side to come up with an appropriate therapy when they have difficulty in communicating with elderly patients,” said Prof. Fumio Nagashima at Kyorin University School of Medicine’s Medical Oncology Department.

The Health, Labor and Welfare Ministry plans to draw up treatment guidelines for elderly patients on chemotherapy.

Survival rates also released

The center on Wednesday also released the latest data on the survival rates of cancer patients five years after their diagnosis, which are based on treatment results of about 214,500 patients who were diagnosed with cancer in 2008 at the designated cancer hub hospitals.

The five-year survival rate for all cancer patients was 65.2 percent. The survival rates for patients with certain types of cancer were relatively high: 97.7 percent for prostate cancer, 92.7 percent for breast cancer, and 82.8 percent for uterine corpus cancer. Among prostate cancer patients, the survival rate for those who were in stages 1, 2 and 3 was 100 percent.

In contrast, the figure for pancreatic cancer, which is difficult to detect at an early stage, was just 9.9 percent.

There is a tendency for survival rates to drop rapidly as the stage advances. The five-year survival rate for stomach cancer was 95.0 percent for those at Stage 1, but it dropped to 9.0 percent for those at Stage 4. Speech

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