Aging and Cancer

Approved by the Cancer.Net Editorial Board, 09/2016

Age is the greatest risk factor for developing cancer. In fact, 60% of people who have cancer are 65 or older. So are 60% of cancer survivors. If you are an older adult with cancer, you are not alone. But you should know that age is just one factor in your cancer and treatment.

The best treatment plan for you depends on your general health, lifestyle, wishes, and other factors. The information on these pages can help you learn your options, cope with concerns, and plan for treatment and recovery.

How being older can affect cancer treatment

Knowing how cancer and treatment might affect you as an older adult is important. You can plan to get help during treatment. If you are concerned about practical issues, such as getting to treatment or paying for it, tell your health care team. They can help you identify potential means of support.

The list below gives tips on planning for some common situations you might face as an older adult.

  • You have another disease or disability – Talk with your doctor about your medications and treatment plan for all your conditions. Make sure your cancer doctor talks with your other doctors. It is important for your entire health care team to know your situation.

  • You worry about getting to treatment and appointments -- Talk with family members and your health care team about options. Many cities have special bus services for people with health concerns. Other options include private medical transportation, rides from friends and family, and more. A social worker on your cancer care team can help you learn about your options.

  • You need help with daily activities – such as shopping, getting dressed, or taking care of your family. Options include getting help from friends or family members, hiring someone to help, or finding help through a nonprofit organization, senior center, or your spiritual community.

  • You need help with meals – Good nutrition is an important part of cancer treatment. During treatment, older adults are especially likely to lose weight without trying. This can put you at risk of other health issues. Options include having friends or family bring food, stocking the pantry with foods that taste good to you, and ordering meals from a service, if your budget allows.

Free websites such as CaringBridge, Take Them a Meal, and CareCalendar let you share your needs. Friends and family can use the website to sign up to help. Learn about other online communities that provide support.

If you have specific health conditions

Certain serious health conditions are more common in adults over 65. These include:

  • High blood pressure

  • Heart disease

  • Lung disease

  • Diabetes

  • Kidney disease

  • Arthritis

Your doctor may call these co-existing conditions when you have them at the same time you have cancer. Also, doctors call conditions that last longer than a few days or weeks chronic conditions. Learn how chronic conditions can affect cancer and treatment in older adults.

How a health assessment can help

A health assessment is a complete check of your overall health. This can be a good idea before you start treatment. Knowing as much as possible about your health helps your doctor make sure the treatment plan is as safe and successful as possible.

A health assessment often includes checking the following items.

  • Your physical health – Your doctor can do a complete physical examination, including checking on any chronic conditions and working with your other doctors who manage these conditions.

  • How independent you are – For example, what activities you can do on your own, and what you might need help with. This can include checking your balance, walking speed, strength, thinking, and memory.

  • Vision and hearing

  • Medications

  • Any falls you may have had

  • Eating habits and weight

  • Emotional health

  • Bladder and bowel control

Your doctor will also talk with you about your care and support during cancer and treatment.

Learning about all your treatment options

Before you decide on cancer treatment, make sure you know all your options. Studies show doctors do not always offer older adults every treatment available. This can be from concern about side effects, thinking you want less treatment because of your age, or other reasons. Therefore, older adults might receive less treatment than younger people. This might mean:

  • Having fewer tests, such as biopsies, to learn the stage of cancer. A biopsy is when a doctor removes a small sample of tissue and checks it for cancer.

  • Getting milder treatment or no treatment at all, even though several studies have shown cancer treatment helps older adults.

  • Not being invited to join cancer clinical trials (research studies in people). Because 60% of people with cancer are older adults, it is very important for research studies to include older adults. Doctors need to learn which treatments work best in people over 65. They also need to learn how those treatments might work differently in younger people.

No matter what your age, you have the right to know all your treatment options. Then you can make a decision with your doctor about cancer treatment.

Questions to learn your options

When you meet with your doctor for the first time, consider asking the questions below. You might want to write down the answers. You can also take someone with you to help you remember.

Questions about your cancer

  • What is the exact name and type of cancer I have?

  • How did you diagnose it?

  • What tests did you do? What did they show?

  • Do I need more tests?

  • What stage is the cancer, and what does that mean?

Questions about treatment

  • What are my treatment options?

  • What clinical trials are open to me?

  • What treatment plan do you recommend, and why?

  • Who is in charge of my treatment? My care after treatment?

  • What are the possible side effects of treatment? Please tell me what to expect during treatment and shortly after. Also, what should I expect in the long term?

Questions about cancer support

  • Who is on my health care team? What does each person do? Who is the team leader?

  • Who can I talk with about the cost of cancer care?

  • What happens next?

  • What support services are available for me and my family?

Emotional and lifestyle concerns

As an older adult, you might deal with the mental and emotional challenges of cancer better than some younger people. But you might also have different concerns. For example, if you are over 65, you might be concerned about:

  • How treatment could affect your ability to live on your own

  • How chemotherapy will affect your memory

  • If you can have a good quality of life – You might be more interested in this than a long-term cure.

Below are some ways to plan for specific emotional and lifestyle concerns.

How to stay independent -- This can mean living on your own, taking care of yourself, and being in charge of your health care decisions. If you do not have friends or family members nearby, a social worker on your health care team can help you find support. Many services for older adults are free or low cost.

How to stay safe during treatment -- Cancer, treatment, or chronic conditions might make it more difficult to move around. For example, medication might make you feel dizzy. Before you start treatment, make your home as safe as possible. This can include:

  • Adding better light – For example, adding a lamp to a dim room or putting a night light in the bathroom.

  • Clearing clutter – such as papers, boxes, or other items you could trip over.

  • Wearing sturdy shoes or slippers – Avoid flip-flops and high heels.

  • Adding safety equipment – such as railings in stairs and bathrooms. Check any steps in your home to make sure you can hold the railing easily. Consider putting “grab bars” in the shower and near the toilet to help you stay steady.

A social worker or a visiting nurse service can visit your home and suggest changes to help you stay safe.

How to feel less alone – If you are over 65, you might feel more alone than someone younger. This could be because your family does not live nearby or you moved to a new home. Or it could be because a spouse, family members, or friends have died. Ways to feel less alone include:

  • Joining a hospital or clinic support group – Other people with cancer understand your experience in a different way from people that have not had cancer.

  • Asking your health care team about community resources, such as visiting nurse services

  • Talking with a counselor if you feel depressed or anxious

  • Spending time with a hobby group or spiritual community

Talk with your doctors, social workers, or another person on your cancer care team. Your team can give you more tips and tell you about local resources.

How to meet your spiritual needs —Studies show that spiritual beliefs are important to many people with cancer. Spiritual care can be an important part of coping with cancer. For example, people have asked for the following types of support:

  • Wanting the health care team to understand they have spiritual concerns

  • Wanting doctors to consider their religious beliefs during treatment

  • Wanting doctors and spiritual leaders to be in contact with each other

 To include spiritual beliefs in your treatment, you can:

  • Talk with your doctor about how your beliefs affect your decisions

  • Talk with your spiritual leader or a hospital chaplain

  • Ask your health care social worker to help you find a counselor who shares your beliefs

  • Find a support group that talks about spiritual concerns

Learn more about the role of a chaplain in cancer care.

Financial concerns

Your health care team often helps people arrange cancer care. This includes managing the cost. So if you are worried about paying for treatment, tell your doctor, social worker, or another health care team member.

It is also important to learn what Medicare and other insurance programs may pay for. The information below tells you more.

Medicare

Medicare is a United States program that began in 1965. Since then, it has been the main insurance provider for adults 65 and older. Medicare has different parts that pay for different health care services. These are:

  • Part A -- pays for inpatient care (such as hospital care). It also pays for skilled nursing care, hospice care, and some home care.

  • Part B -- pays for doctor services and outpatient care (such as in a doctor’s office). It also pays for physical and occupational therapy and certain supplies or equipment if you need it for medical reasons.

  • Part C -- also called Medicare Advantage. This part of Medicare lets you use Medicare insurance plans from private companies. Medicare approves the companies. They provide Part A and Part B care. They might also pay for prescription drugs.

  • Part D – pays for prescription drugs.

Medicare might not cover all your health care costs. Medicare laws have changed in the past few years. Depending on your Medicare plan, you might need to pay 20% of your medical costs if you do not have other insurance. Paying 20% of some cancer treatments can still be very expensive. Talk with a nurse, social worker, patient navigator, or other member of the cancer care team for help on understanding the exact costs of your cancer care with Medicare.

For more information about Medicare, visit www.medicare.gov or call 800-633-4227.

Other types of insurance

You might have non-Medicare insurance. If so, it might pay for costs Medicare does not. This can include:

  • Deductibles – The amount you need to pay before insurance starts paying your bills.

  • Co-insurance – The amount of a bill you are responsible for. It is often about 20%, though it might be more or less.

  • Co-payments – A set amount you must pay at each appointment.

  • Other expenses, depending on your insurance plan.

The Patient Protection and Affordable Care Act of 2010 made changes that could affect you. Find the most recent information at www.HealthCare.gov.

Medicaid is a program funded by the U.S. government. Each state runs its own Medicaid program. It is for people over age 65 who have limited financial resources and low incomes. This includes people in nursing homes.

Other types of insurance, such as disability insurance and long-term care insurance coverage, may pay some expenses if health insurance does not pay.

You might need extra help paying for treatment if:

  • You have Medicare, but no other insurance

  • Your insurance does not pay for prescription drugs – Cancer drugs can be very expensive.

Most hospitals and clinics have programs to help you. Tell your doctor, nurse, or social worker if you are concerned about the cost of treatment. A social worker or hospital financial counselor can help. Also, some organizations help with cancer treatment costs. Find organizations that offer financial help.

Learn more about managing the cost of cancer care.

More Information

Support and Resource Links

Cancer in Older Adults