7 million cancer survivors are....

February 4, 2010

We have all heard the statistic. Currently, there are an estimated 12 million cancer survivors living in the United States. Have you ever considered the age break down of these 12 million people? Have you ever considered that survivors of different ages, by definition, have differing needs? In fact, an estimated 7 million of the 12 million survivors are over the age of 65 years old. This means that nearly 60% of the survivor population is 65 or older!

When President Nixon declared “war on cancer” in 1971, there were an estimated 3 million American cancer survivors. In under 40 years, that prevalence has risen 400%. Why? Well, of course, the answer is that medical and scientific communities have developed more effective treatments and deeper understandings for and of many types of cancers. Additionally, scientists have developed much more effective diagnostic techniques, so more cancers are “caught” or recognized.

So when we recognize that more cancers are diagnosed, and the treatments for most cancers are improving, we can understand why the estimated number of cancer survivors has increased so dramatically. We can also understand why the proportion of survivors over 65 is so high – survivors are living longer, so the probability that they will arrive at 65 and beyond is high. Why did I just go through such inane logic? I’m glad you asked. Recently, the Journal of the American Geriatric Society published an edition with several articles focusing on the needs of survivors over 65 (older survivors).

Older survivors are like any other sub-set of the survivor population. There are a few issues that affect the entire sub-population, and there are many more issues that affect only segments of the sub-population. In an article titled “Promoting Healthy Lifestyles in Older Cancer Survivors to Improve Health and Preserve Function,” the authors suggest that one primary concern for most older survivors is the loss of physical functioning; in fact, it seems that older survivors have twice the risk of having at least one physical limitation. As a suggestion to address this issue, the authors wrote, “In conclusion, there is tremendous potential for exercise and diet interventions to improve the overall health and well-being of cancer survivors. For older cancer survivors, particular benefits may be observed in the area of physical functioning…” In short, the authors are suggesting that older survivors consult their physicians to develop unique diet and exercise plans that meet each survivor’s unique needs.

In a qualitative analysis in the same journal issue, an article titled “Toward Advocacy in Cancer Care for Older Adults: Survivors Have Cautious Personal Actions but Bold Advice for Others,” researchers examined the prevalence of “do what I say, not what I do” among older cancer survivors. The researchers compared the personal coping strategies of survivors with the advice they give to other survivors. You may recognize this type of advice. On this blog, we have started a series named Open Letter from Survivors to Survivors, and our first two letters have been from Scott Capozza and Pat Sclafani. The researchers examined older survivors and the discrepancies between their own behaviors and the advice they proffer. The largest differences between action an advice were observed in:

1) “get a second opinion and research options” – 6% got a second opinion, but 29% suggested that it was a good idea.

2) “maintain a positive attitude” – 39% suggested it but only 15% said they maintained a positive attitude themselves.

3) “accept it and do not dwell” – only 18% suggested this as a coping mechanism, but 27% said they used it themselves.

4) “rely on family and support” – while 22% said they relied on social support, only 13% suggested it to others.

This is really interesting stuff. Take a look at those differences. The authors of the study leave the differences up to our interpretation. Certainly one way to think about it is that the difference between the advice and the action is older survivors saying “learn from my mistake.” I’m not going to suggest one way or the other; rather, I’m just going to ask that we consider these differences and what they might mean for survivors.