Age discrimination could limit treatments offered to people with prostate cancer

This week saw a major investigation from The Times describing how the NHS overwhelmingly neglected and, worse, outright discriminated against older people during COVID. The Guardian weighed in, citing this as an amplification of something that has been happening for a while.

Both reports generated widespread condemnation across many quarters, and stepped up advocacy amongst elderly and age support organisations. At The Focal Therapy Clinic, our own patients have reported that they have been discriminated against due to their age in very specific ways.

Age discrimination in healthcare

In our 20 years’ experience of treating patients, we have found that this experience of ageism can be what drives people with prostate cancer to approach us. Many come to us because they have felt dismissed, abandoned and even actively discriminated against in their treatment for prostate cancer within the NHS – all of which they perceive as being due to their age. Being over 70 doesn’t mean that you are unimportant.

We have also noticed that two parallel universes have emerged. The first is where some healthcare providers feel that men over 70 are coming to the end of their lives and aren’t worth treating. The second is where men are fit and active when they are diagnosed with prostate cancer, with expectations of many more years of fitness and health.

In this second, more realistic and modern, universe, men over 70 are living full, active lives. They are engaged in sport, travel, their family and their community. They are not willing to compromise on their level of commitment to any of these, despite their prostate cancer diagnosis – if you’re living in this universe, you may not consider yourself elderly at all.

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Our patients tell us that they are fitter and more focused now than they have ever been. For them, their experience of aging is that “70 is the new 50”. Yet they are consistently denied the treatment they deserve.

The lasting impact of COVID on NHS treatment

Although COVID can feel a long time ago, the restrictions to treatment available have remained. This is partly due to patient backlogs and ongoing lower resources.

Some men are experiencing both undertreatment – eg active surveillance – and overtreatment – eg hormone therapy – relative to their personal circumstances and intentions. There is a significant disconnect between the expectations these men and their partners have for the quality of their lives and how the NHS engages with them around a disease such as prostate cancer. This is a disease which affects lots of men and is something they may have to live with for some time, so awareness of all available treatment options is crucial.

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On the one hand, there is a perception that men over 70 are “old, frail and vulnerable”, which has been amplified and reinforced by COVID (quite reasonably in many cases, but not all). On the other hand, there are new insights around the importance of exercise, social engagement and prevention.

70 is the new 50

As we are learning more and more about living longer, healthier lives, the “enhanced longevity” approach is, appropriately, gaining steam. We would encourage healthcare practitioners to regard all men with a prostate cancer diagnosis, including those over 70, as having expectations of a full life. These men are willing to make commitments and sacrifices to achieve that.

At The Focal Therapy Clinic, this is a movement we are watching very closely and look forward to sharing more about it. If you are unhappy with your experience of prostate cancer diagnosis and treatment and would like a second opinion, contact us to book a no-obligation appointment today.

If you have thoughts, insights, stories and experiences around ageing you would like to share, please get in touch at [email protected] — we’d love to hear from you.