Next Decade to See Boom in Older Cancer Survivors

New Challenges for Health System as 42% Increase Expected by 2020

By Salynn Boyles
WebMD Health News

Reviewed by Laura J. Martin, MD

Oct. 6, 2011 -- The number of older Americans living with cancer or who are long-term survivors of the disease will rise dramatically over the next decade, a new analysis shows.

By 2020, more than 11 million cancer survivors will be 65 years old or older, representing a 42% increase in just 10 years, according to projections from the National Cancer Institute (NCI).

Largely because older cancer patients and survivors tend to have other health problems, the challenges of caring for them will increase with their numbers, says Julia H. Rowland, PhD, who directs the NCI's Office of Cancer Survivorship.

In a study published in the October issue of Cancer Epidemiology, Biomarkers & Prevention, Rowland and colleagues characterized older cancer survivors as "overlooked, understudied, underserved, and vulnerable."

"We will see a wave of older adults with cancer or with a history of cancer as baby boomers grow older," she tells WebMD. "The good news is that cancer is no longer a death sentence. It is a disease that can be cured and people often live for many decades after treatment. But we have a lot to do to prepare for the unique challenges that older cancer patients and survivors present."

A Patient's Perspective

Oncology nurse Lillie Shockney, RN, knows all too well the challenges facing the health care system and older cancer patients and long-term survivors.

A two-time breast cancer survivor, Shockney directs the Johns Hopkins Breast Center and is a long-time advocate for patients with the disease.

Her first breast cancer was diagnosed 19 years ago when she was in her mid-30s. She was treated for a second, unrelated cancer in her other breast two and a half years later.

"I understand the issue from both sides. I have been living and breathing it for many years," Shockney tells WebMD.

She says one big concern is that there will be a major shortage of oncologists in years to come as medical students choose more lucrative specialties.

By one estimate, there will be a need for about 3,800 more oncologists in the U.S. than will be practicing within a decade.

"We will have a lot more people to take care of, with far fewer oncologists to take care of them," she says.

Increase in Cancer Survivors

In the four decades since President Nixon declared a "war on cancer" while signing the National Cancer Act, the number of cancer survivors in the U.S. has increased about fourfold, from 3 million to 12 million.

The newly reported projections were made by analyzing data from the NCI's Surveillance, Epidemiology and End Results (SEER) registry, which tracks cancer incidence and survival in the U.S.

The analysis revealed that:

  • Close to 60% of cancer survivors in the U.S. are aged 65 or older, and this figure is projected to rise by 3% by 2020.
  • The vast majority of people over the age of 65 with a cancer history will be free of cancer, but most will have other health conditions that may be complicated by past cancer treatments.

Shockney says general practitioners, nurse practitioners, and other health care professionals will increasingly be called on to treat noncancer-related conditions in older cancer survivors.

"In the past, oncology specialists have followed cancer survivors for the rest of their lives, but that is not going to be possible in the future," she says. "There is an urgent need to include cancer survivorship care into medical school and residency programs for primary care doctors."


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SOURCES: Parry, C. Cancer Epidemiology, Biomarkers & Prevention, October 2011; vol 20: online edition.Julia Rowland, PhD, director, National Cancer Institute Office of Cancer Survivorship.Lillie Shockney, RN, director, Johns Hopkins Breast Center; associate professor, Johns Hopkins University School of Medicine and School of Nursing.News release, American Association for Cancer Research.Journal of Clinical Oncology, April 12, 2007; vol 25. ©2011 WebMD, LLC. All Rights Reserved.