NAEDI did a good thing on older age

The near total absence of older people in the media, news and charity PR that otherwise surrounds stories of cancer - a disease of ageing - is, as any regular readers might know, a deep interest of mine. I’ve spotted an unexpected item in Cancer Research UK’s bragging area, referencing age. Hat tip to them for their role in generating it.   

In the NAEDI newsletter (National Awareness and Early Detection Initiative, for cancer) number 12 from December 2014, the Early Diagnosis Advisory Group, who do “policy relevant research or activities that add to the scientific evidence base to achieve earlier diagnosis and enable better access to treatment” announced the results of their most recent funding call.

They have awarded five project grants, of which two feature older people.  

1.     The media’s representation of cancer and how it may affect older adults’ understanding of cancer risk and help-seeking behaviour

2.     How older people’s fatalistic attitudes towards ill health and dying may connect to help-seeking behaviours.

I haven’t spotted who either of the project leaders are, nor how much is being spent yet, but these are exactly the kinds of research questions that should be asked – so I’ll find who is. I wonder if whoever is in charge of 1 might observe how often cancer charities a) are a catalyst for all cancer media coverage and then b) in what proportion older men and women feature, (which will be low) and then uncover how often cancer charities even tried to get older men and women with or at risk of cancer into those stories. By ‘older’ I don’t mean 55, I mean 70, 75  and more……

My preliminary conclusion, reached without the benefit of any of grant money or research evidence and led by dipping into my vat of prejudice instead, is that there is no useful general media coverage that models cancer risk and help-seeking behaviour (however inaccurately) for men and women post working age. Most of what cancer charities do in the media for raising brand awareness and increasing fundraising is built on the critical mass of ‘younger’. Similarly, this is how their anti-cancer health promotion in the media is also orientated.  

In addition, the media is at best ambivalent about old people. At worst downright antagonistic. Media engagement with cancer is founded on seeking out the stories of unusually young people with it. This is compounds their separate aversion - to the cancer stories of older people. Combine the chronic gerontophobia of the media with its appetite for news of celebrity support for the fundraising and brand of any cancer charity and older people have never had their proper place in the cancer story.   

I’m not quite so sure about 2 – but I mean I lack information, rather than the project lacks meaningful insight. There is something deeply wrong with the language of cancer around age and older age and this must influence older people.

It’s muffled - so some old people will be fatalistic due to woefully low expectations, maybe derived from personal experience but still decades in the past. Thus their lives are shortened or lived in far more discomfort than necessary through not seeking help promptly.

It’s muddled – so older people are exposed to the weird perky undertone of much cancer rhetoric in the media, where ‘life saving’, ‘all clear’ and ‘cure’ feature.  This, I suppose, might create some totally unrealistic expectations in a subset of older people who, instead of being fatalistic, go completely the other way and don’t spot that the cancer story of a 42 year old Mum is not going to be very similar to the story they can expect as e.g. an 82 year old great grandma with a different cancer and some co-morbidities.  

And finally, the supposed fatalism of older people might be nothing of the sort. It could be entirely rational, because cancer does frequently present the life ending outcome as commonly feared - and which is so often brushed past in the media. The skill is to tread the middle path alongside older people – to dismantle the fatalism where treatment and care are delayed, causing considerable harm, whilst also avoiding badly written plot diversions in the last chapter, towards the comfort, for the teller, of the sentimentalised 'life beyond cancer’ which may not be on offer for a sizeable group of older people with a sizeable range of cancers. 

Instead, offer palliation fully, skillfully and in time.

Cancer is all about stories – in the news, from the GP, the nurse or the neighbour, in the home and in the one in your head, too. Cancer charities and the media need to create another one, for older people. There will be little that is good in the status quo but, through NAEDI, someone is about to quantify that baseline. Good.