Recurring theme…. ageism & cancer

About 10,000 men die each year in the UK as a result of prostate cancer. About 36,000 men are diagnosed with prostate cancer and fear they may die. Many of those 36k won’t die any time soon, not from prostate cancer. Which is good. Some will of course, but most probably not in the next five years, nor even in the next ten. 

 

The diagnosed group are the ones in the media headlines. There are more younger men in that group. The under 65s. By and large, these are not the bulk of men doing the dying. 

 

For each of the men who die of prostate cancer under the age of 70 there are another 6 men who will die over the age of 70.

 

You wouldn’t have heard their stories in the media, seen their pictures or spotted them in headlines. If we’re not seeing them are they simply OK? Or are they denied equitable treatment, delivered in timely fashion, with compassion? We can’t even feed elderly people in hospital so I’d not assume older men dying from prostate cancer are immune to the vagaries of ageist, don’t carist, care and support.

 

Each of those 10,000 men lived through a process of dying – often over some years, requiring just as much, if not more, information and support as younger men who have just been diagnosed with an early cancer. Treatments become less effective, are modified and modified again. Visits to hospital come more closely together. Eventually those men meet new staff who will look after them, with familiar names like pain, community nurse or Macmillan or with unusual names like palliative or hospice or Marie Curie. Then there are more scans, more X rays, more discussion about declining health. The occupational therapist comes and makes helpful suggestions about getting around at home safely, more easily. Some delivery men come with a new bed for downstairs. Over the weeks eating and drinking becomes a bit of a chore. Then you only want to sit in your pyjamas hoping Teletubbies will be on soon, willing some peace and quiet out of thin air. And your back aches.

 

About 36,000 men pay a mental cost for their diagnosis. We spend much time and energy looking after them. Which is as it should be. The physical costs will exist too, but these are often from the treatment, not the cancer.  

 

The 10,000 men who die are struggling with the worst actually happening rather than fearing that it might. The cost of cancer is paid in their life lost, not just in the side effects of treatment or mental pain. Five out of six of those 10,000 men – the ones who die over 70 - won’t be the subject of  media scrutiny or policy prioritisation in health service delivery.

 

We don’t spend much time and energy keeping a campaigning eye on them, their rights, their expriences. And that’s not as it should be. Sometimes advocacy by 'patient voice' has a down side and this is one of them. Younger men, of working age or early retired are most likely to do the advocacy and they are not the best advocates for older men with prostate cancer. They may even deliberately avoid being identified as 'older men', keen to comment 'it's not just older men who get prostate cancer'. 

 

True, but why the 'just'? What does their special pleading signify? Are we expected to agree that there would be no point to prostate cancer campaigning if it was just older men?

 

Prostate cancer survivorship for older men is uniquely concerning as it is a lot of men, older men, dying over some years, not just in the difficult last few weeks.

 

Just how bad does it have to get for older men to be noticed?