Ageism or not ageism that is the question.

Dear Aedh Wishes,

Thanks for reaching out to Macmillan today. I’m Kirstine, one of the information nurses here. I’ll do my best to tread softly as I can appreciate what an upsetting time this must be for you and your mother.

It’s difficult for me to comment on the type of cancer your mum may have but I expect the specialist team at the hospital will be forming a strong opinion of what they are looking at from any tests and investigations they are able to carry out for your mum.

Age alone should never prevent a person being offered treatment if it is deemed suitable for them and the type of cancer they have. You might find our booklet Cancer and Older People helpful to read. Doctors will always try to assess the individual holistically and to weigh up the risk and benefits of any given treatment they are considering. They might not recommend a treatment if they think it will not help, or if they feel the side effects may be too severe. Unfortunately, with age we are much more likely to experience degenerative changes, frailties or other health conditions that could make tolerating harsh treatments like chemotherapy much more challenging.

It is not unusual for people to decline the offer of further treatment; it is a situation that the team will encounter regularly. Some people chose not to have treatment that might make them feel more unwell and elect to have the best quality of life they can in the time they have left. This is very much an individual decision and equally as valid a choice as having treatment.

How a cancer progresses and what may happen towards the end of life if a cancer cannot be, or is not, treated varies from person to person, but support will be available from the healthcare team. If the person with cancer developed a complex pain or symptom, they may be referred to the local Palliative Care Team, who, along with the GP, would help to keep the symptoms manageable and provide ongoing emotional support. You might also find it helpful to read our booklet on managing symptoms of cancer.

Before asking for a second opinion, it’s worth asking the consultant team to go over the diagnosis and explain anything you or your mum don’t understand. If your mother is unhappy with the diagnosis or would like to consider a different course of treatment, she can discuss this with them. The consultant team will be happy to explain things, and, in many cases, there may be no need for a second opinion.

If you are both still unhappy, speak to the GP. They will be able to refer for a second opinion, either on the NHS or privately.

When somebody is referred for a second opinion, their medical information will be sent to the new doctor or specialist. This will include any scans, test results and any earlier treatments they have had. If needed, the new specialist can ask for information from the original doctor and hospital. This process can take some time to complete though and may lead to the same information being given that you already know which can be disappointing for many people. It may also involve additional travelling if the new hospital is further away and it’s important to weigh up how this might feel for mum, especially if she chooses to have treatments.

After having the second opinion, if mum wanted to be treated under the second doctor, this would need to be formally agreed and arranged with them.

For anyone who might choose to go for a second opinion, we would encourage discussing or informing the initial consultant team about this. If there is a serious medical condition requiring urgent treatment, we advise discussing this with the team and ask whether any delay in starting treatment could affect immediate wellbeing or overall outcomes.  

I hope this information is helpful for you today. Please don’t hesitate to come back to us again here at the Online Community, or through our Support Line if you’d like to chat in person with a nurse.

Wishing you and your mum all the best with this decision.

Take care,

Kirstine – Macmillan

Cancer Information Nurse Specialist

Our ref: KDf/ AT