The leading risk factor for cancer is not smoking, alcohol, or sun exposure, but rather something far more insidious and unavoidable: ageing. This is a critical insight, especially as the global population of older adults is rapidly growing. By 2068, approximately 29% of Canadians will be over the age of 65, and cancer is one of the most prevalent diseases in this demographic. This demographic shift demands a reevaluation of cancer care, particularly for older adults, who often face unique challenges and complexities in treatment. While international guidelines advocate for geriatric assessments to guide cancer treatment decisions for older adults, the reality in Canada is far from ideal. Currently, only a handful of specialized geriatric oncology clinics exist, and their implementation is not widespread. This is despite overwhelming evidence of their cost-effectiveness and benefits to patients. The barriers to implementing these services are multifaceted. Cost is a significant concern, but with demonstrated cost savings, it's a non-issue. Health human resources, particularly the shortage of geriatricians, are another challenge. However, nurse-led models show promise as a more affordable and innovative solution. Inertia within the clinical care model, which has remained largely unchanged for decades, also hinders progress. But perhaps the most insidious barrier is agism, the discrimination based on age. We would never accept a scenario where children diagnosed with cancer couldn't access pediatricians, yet we often overlook the need for specialized geriatric services for older adults. The solution lies in stratifying care programs around those who need them most: the frailest and most vulnerable. This approach not only improves quality of life but also has significant financial implications. While personal stories and international guidelines may not sway decision-makers, the potential for cost savings could be the tipping point needed to drive change. In my opinion, the future of cancer care for older adults lies in embracing innovation, addressing resource constraints, and challenging ageist attitudes. It's time to revolutionize the way we care for our ageing population and ensure they receive the specialized treatment they deserve.
