A Global Look at Cancer Care — On the Precipice of Transformation

Patrizia Saccenti remembers the day her husband Paolo was diagnosed with a rare type of lung cancer seen in only an estimated 5% of patients. It was September 2017, and she noticed her husband’s lymph node in his neck was swollen. They went to the hospital and ordered a chest x-ray; it came back negative. Patrizia was still worried. 

“I took the x-ray to a colleague, and we decided to do a chest CT scan,” Patrizia says. “I followed the scan and halfway through we added liquid contrast. It was all there: A pulmonary nodule with various affected lymph node stations. My husband was still on the CT bed when I told him with tears in my eyes.” 

If Patrizia sounds like she knows more than an average grief-stricken partner, that’s because she does. A retired thoracic surgeon and psychoanalyst, Patricia now advocates for patients suffering from lung cancer in Europe, while also taking care of her husband and their three sons.

Handling the news that a loved one has been diagnosed with cancer is devastating, but the challenges and stress of caring for them — especially if they’re older — can be unique. Ageing cancer patients have to simultaneously manage both their diagnosis and the typical issues of growing older. According to research conducted by the WHO’s International Agency for Research on Cancer, 37% of cancer diagnoses are in people over 70 years old. By 2040, that number is expected to more than double.

Midori Takahashi, Patient, Japan

Caregivers are a vital part of the global cancer community, as they often serve as advocates, assistants, and emotional support for those fighting the disease. But the first-person experience of those dealing with cancer on a personal basis can give a fuller portrait of the cancer landscape, which is why the perspectives of people like Midori Takahashi are so vital. 

Midori Takahashi has been diagnosed with cancer twice. Her first time was in 2007 when she was told she had breast cancer, and then again in March 2021 when she was diagnosed with uterine cancer. “When I was told about my breast cancer… I was quite shocked,” Midori told BBC StoryWorks. “The uterine cancer diagnosis I had this year, I took it in stride.” 

Both times, Midori received comprehensive information about her diagnosis and treatment strategies from her doctor, a layered approach that helped her feel more at ease with her diagnoses. However, as much as the Japanese healthcare system does an excellent job in providing details about care, Midori claims it doesn’t provide the holistic care that many patients need. “Patient support such as livelihood support including for example, how to request an accommodation at your place of work so you can continue to do your job or when and where to reach out for psychological support — these resources continue to be lacking in Japan and we need more help,” she says.

These challenges are exacerbated for older cancer patients, especially as Japan’s population continues to age rapidly. In the next two decades, more than a third of the country’s population will be 65 and older, which means the ageing cancer population — and their unique challenges — will grow in tandem. Although Japan has some of the healthiest older citizens in the world, they will still require a healthcare system that can help them navigate diagnosis and care.

“We need a society where ageing people are supported as community members rather than being cared for solely by healthcare professionals or caregivers,” Midori says, advocating for a more rounded, team-based course of caregiving, “I hope the concept of ‘team’ medical care prevails in our society.”

Dr. Hedva Gonen, Doctor and Survivor of Skin Cancer, Israel

Dr. Hedva Gonen was diagnosed with melanoma in 2013, just as “the ‘revolution’ in melanoma treatments” had started, she says. Her unique position as both a biochemist and a cancer patient gave her a unique perspective on care and advocacy, and provided valuable insights in helping her found and lead the Israeli Association for Skin Cancer. 

Ravindran Kanesvaran, Doctor, Singapore

Beyond caregivers and patients, there is a global network of researchers looking at how new technology and treatments can help improve the outlook of the global cancer community. Dr. Ravindran Kanesvaran, an oncologist, has spent his career investigating how cancer impacts people, especially older patients, and believes that caring for ageing cancer patients will require the medical community to check their own biases.

“When you look at cancer as a whole, it is a disease of the ageing,” says Dr. Ravindran Kanesvaran, a medical oncologist based at the National Cancer Center of Singapore and president of the International Society of Geriatric Oncology (SIOG). The average age for cancer diagnosis worldwide is 65 years old, which means cancer and other health issues that accompany ageing intersect regularly. 

Dr. Kanesvaran’s work with SIOG focuses on bringing comprehensive, effective care to older cancer patients around the globe. Dr. Kanesvaran observes that often, older patients aren’t given the same level of care that younger patients are, due to a common issue: Ageism. “To a great extent, treatment is denied to them because of age” he says. “Ageism is one of the challenges and it impacts the quality of care, which in turn affects outcomes like survival.”

Fighting against ageism in the healthcare system means changing the perception of older patients as a homogeneous group. “We can’t categorize them by age,” he says. Instead, Dr. Kanesvaran advocates for a more personalized level of care, a previously time-intensive practice that is fast becoming a viable option because of advances in technology like genome sequencing and sophisticated data analysis. “There are centers using Big Data to develop tools that make it easier for healthcare practitioners to calculate parameters like toxicity of certain treatments,” Dr. Kanesvaran says.

These technologies are expected to allow for truly personalized care, especially for the older patients who may have conditions that make traditional courses of care impractical. Improved screening techniques can help detect cancer earlier for ageing patients as well, an advance that could help them start treatment earlier. “The hope is that a patient will have their blood taken and you can do analysis and detect predisposition to cancer before it develops,” Dr. Kanesvaran says. “And when you do that, you’re going to be able to help a lot more patients.”

A full picture of cancer includes the perspectives of patients, caregivers, and doctors, which is why Midori, Rogério, Patrizia, Dr. Gonen and Dr. Kanesvaran are such vital components of how the world cares for its cancer patients. Cancer care is transforming one country at a time, and these global outlooks can provide a guide for what needs to change and what transformations we can expect. Cancer patients are growing older and continuing innovation and evolution of care are important to ensure their needs are being met.