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Researchers Say Older Women Face Bias in Cancer Treatment

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Older women with breast cancer often face age bias when it comes to screening and treatment for the disease, researchers say.

Women over 70 with breast cancer are less likely than their younger counterparts to be offered screenings, participation in clinical trials, chemotherapy, radiation and other treatment options, several researchers said during a panel discussion at the San Antonio Breast Cancer Symposium.

The differences in treatment are a result of widely held misconceptions about the older breast cancer patient, said Dr. Ian Fentiman, an oncologist at Guy's Hospital in London.

``There are people treating older women in a very stereotyped way,'' he said.

Often, effective treatments aren't recommended for older female patients with breast cancer because physicians see them nearing the end of their lives and believe it's ``unkind'' to intervene aggressively, Fentiman said.

But there is mounting evidence that older patients respond favorably to a number of treatment options.

Radiation is withheld from older women because of fears, in some cases, of possible cardiac damage, Fentiman noted. But too often, physicians don't recommend it because they don't believe their aging patients can tolerate it, he said.

``The main reason they don't tolerate it is because they're not offered it,'' he said.

Studies also show doctors should consider standard chemotherapy for older women who are in good general health and whose tumors would respond to the treatment regimen, said Dr. Hyman Muss, director of oncology at the University of Vermont.

But the number of other health conditions that can exist alongside breast cancer in older women makes things challenging for physicians, Muss acknowledged. Conditions such as hypertension, diabetes and arthritis can complicate care, he said.

The panel discussion, which occurred Saturday on the last day of the respected symposium, also touched on ways to improve breast cancer care in minority populations.

Dr. Harold Freeman, of the Ralph Lauren Center for Cancer Care and Prevention in New York City, highlighted an ongoing program in Harlem that has helped improve early-stage breast cancer survival rates over the last decade.

The initiative is aimed at helping minority, low-income breast cancer patients at Harlem Hospital navigate the health care system to get effective treatment.

When a patient receives abnormal test results, she is paired with a ``navigator'' who helps guide her through the process of diagnosis, treatment and overall survival of breast cancer.

Freeman said African-American women have the highest death rates from breast cancer of any group even though white women face the highest incidence of breast cancer.

``Race is operating somehow in this country as a negative,'' said Freeman, who also directs the Center to Reduce Cancer Health Disparities at the National Cancer Institute.

Health disparities are driven by ``the human condition in which people live,'' which can include factors such as poverty, the lack of health insurance, low education and economic status, he said.


(The San Antonio Express-News web site is at

c.2003 San Antonio Express-News

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