Rising to the medication's requirements: The experience of elderly cancer patients receiving palliative chemotherapy in the elective oncogeriatrics field

• Published in: Social science & medicine Vol. 242; p. 112593
• Main Authors: Foley, Rose-Anna, Hurard, Lucie Lechevalier, Anchisi, Annick, Anchisi, Sandro
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.12.2019; Pergamon Press Inc; Elsevier
• Subjects: Cancer; Cancer therapies; Chemotherapy; Decisions; Drugs; Elderly; End of life; Ethical dilemmas; Experience; Frail; Humanities and Social Sciences; Interviews; Medical personnel; Medicine; Medicines; Older people; Oncogeriatrics; Oncology; Palliative; Palliative care; Patient satisfaction; Patients; Photography; Physical ability; Resistance; Sociology; Switzerland; Tolerance; Treatment methods; Chemotherapy; Experience; Oncogeriatrics; Medicines; Palliative; Decisions; End of life; Switzerland; Elderly
• ISSN: 0277-9536; 0037-7856; 1873-5347
• DOI: 10.1016/j.socscimed.2019.112593

A new subfield of oncology has emerged in the last twenty years to raise awareness and address the specific needs of elderly cancer patients, a population that was long neglected in oncology. We sought to understand the individual experiences, as well as moral and social implications of considering elderly cancer patients as “treatable”. Following an anthropological critical interpretative approach focusing on practical and symbolic effects of chemotherapy in a rapidly evolving medical field, we conducted 20 semi-structured interviews and observations of medicine storage places at home among elderly cancer patients aged 70 and over in a clearly incurable situation receiving palliative chemotherapy. We used photographs representing paths as triggers in interviews, and compared the patients' views with those of 12 health professionals in oncology during a brief open-ended interview. Elderly cancer patients consider themselves to be survivors and fighters. Their long trajectory is a result of their successful struggle and tolerance of the treatments allowing them to carry on. They continually observe their physical ability and test their resistance, they resist complaining and are grateful to have cancer at a late stage of life. By highlighting their active life rather than the treatment inconveniences, they show they are “young elderly” persons, capable of keeping active physically. They are treated precisely because they demonstrated that they had the physical and moral capacity to take the hit of the chemotherapy to their bodies and had the will to fight. The development of oncogeriatrics has enabled the treatment of the fittest cancer patients over 70, but the ethical debate to treat some elderly patients and not others, and decisions of therapeutic abstention facing frail elderly cancer patients remains an issue rarely discussed. This aspect should not be eluded by the important progress achieved in medicine facing cancer. •Unique focus on elderly cancer patients receiving palliative chemotherapy.•Retraces the emergence of oncogeriatrics.•Combines interpretative and critical medical anthropology.•Reveals life and death medical decisions facing the elderly.