Understanding dementia

It is well known that the incidence of cancer increases with age and that the number of people diagnosed is rising, although mortality rates are decreasing due to early diagnosis and improvements in treatment.

As people live longer, healthcare professionals must deal with comorbidities, polypharmacy and age-related issues. In oncology these issues add to the complexity of assessing patients’ suitability for treatment, including determining the most appropriate options and managing side effects. Cognitive impairment is also a significant challenge because it has implications for information provision, decision making, assessment, treatment options and clinical management.

Dementia and delirium are the main causes of cognitive impairment for patients with cancer. In the UK there are 850,000 people with dementia; by 2025 there are likely to be more than one million and by 2050 more than two million (Alzheimer’s Society 2014). Dementia has a significant effect on families who provide informal care. There are approximately 700,000 informal carers and this number is expected to increase to 1.7 million by 2050.

More research is required to improve the care of patients with dementia and cancer, and their families. This research should be a priority for NHS cancer services. There have been many developments at the Christie NHS Foundation Trust since the appointment of dementia nurse consultant Lorraine Burgess, including dementia training for staff, greater links between community and hospital, patient assessments, improvements to ward environments and new menus. Further research is planned.

In 2016, Cancer Nursing Practice aims to publish a series on dementia and cancer to outline new clinical developments and research evidence.