Health Literacy is Not just Reading Ability: Rethinking Cancer Education for Older Adults.

Cancer education is often conceptualized as the delivery of simplified information, based on the assumption that improved readability leads to patient understanding. However, this perspective inadequately captures how older adults experience cancer care. Health literacy in oncology extends beyond the ability to read and comprehend written materials to include interpretation, navigation, emotional processing, and confidence within complex healthcare systems. Older adults frequently face overlapping challenges such as sensory impairment, cognitive changes, emotional distress, social isolation, and limited digital familiarity, all of which influence how cancer-related information is received and acted upon. These difficulties are commonly misinterpreted as nonadherence or disengagement rather than manifestations of hidden health literacy barriers. The increasing reliance on digital health technologies further complicates cancer education, as patient portals and electronic communication systems may unintentionally widen disparities among older adults with limited digital confidence. Moreover, cancer information is often interpreted through emotional and social lenses, including fear, stigma, and prior illness experiences, rather than biomedical reasoning alone. This paper argues for a broader, more contextualized understanding of health literacy in cancer education and emphasizes the importance of interactive, relational, and longitudinal communication approaches to support meaningful understanding and patient-centered cancer care among aging populations.