Journal of the American Medical Directors Association
Clinical ExperienceOnco-Geriatric Approach for the Management of Older Patients with Cancer
Section snippets
Methods
Since 2007, through a Swiss Bridge Foundation (Zurich, Switzerland) award, we have been conducting a 3-year study (Figure 1) aimed at the evaluation of the impact of an onco-geriatric unit on several patients’ outcomes. The primary aim of the project is to assess whether assigning a geriatrician to provide daily medical care to older cancer patients (aged 65 years and older) admitted to an oncology ward may increase the number of patients eligible for a chemotherapeutic and/or surgical
Outcomes
Structured cooperation within a multidisciplinary team between oncologists and geriatricians needs to be carefully considered to provide adequate medical care for a graying cancer population.72 Such clinical activity can be defined as a coordinated effort of medical oncologists, surgeons, geriatricians, physiotherapists, nurses, and social workers. The activation of such geriatric oncology programs or onco-geriatric units could be a relatively easy organizational measure to take. This approach
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Palliative radiotherapy in the older adult
2023, Palliative Radiation OncologyPersonalised treatment for older adults with cancer: The role of frailty assessment
2020, Technical Innovations and Patient Support in Radiation OncologyCaring for older cancer patients: A scoping review
2020, Health PolicyCitation Excerpt :As it was considered to be the basis for coordinated and integrated care, it was advocated as the first step in an optimal management of older patients with cancer [17,19,29,33,41,42,45,65,66]. This tool is found not only to be able to help identify unmet and potentially treatable psychological, social and physical needs, but it was also greatly informative for optimizing and tailoring treatment decision-making and improving health outcomes [16,29–31,43,50,60,67,68]. Despite this recognition as the “gold standard” of care, some called for further defining how to interpret and apply the information the CGA provided [37,56,69].
Access to individualized oncology care for older patients in complex healthcare networks: The skilled nurse option
2020, Journal of Geriatric OncologyCitation Excerpt :The nurses collect sociodemographic and clinical data, as well as administer the G8 Questionnaire [3]. They also carry out a ‘first line’ comprehensive geriatric assessment (CGA) as recommended by oncologic societies and the scientific community [1,4–7]. The following questionnaires/scales are completed: Activities of Daily Living scale (ADL), Instrumental ADL (IADL), Mini-Nutritional Assessment (MNA), and Mini-Mental State Examination (MMSE) if the referring physician and/or the nurse suspect a cognitive impairment.
A smartphone Chatbot application to optimize monitoring of older patients with cancer
2019, International Journal of Medical InformaticsCitation Excerpt :Beyond the well-known and feared treatment-related side effects (e.g. severe neutropenia) [2,3], cancer treatments and more particularly chemotherapy could accelerate functional decline [4,5]. Determining personalized treatment protocols supposes to accurately evaluate patients’ functional reserve upstream [6–10]. This is of particular concern in patients with advanced age, poor social conditions, limited access to primary care providers, or living in rural areas [11].
Breast cancer among older women: The influence of age and cancer stage on survival
2018, Archives of Gerontology and GeriatricsCitation Excerpt :For example, a median overall survival of 15.9 months was reported among 34 patients (median age, 74 years; range, 70–84 years) who were treated with oral Vinorelbine as first line treatment (Addeo et al., 2010). Nonetheless, elderly individuals are under-represented in well-designed studies (Early Breast Cancer Trialists' Collaborative Group, 2011), which tend to exclude subjects with very advanced age, frailty, high comorbid burden, cognitive decline, and nursing home status (Cesari et al., 2011). Indeed, overall survival in unselected cohorts of metastatic breast cancer patients seems inferior to survival among clinical trials (Andre et al., 2004).
The authors have declared they have no conflicts of interest.