Article

Geriatric oncology research to improve clinical care.

James Wilmot Cancer Center, University of Rochester, 601 Elmwood Avenue, Box 704, Rochester, NY 14642, USA.
Nature Reviews Clinical Oncology (Impact Factor: 15.7). 07/2012; 9(10):571-8. DOI: 10.1038/nrclinonc.2012.125
Source: PubMed

ABSTRACT Cancer incidence increases with advanced age. The Cancer and Aging Research Group, in partnership with the National Institute on Aging and NCI, have summarized the gaps in knowledge in geriatric oncology and made recommendations to close these gaps. One recommendation was that the comprehensive geriatric assessment (CGA) should be incorporated within geriatric oncology research. Information from the CGA can be used to stratify patients into risk categories to better predict their tolerance of cancer treatment, and to follow functional consequences from treatment. Other recommendations were to design trials for older adults with study end points that address the needs of the older and/or vulnerable adult with cancer and to build a better infrastructure to accommodate the needs of older adults to improve their representation in trials. We use a case-based approach to highlight gaps in knowledge regarding the care of older adults with cancer, discuss our current state of knowledge of best practice patterns, and identify opportunities for research in geriatric oncology. More evidence regarding the treatment of older patients with cancer is urgently needed.

Full-text

Available from: William Dale, Apr 18, 2015
1 Follower
 · 
147 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Treatment for prostate cancer (PCa) has evolved significantly over the last decade. PCa is the most prevalent non-skin cancer and the second leading cause of cancer death in men, and it has an increased incidence and prevalence in older men. As a result, physicians and patients are faced with the challenge of identifying optimal treatment strategies for localized, biochemical recurrent, and advanced PCa in the older population. When older patients are appropriately selected, treatment for PCa results in survival benefits and toxicity profiles similar to those experienced in younger patients. However, underlying health status and age-related changes can have an impact on tolerance of hormonal therapy and chemotherapy in men with advanced disease. Therefore, the heterogeneity of the elderly population necessitates a multidimensional assessment to maximize the benefit of medical and/or surgical options. Providing clinicians with the requisite health status data on which to base treatment decisions would help ensure that older patients with PCa receive optimal therapy if it will benefit them and/or active surveillance or best supportive care if it will not. We provide a review of the existing evidence to date on the management of PCa in the older population.
    Journal of Clinical Oncology 07/2014; 32(24). DOI:10.1200/JCO.2014.55.1531 · 17.88 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: As a result of vast global improvement of health care and living conditions, the world population is aging. In developed countries, more than half of the cancers occur in patients aged 70 and older. In booming Asian nations, such as India, the aging trend is particularly striking, and therefore geria-tric oncology is rapidly coming at the foreground of oncology practice. As these patients have special needs and a different approach to treatment, there is a strong need for the emergence of ge-riatric oncology as a sub specialty in oncology. Scientific data show that a geriatric assessment identifies many problems in older people with cancer, adds prognostic information, and might improve the outcomes of these patients. There is a genuine unmet requirement to design and implement the following: development of individually tailored geriatric assessment tools for different oncology centers; cooperation of aging and cancer research in the understanding of cancer biology , aging and physiology; improved clinical study designs; development of geriatric oncology programs; and screening tools for geriatric patients made accessible to family physicians.
  • [Show abstract] [Hide abstract]
    ABSTRACT: With the aging of our population, the prevalence of prostate cancer is anticipated to rise dramatically. Consequently, physicians will be confronted with the challenges of managing prostate cancer and treatment side effects in older men. The maintenance of mobility and functional independence, which are fundamental goals of the aging patient with cancer, should not be overlooked when choosing treatments and their toxicities focused on cancer control. Consistent with the SIOG (International Society of Geriatric Oncology) guidelines, we recommend standard approaches for older patients with prostate cancer who are fit. Vulnerable patients should also receive standard treatment, provided their health status can be maintained with appropriate interventions. Treatment for frail patients should be adapted to their health status and supportive care interventions should be considered. Individualized treatment plans should take into account patient's remaining life-expectancy from coexisting comorbidities and disability, aggressiveness of the prostate cancer, treatment preferences as well as potential adverse effects of treatment.
    Journal of Geriatric Oncology 09/2014; 5(4). DOI:10.1016/j.jgo.2014.09.177 · 1.15 Impact Factor