Tania Kalsi

• MBBS MRCP MD
• Consultant at Guy's and St Thomas' NHS Foundation Trust

Introduction Older women with ovarian cancer have worse outcomes. Geriatric assessment (GA) may predict outcomes and improve chemotherapy tolerance. Many patients globally do not have access to geriatric oncology services and GA is not routine practice in the UK. This study assessed feasibility of undertaking GA and protocol-led geriatric intervent...

Simple Summary People are more likely to develop cancer as they become older, and as people live longer, the number of older adults with cancer is steadily increasing. Managing cancer in older adults is challenging because they often have long-term conditions and wider needs that complicate treatment decisions and outcomes. However, the care of old...

The development of a Diabetes-Oncology liaison service for cancer patients with diabetes undergoing chemotherapy Utkarsh Dutta1, Alice Smith1, Yuk-Fun Liu2, Rosarie Atkinson2, Anna Brackenridge2, Tania Kalsi1,2. 1King’s College London, London, United Kingdom. 2Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom. INTRODUCTION Older p...

The ageing population poses new challenges globally. Cancer care for older patients is one of these challenges, and it has a significant impact on societies. In the United Kingdom (UK), as the number of older cancer patients increases, the management of this group has become part of daily practice for most oncology teams in every geographical area....

Objectives Older women are increasingly undergoing surgery for gynaecological malignancies. Although survival data is available other outcomes such as functional recovery are less well described. This systematic review and narrative synthesis describes functional recovery after gynaeoncology surgery with respect to baseline characteristics. Materi...

Background: National cancer strategy calls for comprehensive assessments for older people but current practice across the United Kingdom is not well described. Aim: To identify current assessment methods and access to relevant supporting services for older people with cancer. Methods: A web-based survey (SurveyMonkey) targeting health professi...

Background It is widely accepted that advancing age is associated with worse COVID-19 outcomes. However, there is insufficient data analyzing the impact of COVID-19 in the older cancer population. The aim of the study is to establish if age has an influence on severity and mortality of COVID-19 in cancer patients. Methods We reviewed 306 oncology p...

Introduction Older women are increasingly undergoing surgery for gynaecological malignancies. Although survival data is available other outcomes such as functional recovery are less well described. However older people are both more vulnerable to changes in function and often prioritise function over survival. There is limited published research ex...

Introduction The COVID-19 pandemic has disproportionately affected frail older people living in care homes. In the United Kingdom, care homes are largely run by private providers with healthcare accessed through general practitioners and community/hospital services. As a care home provider, there is a need not only to reflect on the challenges, but...

Introduction 20% of cancer patients have pre-existing diabetes. Corticosteroids are an important part of supportive treatment with chemotherapy but risks hyperglycaemia during chemotherapy. Objectives 1. To evaluate how glycaemia is assessed and monitored in older cancer patients undergoing chemotherapy with steroids 2. Develop a clinical pathw...

Introduction Comprehensive Geriatric Assessments (CGA) and multi-disciplinary meetings (MDMs) are effective in improving decision-making and outcomes but is less evaluated in the setting of care homes without nursing. This quality improvement project evaluates feasibility and effectiveness of delivering CGA using MDMs in care homes without nursing....

Introduction The COVID-19 pandemic has disproportionately affected care homes. Southwark and Lambeth are two inner city London boroughs with high levels of social deprivation that were affected early in the UK’s first wave of COVID-19 infections. During the crisis, it became immediately apparent the care homes in these boroughs needed a rapid escal...

Introduction: Prostate cancer is common in older men. Androgen Deprivation Therapy (ADT) is an effective treatment but is associated with long-term medical complications including osteoporosis, hypertension, type 2 diabetes, hypercholesterolaemia, obesity and ischaemic heart disease. Despite this, there are no national/international guidelines on h...

Background The number of older people with cancer has been steadily increasing. Treating older people with anticancer treatments is challenging due to comorbidities, polypharmacy, poorer performance status and underrepresentation in clinical trials. An innovative service, GOLD, has been set up in our Cancer Centre. GOLD delivers comprehensive geria...

Background Survival from cancer in older patients is poorer in the UK than other countries with similar health systems and wealth possibly due to undertreatment and increased toxicities in this specific population. This population-based observational study describes factors affecting systemic anticancer treatment (SACT) use in older patients in Eng...

The incidence of most gynaecological malignancies rises significantly with increasing age. With an ageing population, the proportion of women over the age of 65 with cancer is expected to rise substantially over the next decade. Unfortunately, survival outcomes are much poorer in older patients and evidence suggests that older women with gynaecolog...

Oncology services do not routinely assess broader needs of older people with cancer. This study evaluates a comprehensive geriatric assessment and comorbidity screening questionnaire (CGA-GOLD) covering evidence-based domains and quality of life (EORTC-QLQ-C30). Patients aged 65+ attending oncology services were recruited into (1) Observational coh...

The Association of Cancer Physicians in the United Kingdom has developed a strategy to improve outcomes for cancer patients and identified the goals and commitments of the Association and its members.

Background: Although comorbidities are identified in routine oncology practice, intervention plans for the coexisting needs of older people receiving chemotherapy are rarely made. This study evaluates the impact of geriatrician-delivered comprehensive geriatric assessment (CGA) interventions on chemotherapy toxicity and tolerance for older people...

Background: Although comorbidities are identified in routine oncology practice, intervention plans for the coexisting needs of older people receiving chemotherapy are rarely made. This study evaluates the impact of geriatrician-delivered comprehensive geriatric assessment (CGA) interventions on chemotherapy toxicity and tolerance for older people w...

An evidence-based guidebook that will assist the physician to manage the older cancer patient implementing the appropriate treatment strategy taking account of comorbidities, frailty, and patient choice. Each clinical case will include a concise discussion on patient presentation and of scenarios underpinning issues experienced by older patients fo...

Background: Significant toxicity in chemotherapy trials is usually defined as grade ⩾3. In clinical practice, however, multiple lower grade toxicities are often considered meaningful. The purpose of this observational cohort study was to identify which level of toxicity triggers treatment modification and early discontinuation of chemotherapy in o...

Abstract Background: With a growing number of older people undergoing cancer treatment, identifying their wider needs is becoming increasingly important. CGA screening in non-UK studies have identified broader issues, but tools are too lengthy to implement in the busy NHS oncology clinic setting. We evaluated a briefer self-reporting CGA screening...

Introduction: There is increasing interest in identifying frailty in older people with cancer to aid treatment decision-making. Frailty has been described as a model of deficit accumulation (eg. a frailty index as described by Rockwood1 or “the Balducci criteria”2) and as a phenotype (eg. Fried3). Whether different frailty diagnostic criteria agree...

Background: Outcomes for older people with cancer are poorer in the United Kingdom compared with that in other countries. Despite this, the UK oncology curricula do not have dedicated geriatric oncology learning objectives. This cross-sectional study of UK medical oncology trainees investigates the training, confidence level and attitudes towards t...

A 29-year-old lady presented with an increasingly swollen tongue 3 days after commencing oseltamivir (Tamiflu) for flu-like symptoms. Once identified as the cause, her symptoms rapidly improved with antihistamines and discontinuing the Tamiflu. The authors find only one other case in the literature reporting this very rare side effect.

PEACE (Proactive Elderly Advance CarE) is an advance care planning (ACP) developed at two acute hospital sites in London, UK, for care home (nursing) residents prior to discharge. Patient's preferences are documented, or in the cases of mental incapacity, best interests decisions are made, to give clinical advice and escalation decisions for future...