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Geriatric Oncology

The nation’s demographics are shifting dramatically. The number of Americans age 65 and older is projected to nearly double from 52 million in 2018 to 95 million in 2060, bringing the 65-and-older age group from 16 percent to 23 percent of the total U.S. population.1 By 2030, researchers estimate that 70 percent of cancers will be diagnosed in older adults.2 The population of cancer survivors is increasing accordingly. While 64 percent of cancer survivors in the U.S. are currently age 65 and older, researchers estimate that by 2040, 73 percent of U.S. cancer survivors will fall into that age range.3

Effectively Engaging Caregivers to Support Your Older Adult Patients with Cancer

Speakers discuss several aspects of caregiver engagement, including tools and strategies cancer team members can use to assess and engage caregivers and legal concerns and implications for teams working with caregivers. The speakers will offer you a range of resources to support your work with caregivers as well as to offer to caregivers themselves.
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Thank you to EMD Serono for supporting this through its Embracing Carers™ program.

 

Featured Programs

Age-Friendly Health Systems: Oncology Action Community

Learn how your cancer program can implement the 4Ms Framework of Age-Friendly Care. The Action Community is a network of teams from across different health systems who come together to accelerate their own adoption of the 4Ms and to test and adopt age-friendly care.

Multidisciplinary Approaches to Caring for Older Adults with Cancer

ACCC will identify barriers and best practices for serving this growing patient population in order to help support the multidisciplinary team in understanding and proactively preparing for the impact of our graying nation on cancer prevalence and co-morbidity burden.

From the ACCCBuzz Blog

Geriatric Assessment: One Size Does Not Fit All


May 16, 2019

Spoiler Alert: If you missed this week’s ACCC webinar on “A Review of Validated Tools for Geriatric Assessment and How to Use Them,” this blog post starts with the bottom line takeaway.

Presenter Tanya M. Wildes, MD, cut to the chase in concluding Monday’s webinar: “Let’s agree to stop saying that it [geriatric assessment] is time-consuming!”

Contrary to popular belief, she said, assessments for elderly patients with cancer, do not consume much of a provider’s time. Feasibility studies indicate that an abbreviated geriatric assessment takes about 20 to 25 minutes, of which only 4 to 6 minutes require a provider’s time. Those few minutes are time well-spent, said Dr. Wildes, considering the excessive time providers may have to spend on managing adverse events for older patients who would have responded better to a treatment plan modified for their specific needs. Dr. Wildes is Associate Professor of Medicine at Washington University School of Medicine in St. Louis, Missouri. During the May 13 webinar, she reviewed the development, validation, and utility of the most commonly used geriatric assessment tools.

For the webinar, Dr. Wildes described the differences between geriatric screening tools and geriatric assessments. Both can be used to improve care for senior adult patients. Screening tools can be used to determine whether a patient should be referred for further evaluation; geriatric assessment tools can be used to capture a more comprehensive view of the elderly patient across multiple domains both to refer for needed support services and to determine a patient’s risk for specific negative outcomes.

For elderly patients with cancer, a comprehensive geriatric assessment (GCA) takes into account a series of patient-specific variables—including cognition, function, communication, comorbidities, medications (polypharmacy), social support (both environmental and socioeconomic)—together with toxicity risk calculator tools—to arrive at a risk prediction for potential negative treatment outcomes such as chemotherapy toxicity and early mortality. With this information, said Dr. Wildes, oncologists can more effectively modify cancer treatments and the care team can better understand and address the patient’s supportive care needs.

Dr. Wilde discussed some of the most commonly used validated assessment tools and reviewed current research on their efficacy. Among the most frequently utilized are the CARG Chemo Toxicity Calculator (from the Cancer and Aging Research Group), the CRASH Score Calculator (Chemotherapy Risk Assessment for High Age Patients from the Moffitt Cancer Center), and ePprognosis, an online tool from the University of California San Francisco. Each of these assessments, noted Dr. Wildes, have their respective strengths and weaknesses. Visit the ACCC website for a comprehensive list of geriatric oncology screening and assessment tools and resources.

To address the utility of assessments, Dr. Wildes reviewed a series of published studies that have evaluated the extent to which oncologists modify individual treatment regimens in response to the results of geriatric patient assessments. Among the findings is evidence that providing an oncologist with the results of a senior adult patient’s assessment increases modifications for age-related concerns and improves patient satisfaction with provider communication.

If you missed Dr. Wildes’ webinar or any webinars in ACCC’s series on multidisciplinary approaches to caring for geriatric patients with cancer, you can view them on demand. Join us for the next webinar in the series—Empowering the Multidisciplinary Team to Support Care for Geriatric Oncology Patients—on Tuesday, May 21. All webinars require registration and are free of charge.

 

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References

  1. Population Reference Bureau. Fact Sheet: Aging in the United States. Available online at: https://www.prb.org/aging-unitedstates-fact-sheet.
  2. Smith BD, et al. Future of cancer incidence in the United States: burdens upon an aging, changing nation. J Clin Oncol. 2009;27:2758-2765.
  3. National Cancer Institute Division of Cancer Control & Population Sciences. Office of Cancer Survivorship. Statistics. Available online at: https://cancercontrol.cancer.gov/ocs/statistics/statistics.html.