Developing an electronic geriatric assessment to improve care of older adults with cancer receiving radiotherapy

Abstract

Older adults make up a substantial proportion of patients diagnosed with cancer. Gaps in evidence of care for older adults with cancer leads to treatment heterogeneity and poor outcomes. Medical and Surgical Oncology clinics throughout the world are increasingly using Geriatric Assessment (GA) based approaches to treatment that are beginning to improve care through treatment decision-making communication, health-related quality of life outcomes, and reducing chemotherapy toxicities. Yet, GA based approaches are not often used in radiation oncology clinics. This manuscript aims to describe the ongoing development of an electronic patient-reported GA with real-time data interpretation and recommendation delivery to help increase the use of a personalized GA based approach to the care of older adults within radiation oncology clinics. Future studies demonstrating the utility and benefit of GA based approaches to help older adults undergoing radiotherapy for their cancers are still sorely needed.

Radiation Therapy in Older Adults With Cancer: A Critical Modality in Geriatric Oncology

“…29 In fact, several radiation oncology clinics have already begun implementing these tools in clinics to help with shared decision making per ASCO/ National Comprehensive Cancer Network guidelines. 36,37…”

Older adults and the unique role of the radiation therapist: Future directions for improving geriatric oncology training and education

“…This can result in increased risk of falling, infection, increased levels of fatigue, poor appetite and weight loss, increased chance of hospitalisation, gaps and or cessation of treatment, poor outcomes and diminished quality of life [18]. Hence the implementation of multi-disciplinary geriatric screening and assessment prior to undergoing cancer treatments, including RT, has been advocated [19][20][21][22][23]. The identification of frailty that is potentially reversible can improve health outcomes and enhance quality of care for older adults [18,24].…”

The Impact of Frailty Screening on Radiation Treatment Modification

“…This group implicitly has a lower functional reserve, is more likely to become frail, and is more vulnerable to stressors such as cancer or its treatments [ 5 , 6 ]. These factors, coupled with a lack of evidence, can sometimes lead to the omission of curative treatments, or in contrast, to the application of aggressive treatments [ 7 ]. In this sense, the comprehensive geriatric assessment (CGA), which analyzes functionality, comorbidities, polypharmacy, nutritional and psychological status, cognitive ability, and social support has been shown to be an excellent predictor of morbidity and mortality in oncological settings [ 8 , 9 ].…”