Geriatric Surgical Oncology

Chesney, Tyler R.; Alqurini, Naser; Alibhai, Shabbir M.H.

doi:10.1007/978-3-030-48363-0_13

Cited by 3 publications

(2 citation statements)

References 146 publications

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“…Overall, geriatric assessment aims to (i) identify geriatric impairments, (ii) provide management strategies for deficits to maximize benefit of geriatric assessment, (iii) estimate prognosis and treatment intolerances, (iv) ascertain dominant comorbidities with greatest life-limiting or quality-of-life-limiting impact, (v) facilitate early involvement of anesthesiology and other perioperative clinicians, and (vi) coordinate supportive management and management of geriatric deficits to support treatment-tolerance and recovery [13][14][15][16][17]. Examples of interventions include physiotherapy referral and exercise, occupational therapy referral, home assessment, falls risk reduction strategies, medication management, dementia care and delirium prevention, social work referral, caregiver involvement and support [16,17].…”

Section: More On Geriatric-focused Assessment and Managementmentioning

confidence: 99%

Geriatric assessment and treatment decision-making in surgical oncology

Chesney

Daza

Wong

2023

Current Opinion in Supportive &Amp; Palliative Care

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Purpose of reviewPresent an approach for surgical decision-making in cancer that incorporates geriatric assessment by building upon the common categories of tumor, technical, and patient factors to enable dual assessment of disease and geriatric factors. Recent findingsConventional preoperative assessment is insufficient for older adults missing important modifiable deficits, and inaccurately estimating treatment intolerance, complications, functional impairment and disability, and death. Including geriatric-focused assessment into routine perioperative care facilitates improved communications between clinicians and patients and among interdisciplinary teams. In addition, it facilitates the detection of geriatric-specific deficits that are amenable to treatment. We propose a framework for embedding geriatric assessment into surgical oncology practice to allow more accurate risk stratification, identify and manage geriatric deficits, support decision-making, and plan proactively for both cancer-directed and non-cancer-directed therapies. This patient-centered approach can reduce adverse outcomes such as functional decline, delirium, prolonged hospitalization, discharge to long-term care, immediate postoperative complications, and death. SummaryGeriatric assessment and management has substantial benefits over conventional preoperative assessment alone. This article highlights these advantages and outlines a feasible strategy to incorporate both diseasebased and geriatric-specific assessment and treatment when caring for older surgical patients with cancer.

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Section: More On Geriatric-focused Assessment and Managementmentioning

confidence: 99%

Geriatric assessment and treatment decision-making in surgical oncology

Chesney

Daza

Wong

2023

Current Opinion in Supportive &Amp; Palliative Care

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“…Approaches may include local excision combined with adjuvant treatment, or even the avoidance of surgery all together [ 66 , 67 , 68 ]. While many older adults may safely undergo standard treatments, several modifications are now available based on an overall multidimensional health assessment to guide treatment choices [ 69 , 70 , 71 , 72 ]. With this tailored approach to older adults with colorectal cancer, excellent goal-concordant outcomes can be achieved [ 73 , 74 ].…”

Section: How Should the Evolution Of Treatment Options Impact Screening Recommendations?mentioning

confidence: 99%

What Should We Recommend for Colorectal Cancer Screening in Adults Aged 75 and Older?

2021

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The current recommendation to stop colorectal cancer screening for older adults is based on a lack of evidence due to systematic exclusion of this population from trials. Older adults are a heterogenous population with many available strategies for patient-centered assessment and decision-making. Evolutions in management strategies for colorectal cancer have made safe and effective options available to older adults, and the rationale to screen for treatable disease more reasonably, especially given the aging Canadian population. In this commentary, we review the current screening guidelines and the evidence upon which they were built, the unique considerations for screening older adults, new treatment options, the risks and benefits of increased screening and potential considerations for the new guidelines.

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Setting Expectations: The Role of Preoperative Counselling in High-Risk Surgery for the Older adult

Tao,

Brasel

2024

Curr Geri Rep

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Geriatric Surgical Oncology

Cited by 3 publications

References 146 publications

Geriatric assessment and treatment decision-making in surgical oncology

Geriatric assessment and treatment decision-making in surgical oncology

What Should We Recommend for Colorectal Cancer Screening in Adults Aged 75 and Older?

Setting Expectations: The Role of Preoperative Counselling in High-Risk Surgery for the Older adult

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