The assessment of clinical resources in a senior adult oncology program

Johnson, David; Blair, Jo; Balducci, Lodovico; Extermann, Martine; Crocker, Theresa; McGinnis, Molly M.; Vranas, P.; Lee, H.

doi:10.1016/j.ejon.2006.04.012

Cited by 5 publications

(3 citation statements)

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“…Institutions and private practices will need to develop multidisciplinary structures to treat what already is and increasingly will be a major part of their patients. It is estimated right now that in tertiary centers half of the older cancer patients are in need of a comprehensive oncogeriatric approach (36). These structures will need to include not only oncologists and geriatricians, but also a team of social workers, dieticians, physical therapists, pharmacists, nurses and mid-level practitioners with knowledge pertaining to this patient population.…”

Section: P R O G R a M D E V E L O P M E N T S A N D C L I N I C A L mentioning

confidence: 99%

“…Many groups are trying to develop a short screening tool that could be applied easily in an oncology practice to select patients for further comprehensive evaluation (30)(31)(32)(33)(34)(35). It appears that about half of patients 70 and older are needing such a referral (30,36). Our group uses the SAOP2 screening tool (37), but several tools, such as the VES 13, the TRST, and others are being actively tested.…”

Section: Geriatric Assessments and Interventionsmentioning

confidence: 99%

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Geriatric Oncology: An Overview of Progresses and Challenges

Extermann

2010

Cancer Res Treat

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I n t r o d u c t i o nThanks to the global improvement of health care and living conditions, the world population is aging. Already, in developed countries, half of the cancers occur in patients aged 70 and older. In booming Asian nations, such as South Korea, the aging trend is particularly striking, and therefore geriatric oncology is rapidly coming at the foreground of oncology practice. In this article, we plan to review the main acquisitions of this field over the last decades, as well as the areas of present critical research. C o n c e p t u a l F r a m e w o r k sThe notion of geriatric oncology was first articulated in the eighties by pioneers such as Rosemary Yancik, Paul Carbone and Jerry Yates (1). Some of the early studies, mostly retrospective reviews of study data, also started in the eighties (2,3). Over the last twenty years, the framework of the research has been mainly to define the characteristics of older cancer patients, analyze how they were tolerating cancer treatments, and how to best integrate geriatric tools and expertise (mostly the CGA) into cancer care.The following concepts are presently under very active investigation: -A two steps approach to the initial evaluation of older cancer patients is becoming the paradigm of choice. A short screening tool applied in the oncology practice, followed by a more comprehensive geriatric assessment and an integrated approach by a multidisciplinary team for those who screen positive. A range of short screening tools are becoming available for use (see below).-The integration of geriatric instruments as decision tools in the treatment of cancer. At this year's ASCO meeting, two scores for predicting toxicity from chemotherapy were presented (4,5). These Thanks to the global improvement of health care and living conditions, the world population is aging. Already, in developed countries half of the cancers occur in patients aged 70 and older. In booming Asian nations, such as South Korea, the aging trend is particularly striking, and therefore geriatric oncology is rapidly coming at the foreground of oncology practice. As older patients have a very variable health status, the need for proper integration of an oncologic and a geriatric approach has become increasingly clear. The last two decades have seen the development of geriatric oncology programs and research, which we review here. An increasing amount of data is making clear that a geriatric assessment identifies many problems in older people with cancer, adds prognostic information, and might improve the outcomes of these patients. The near future will likely deliver the following: Operationalization of geriatric assessment into assessment and decision tools, as well as multidisciplinary interventions, in oncology; cooperation of aging and cancer research in the understanding of cancer biology, aging physiology, pharmacology of anticancer drugs; improved clinical study designs; development of geriatric oncology programs, and screening tools accessible to the private practitioner.

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Section: P R O G R a M D E V E L O P M E N T S A N D C L I N I C A L mentioning

confidence: 99%

Section: Geriatric Assessments and Interventionsmentioning

confidence: 99%

Geriatric Oncology: An Overview of Progresses and Challenges

Extermann

2010

Cancer Res Treat

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“…In addition to function, depression, and cognitive screening, the screen includes questions regarding quality of life, self-rated health, falls, nutrition, sleep, polymedication, and social questions (drug payment and caregiver availability). After more than 8 years of clinical use in its second version, this screen has demonstrated face validity, finding that 63% of senior cancer patients needed psychosocial counseling, 40% dietary intervention, and 14% medication counseling and assistance (the latter probably underestimated) [7]. Its performance was validated against an multidimensional geriatric assessment [8].…”

Section: The Senior Adult Oncology Program (Saop) 2 Screening Toolmentioning

confidence: 99%

Basic Assessment of the Older Cancer Patient

Extermann

2011

Curr. Treat. Options in Oncol.

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Cancer is a disease of the elderly (median age 67 in the US), and this is a population with a variable health status. Therefore, treating the older half of the cancer population will present the challenge of not only addressing tumor diversity (the side often referred to in "personalized cancer care" discussions), but patient diversity as well as the interaction between these two heterogeneities. In that sense, geriatric oncology is the ultimate personalized cancer care. In this article, we will address the recent updates in the basic assessment of the patient's condition, and their implication for clinical and research use. The main progresses reported in the last couple of years pertain to geriatric screening tests, and to prediction of the tolerance to treatment. Some important data on the impact of comorbidities on cancer behavior have emerged, but the clinical implications of these data are still being sorted out. We recommend a two-step approach to the basic evaluation of the older cancer patient. First a short screening with a tested screening instrument. Then further work-up of the geriatric findings in parallel with the oncology work-up to define an integrated treatment plan.

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General Principles in Older Adults with Cancer

Extermann

2012

Cancer and Aging Handbook

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The assessment of clinical resources in a senior adult oncology program

Cited by 5 publications

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Geriatric Oncology: An Overview of Progresses and Challenges

Geriatric Oncology: An Overview of Progresses and Challenges

Basic Assessment of the Older Cancer Patient

General Principles in Older Adults with Cancer

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