In this E-Learning module, the authors elaborate the basics in terms of cancer and aging, available decision-making tools for practice in geriatric oncology, organisation models of geriatric oncology service and discuss the clinical cases in older patients with breast and lung cancer.
The authors present a number of clinical challenges in geriatric oncology practice, like competing causes of morbidity and mortality, functional heterogeneity in older adults, lack of geriatric oncology services, as well as a lack of data on older patients with cancer. Older patients with the same chronological age are different with genetics, lifestyle, socio-economic, mental and cultural issues playing a role.
The module touches comprehensive geriatric assessment and associated challenges in terms of time and human resources needed. Domains of G8 screening tool are provided, as well as of Lee score for predicting mortality from other causes, CARG and CRASH scores for predicting chemotherapy toxicity.
Steps in making treatment decisions for older patients are described. Models of care are illustrated, and lack of geriatricians emphasised. The authors advocate that oncologists should be trained in the basic principles of geriatrics and geriatricians should be educated on cancer-specific considerations for geriatric assessment. Geriatric oncology models of care are heterogeneous and need to be adapted to specific situations.
More investment in the organisation of geriatric oncology education and models of care is the key to improve management and outcomes for older patients with cancer. Therefore, this E-Learning module is an excellent opportunity for oncologists to learn that blueprints for the organisation of geriatric oncology care are available worldwide. Furthermore, validated tools for life-expectancy, treatment benefit and chemotherapy toxicity risk in older patients are available, as well as evidence-based data on the impact of comprehensive geriatric assessment in chemotherapy toxicity.
In this module, the authors highlight a lack of clinical trials data on older patients with cancer and advocate for specific clinical trials to improve the participation of older patients in phase 3 trials.
