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Geriatric Oncology

Preparing for Future Challenges in Geriatric Surgical Oncology

In the past decade, advances in surgical oncology have been echoed in the field of geriatric oncology. The current literature regarding older people with cancer includes mainly retrospective cohort studies, focusing on alternatives to radical surgery in comorbid patients. More recently, work has...

Geriatric Oncology
Global Cancer Care

Geriatric Oncology: A Multidisciplinary Approach in a Global Environment

Geriatrics for the Oncologist is guest edited by Stuart M. Lichtman, MD, and developed in collaboration with the International Society of Geriatric Oncology (SIOG). Dr. Lichtman is an Attending Physician at Memorial Sloan Kettering Cancer Center, Commack, New York, and Professor of Medicine at...

Geriatric Oncology

Pioneer in Geriatric Oncology, Hyman Muss, MD, Continues to Improve Care for Older Patients

Hyman Muss, MD, a pioneer in geriatric oncology, considers himself “a real Brooklyn boy.” His father was a dentist, and his uncle was a general practitioner. “They both practiced out of a small brownstone house in Brownsville-Crown Heights. It was sort of reminiscent of the famous movie The Last...

CNS Cancers
Geriatric Oncology

Optimizing Treatment for Elderly Patients With Glioblastoma

In 2005, Stupp and colleagues published their landmark paper demonstrating in a randomized phase III trial that the addition of temozolomide to radiation increased overall survival in patients with newly diagnosed glioblastoma. Notably, patients over age 70 years were excluded from this study.1...

CNS Cancers
Geriatric Oncology

Short-Course Radiotherapy Plus Temozolomide Improves Survival in Older Patients With Glioblastoma

In a phase III trial reported in The New England Journal of Medicine, James R. Perry, MD, of Sunnybrook Health Sciences Centre, Toronto, and colleagues found that adding temozolomide to short-course radiotherapy improved overall survival in patients aged at least 65 years with newly diagnosed...

Breast Cancer
Geriatric Oncology

Accrual of Older Patients to Breast Cancer Trials: A Critical Need

As the U.S. population ages,1 the number of older women with breast cancer will increase,2 as well as the number of patients with frailty and other comorbid medical conditions. These patients are at increased risk for toxicity and functional decline during their breast cancer treatment course....

Geriatric Oncology

Using Geriatric Assessment Strategies to Inform Patient-Centered End-of-Life Care

End-of-life care in any patient with cancer is challenging for the patient, family, and physician. Issues faced at the end of life include pain, depression, loss of dignity, and hopelessness. In the geriatric patient, additional complexities are present in the form of comorbid conditions,...

Geriatric Oncology

New Constructs for Use in the Identification of Depression in Older Patients With Cancer

Elderly patients with cancer are far less likely to be diagnosed with depression than patients in any other age group for two primary reasons: There is an overlap between cancer symptoms/treatment side effects and the diagnostic criteria for depression, and older adults are more likely to present...

Geriatric Oncology

Future Perspectives in Geriatric Oncology: How the Young Can Care for the Old

In the upcoming decades, the number of older adults with cancer will drastically increase due to aging of Western societies.1 The risk of cancer strongly increases with age. Consequently, all future oncologists will be exposed to the challenges of caring for this heterogeneous population. Older...

Geriatric Oncology
Colorectal Cancer

Tailoring Treatment for Older Adults With Colorectal Cancer

Nearly 60% of colorectal cancer cases are diagnosed in patients ≥ 65 years, with a median age at diagnosis of 68 years,1 but this population makes up only 34% of clinical trial participants.2 In addition, the older adults enrolled on clinical trials are traditionally the most-fit older adults....

geriatric oncology
survivorship

Arti Hurria, MD, on Senior Citizens: Living Through and Beyond Cancer

Arti Hurria, MD, of City of Hope, discusses the assessment of older patients with cancer.

Geriatric Oncology
Leukemia

Androgen Maintenance in Elderly Patients With AML

The addition of norethandrolone as maintenance therapy improved survival in patients aged ≥ 60 years with acute myeloid leukemia (AML), according to a French phase III trial reported in the Journal of Clinical Oncology by Pigneux et al. Norbert Ifrah, MD, of CHU d’Angers, France, is the...

Geriatric Oncology

Falls in Older Patients With Cancer: Recognizing and Reducing the Risk

In older patients, a current or previous cancer diagnosis confers a 15% to 20% greater risk of suffering a fall.1 Defined as an “unexpected event in which the participant comes to rest on the ground, floor, or lower level,” a fall occurs in 30% to 50% of cancer patients 65 years of age or...

Breast Cancer
Geriatric Oncology

Expect Questions About Screening Mammography for Women Aged 75 Years and Older

A study finding that there is no clear cutoff age to stop breast cancer screening has received national coverage in newspapers and CNN as well as in health and medical publications. “I am glad this is catching fire, because it really needs to be out there,” Cindy S. Lee, MD, the study’s lead...

Issues in Oncology
Breast Cancer
Geriatric Oncology

Study Suggests No Evidence for Screening Mammography Cutoff Age

An analysis of data from nearly 6 million screening mammograms found no evidence for a clear cutoff age to stop breast cancer screening. Screening mammography among women aged 75 years was associated with higher cancer detection and lower recall rates than among younger women in the study. These...

Geriatric Oncology

Co-occurrence of Cancer and Cognitive Impairment in Older Adults

The prevalence of both cancer and cognitive impairment increases with age.1-3 Based upon Surveillance, Epidemiology, and End Results (SEER)-Medicare studies, it is estimated that 3% to 7% of patients with cancer aged ≥ 65 also suffer from dementia, although the true prevalence of dementia in this...

lymphoma
geriatric oncology

Catherine Thieblemont, MD, PhD, and Julie Vose, MD, MBA, on DLBCL: Results From the Lysa Remarc Study

Catherine Thieblemont, MD, PhD, of Hôpital Saint-Louis and INSERM, and Julie Vose, MD, MBA, of the University of Nebraska Medical Center, discuss phase III trial findings on lenalidomide maintenance in elderly patients with DLBCL treated with R-CHOP in the first-line setting (Abstract 471).

Geriatric Oncology

Meeting the Needs of Older Adults With Cancer

I have served as a patient advocate in many different ways since I was diagnosed with breast cancer in October 2000. For many years, my advocacy was focused on issues related to breast cancer. Since 2012, I have also been engaged in identifying and meeting the needs of the rapidly growing...

Geriatric Oncology
Symptom Management

Cardio-oncology in the Geriatric Patient

As cancer therapies improve and the population as a whole increases, there are rising numbers of elderly patients with cancer. More than half of patients newly diagnosed with cancer are aged 65 years or older.1 In January 2012, it was estimated that more than 8 million cancer survivors were over...

Geriatric Oncology

ASCO 2016: Geriatric Oncology Highlights

Clinical trials focused on older adults with cancer were featured prominently at the 2016 ASCO Annual Meeting. There was a plenary session in glioblastoma, a clinical symposium on immunotherapy, and multiple educational lectures highlighting the growing literature and unique challenges in the...

Geriatric Oncology

Spotlight on ASCO’s Geriatric Oncology Webpage

With the increasing population of older adults with cancer, there has been a commensurate need for more readily available and widely accessible educational and clinical resources in geriatric oncology. As part of the Cancer and Aging Research Group and ASCO’s Geriatric Oncology Special Interest...

Issues in Oncology
Geriatric Oncology

Safety Concerns Weigh Heavily in Elderly Patients With Cancer

Active pharmacovigilance in detecting and assessing the safety signals related to drugs and devices, and disseminating those findings to relevant stakeholders, is an important component in delivering safe, high-quality care in the cancer setting. To reach a better understanding of this issue,...

Geriatric Oncology
Survivorship

The Complexities of Care for Older Cancer Survivors

Integrated care, a focus on prevention and screening, and acknowledgment of comorbidities on the impact of treatment all play a critical role in the cancer survivorship of older patients, according to Martine Extermann, MD, PhD, a medical oncologist at Moffitt Cancer Center in Tampa, Florida....

Geriatric Oncology
Supportive Care
Leukemia

Assessment of Fitness, Function, and Quality of Life Essential in Treatment of Older Patients With CLL

Significant progress has been made in the past 2 decades in the care of patients with chronic lymphocytic leukemia (CLL). Recently, the therapeutic armamentarium has expanded for such patients with the introduction of new targeted agents. CLL is predominantly a disease of the elderly, with a...

Geriatric Oncology
Global Cancer Care

Geriatric Oncology in Asia: The Dawn of a New Era in Cancer Care

Asia is currently experiencing an unprecedented rate of growth in its aging population. This “silver tsunami” has translated into a burgeoning number of older patients with cancer, as cancer is a disease of aging. However, unlike their Western counterparts, elderly patients with cancer in Asia are ...

Geriatric Oncology
Issues in Oncology

Geriatric Patients With Cancer and the Problem of Polypharmacy

Older patients with cancer generally have multiple comorbidities, with each often requiring separate medications. Studies have shown that polypharmacy and inappropriate drug use are prevalent among older cancer patients, leading to an enormous amount of preventable adverse events, many requiring...

Geriatric Oncology

Medical Decision-Making: At the Heart of Care for Older Patients With Cancer

Although oncology has moved toward a personalized approach to care, medical decision-making within the context of multidisciplinary care has broad public health implications. To shed light on this and other relevant issues, The ASCO Post recently spoke with William Dale, MD, PhD, of the University ...

Supportive Care
Geriatric Oncology

The Role of Occupational and Physical Therapy in Geriatric Oncology

With individuals aged 65 and older accounting for more than 50% of the U.S. population diagnosed with cancer,1 the demand for occupational and physical therapists to treat this population will increase in the years to come. Thus, it is essential for primary care providers to know that the...

Prostate Cancer
Geriatric Oncology

Significant Increased Risk of Noncancer Hospitalization Following Diagnosis of Prostate Cancer in the Elderly

Elderly men had a significant increase in the risk of noncancer hospitalizations following the diagnosis of prostate cancer, according to a population-based retrospective cohort study conducted by Amit D. Raval, PhD, and colleagues at West Virginia University, Morgantown. Results were published in...

Geriatric Oncology

Supportive Care in the Older Adult With Cancer: What You Need to Know

The median age of patients at the first diagnosis of cancer in the United States is 65 years, and the majority of patients with cancer are older adults.1 As we have learned from previous articles in this series, older patients with cancer require more complex care. Older adults are more likely to...

Geriatric Oncology
Breast Cancer

Geriatric Assessment Is Key to Treatment Decisions for Patients 80 Years and Older

A review of major studies and the current literature underscored the role of geriatric assessment in making treatment recommendations for patients aged 80 years and older with early and metastatic breast cancer. The review was published in the Journal of Oncology Practice. The corresponding author...

Geriatric Oncology

Geriatric Assessment of Transplant-Ineligible Older Adults With Multiple Myeloma: A Novel Approach in the Era of Novel Agents

Myeloma is a disease of aging, with a median age at diagnosis in the United States of 69 years.1 As the population ages, forecasts estimate that, within 20 years, 3 of every 4 people diagnosed with multiple myeloma in the United States will be between the ages of 64 and 84 years.2 In anticipation...

issues in oncology
lung cancer
geriatric oncology

Management of Advanced Lung Cancer in the Elderly: A Reason to Rejoice or a Cause for Concern?

There is ample evidence to suggest that older adults with a good performance status (0 or 1) with advanced non–small cell lung cancer (NSCLC) should be treated with combination chemotherapy akin to younger patients.1,2 However, older adults comprise a heterogeneous group that has been...

issues in oncology
supportive care
geriatric oncology

Deconditioning in Older Adults With Cancer: A Cascade to Dependency

It is estimated that nearly half of adults over age 80 living in the community are frail despite apparent functional well-being.1 Frailty is recognized as a clinical syndrome in which three or more of the following criteria are present: unintentional weight loss, self-reported exhaustion, weakness, ...

Gynecologic Cancers
Geriatric Oncology

Elderly Patients with Ovarian Cancer Least Likely to Receive Chemotherapy

An analysis of data for 4,617 women aged 65 years or older diagnosed with epithelial ovarian cancer found that those in the oldest age group, 80 and up, were least likely to receive any chemotherapy. While 53% of patients 80 and older received no chemotherapy, the rate was less than half (22%) for...

Survivorship
Supportive Care
Geriatric Oncology

Yoga, Geriatric Assessment, and Nausea/Vomiting Addressed in Session on Supportive Care and Survivorship Issues

Marie E. Wood, MD, of the Familial Cancer Program at the University of Vermont, Burlington, addressed clinically relevant issues in supportive care and survivorship at the Best of ASCO® Annual Meeting ‘11 in Miami. Delayed Nausea and Vomiting Two studies addressed the problem of...

Geriatric Oncology

Geriatric Oncology, a Much Needed Discipline for Future Cancer Care

The U.S. health-care system, with its rapidly aging population, faces a multitude of difficult clinical and financial challenges in caring for its burgeoning population of older patients with cancer. Moreover, age-related social and medical issues among older patients need to be addressed by a...

Lymphoma
Geriatric Oncology

Expert Point of View: Therapy for Hodgkin Lymphoma in the Elderly Remains Undefined

Elderly Hodgkin lymphoma, typically defined as affecting individuals ≥ 60 years of age, remains a disease for which no standard treatment recommendation exists. This population is underrepresented in clinical studies, and survival rates in older patients with Hodgkin lymphoma are significantly and ...

Lymphoma
Geriatric Oncology

Therapy for Hodgkin Lymphoma in the Elderly Remains Undefined

At the 2011 Pan-Pacific Lymphoma Conference held recently in Kauai, Hawaii, Andrew M. Evens, DO, MSc, Director of the Lymphoma Program at the University of Massachusetts Medical School in Worcester, discussed Hodgkin lymphoma in elderly patients. Event-free survival and overall survival rates in...

Geriatric Oncology

Moving the Field of Geriatric Oncology Forward

With the aging of the population, virtually all of the subspecialties of oncology will soon be concerned primarily with the care of older patients. While there is not one precise definition of the age of “geriatric” patients, it is clear that the aging of our society has necessitated a focus on the ...

Lung Cancer
Geriatric Oncology

Canadian Registry Study of Adjuvant Therapy for NSCLC Shows Increased Use in Elderly Patients and Improved Survival

Cisplatin-based adjuvant therapy is recommended for patients with resected stage II–IIIA non–small cell lung cancer (NSCLC). There have been no trials of adjuvant therapy in elderly patients with NSCLC, who constitute a large part of the NSCLC population. A number of analyses indicate that older...

Geriatric Oncology

Geriatric Oncologists: A Small but Passionate Group

Although age is the major risk factor for developing cancer, geriatric oncology is still a relatively new discipline within the oncology community. To gain insight into this evolving component of cancer care, The ASCO Post recently spoke with a leader in the field, Stuart M. Lichtman, MD, of the...

geriatric oncology
issues in oncology

Improving the Care and Study of Older Patients with Cancer 

Predicting toxicity in older patients receiving chemotherapy is an important clinical problem. It has been shown that standard oncology measures such as performance status are not adequate to predict outcomes in the elderly. Clinical measures that are important in geriatric oncology are not...

Leukemia
Geriatric Oncology

Lenalidomide Induces Long-lasting Responses in Elderly Patients

Treatment with lenalidomide (Revlimid) as initial therapy induced long-lasting responses in a phase II study of 60 patients with chronic lymphocytic leukemia (CLL). “Overall, 35 patients (58%) patients had responses lasting more than 36 months and were considered long-term responders,” the...

Geriatric Oncology

Top Five Things Oncologists Need to Know about Cancer in Older Adults 

A workforce shortage of geriatricians and other health professionals certified in caring for older patients with cancer is colliding with the aging of the population and the increasing number of older Americans with cancer. After describing factors contributing to these dual challenges, Arti...

Geriatric Oncology

Using Life Expectancy, Not Age, to Make Cancer Screening Decisions Can Maximize Potential Benefits

Using life expectancy, rather than chronologic age, to inform decisions about whether to continue cancer screening for older persons can maximize the potential benefits of screening, while minimizing the harms, according to results of a population-based cohort study of 407,749 people over 66...

Geriatric Oncology

Addressing the Challenges of an Aging Population

We have an aging population, which is a good thing since people are living longer. [But] cancer is a disease that tends to occur most frequently in older people, so the combination of those two events will lead to many more older people with cancer, a larger cancer population in general, and a...

Geriatric Oncology

Evaluating and Screening Geriatric Patients for Treatment

One of the key questions in geriatric oncology is: How can we use all of the work geriatricians have done over the years in general geriatrics and apply that to the field of oncology? One-quarter to one-third of us are going to develop cancer throughout our lifetime, and half of the time it is...

Geriatric Oncology

International Society of Geriatric Oncology Meeting Explores Multidisciplinary, Tailored Treatment of Older Patients With Cancer

The annual meeting of the International Society of Geriatric Oncology (SIOG, www.siog.org) was held in Copenhagen from October 24 to 26. The theme of the meeting was the “Multidisciplinary Approach Towards Personalized Treatments.” The Society, which was founded in 2000, is a multidisciplinary...

Lymphoma
Geriatric Oncology

Andrew D. Zelenetz, MD, PhD, on Treating the Elderly Lymphoma Patient With Elevated Bilirubin

At the 19th Annual Conference of the National Comprehensive Cancer Network (NCCN), lymphoma expert and NCCN Panel Chair on Lymphoma, Andrew D. Zelenetz, MD, PhD, fielded questions from oncologists. The ASCO Post was there to capture his recommendations for a common clinical scenario—treating the...

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