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Issues in Oncology
Prostate Cancer
Geriatric Oncology

Overscreening for Prostate Cancer in Older Men Remains an Issue

Although most major cancer organizations agree on the guidelines for prostate cancer screening, there is still uneven application of the test, such as in the older patient population, resulting in overdiagnosis and waste in an already fiscally challenged health-care system. Researchers from the...

Leukemia
Geriatric Oncology

Expert Point of View: Susan M. O’Brien, MD

THE STUDY’S discussant, Susan M. O’Brien, MD, Associate Director for Clinical Science, Chao Family Comprehensive Cancer Center, University of California Irvine Health, said the results of the Alliance North American Intergroup Study A041202—demonstrating that ibrutinib (Imbruvica) is more...

Leukemia
Geriatric Oncology

Ibrutinib vs Standard of Care in Front-Line Treatment of Older Patients With Chronic Lymphocytic Leukemia

IBRUTINIB (IMBRUVICA) as a front-line agent proved superior to standard-of-care chemoimmunotherapy for chronic lymphocytic leukemia (CLL) in older patients in A041202, an Alliance-led National Clinical Trials Network study.1 At a follow-up of 38 months, the median progression-free survival was not ...

breast cancer
geriatric oncology

Allison Magnuson, DO, on Older Patients With Breast Cancer: A New Tool to Help Guide Treatment Decisions

Allison Magnuson, DO, of the University of Rochester Strong Memorial Hospital, discusses the development of a chemotherapy toxicity risk score that is associated with dose reduction as well as reduced respiratory distress and fewer hospitalizations (Abstract GS6-04).

Geriatric Oncology

Leader in Geriatric Oncology, Arti Hurria, MD, FASCO, Dies at Age 48

ARTI HURRIA, MD, FASCO, died tragically on November 7, 2018, from injuries sustained in a traffic accident. Dr. Hurria was a national leader in geriatric oncology, embracing the age-associated nuances of the elderly, and leading initiatives and research that advanced this specialty field. “The...

geriatric oncology
palliative care

Katherine C. Lee, MD, on Emergency Surgery and End-of-Life Care

Katherine C. Lee, MD, of Massachusetts General Hospital, discusses her study findings that showed older patients with metastatic cancer who survived emergency general surgery experienced higher intensity end-of-life care than similar patients who did not undergo surgery (Abstract 56).

geriatric oncology
immunotherapy

Matti S. Aapro, MD, on Immunotherapy in Older Patients

Matti S. Aapro, MD, of the Genolier Cancer Centre, discusses the optimal treatment and supportive care for older patients with cancer, including the importance of maintaining dose density and intensity as well as monitoring toxicity.

Geriatric Oncology

Educating Nurse Practitioners on the Care of Older Patients With Cancer in a Comprehensive Cancer Center

To expose future practitioners to the special challenges of treating cancer in older patients, the Geriatrics Service at Memorial Sloan Kettering Cancer Center (MSK) has developed a clinical education model for nurse practitioner students. Why Geriatric Oncology? GIVEN THE aging population, my...

Lymphoma
Geriatric Oncology

Challenges of Managing Older Patients With Diffuse Large B-Cell Lymphoma

As the population continues to age, the interplay between aging and cancer increasingly shows cancer to be a disease of older people. By the year 2030, there will be an increased incidence of non-Hodgkin lymphoma (NHL) in older individuals.1 The median age of patients diagnosed with diffuse large...

lymphoma
geriatric oncology

Peggy Burhenn, MS, RN-BC, AOCNS, on Lymphoma: Managing Older Adults

Peggy Burhenn, MS, RN-BC, AOCNS, of the City of Hope National Medical Center, discusses the challenges of working with older lymphoma patients and the importance of effective geriatric assessments.

Issues in Oncology
Geriatric Oncology

Expert Point of View: Joshua A. Jones, MD, MA

“AS A SOCIETY, we often think about the value of cancer treatments in terms of survival, but for older patients, we need to look beyond that. Geriatric assessments are clearly an effective tool to help us treat the whole patient. It’s a conversation starter that informs and empowers both patients...

Issues in Oncology
Geriatric Oncology

Geriatric Assessment Improves Communication Between Oncologists and Older Patients

A FEDERALLY FUNDED randomized study demonstrated that use of geriatric assessment in the routine care of older adults with advanced cancer significantly improved doctor-patient communication about age-related concerns as well as patient satisfaction with the communication. The study was presented...

Solid Tumors
Issues in Oncology
Geriatric Oncology
Lung Cancer

Chemoradiation in Elderly Patients With Stage III NSCLC Improves Overall Survival

Elderly patients with stage III non–small cell lung cancer (NSCLC) showed improved overall survival when treated with chemoradiation compared with definitive radiation alone, according to findings published by Eric D. Miller, MD, PhD, of The Ohio State University, Columbus, and colleagues in the...

Solid Tumors
Issues in Oncology
Geriatric Oncology

Does Warfarin Have Anticancer Potential in Persons Older Than Age 50?

A Norwegian population–based cohort study indicated that the use of warfarin was associated with a reduced risk of cancer overall and site-specific cancers among patients aged > 50 years. The findings were reported in JAMA Internal Medicine by Haaland et al. As noted by the investigators,...

leukemia
geriatric oncology

Courtney Denton Dinardo, MD, on AML: Treatment Study Results

Courtney Denton Dinardo, MD, of The University of Texas MD Anderson Cancer Center, discusses findings on the durable response with venetoclax in combination with decitabine or azacitidine in elderly patients with acute myeloid leukemia (Abstract 7010).

geriatric oncology

Supriya G. Mohile, MD, on Communicating With Older Cancer Patients: Results From a Community Trial

Supriya G. Mohile, MD, of the University of Rochester Medical Center, discusses study findings on ways to improve communication with older cancer patients using geriatric assessment (Abstract LBA10003).

Geriatric Oncology

A Love of Older Patients With Cancer Drives a Career Path for Arti Hurria, MD, FASCO

Arti Hurria, MD, FASCO, who is Director of City of Hope’s Center for Cancer and Aging, is a first generation of immigrant parents from India. “My parents left India and moved from England to Canarsie, Brooklyn, where I was born. When I was 8, my family moved to Southern California, partly due to...

geriatric oncology
survivorship

Arti Hurria, MD, on Survivorship Care for the Aging Population

Arti Hurria, MD, of the City of Hope, discusses ways to incorporate the principles of geriatrics into oncology care and offer targeted interventions for older survivors.

Geriatric Oncology

Broadening the Evidence Base for Older Patients: FDA-ASCO Workshop Explores Emerging Strategies

In the not-so-distant past, clinical trials were considered an option only for the young and fit. Enrolling older people “used to be thought unethical,” said Janet Woodcock, MD, Director of the U.S. Food and Drug Administration (FDA)’s Center for Drug Evaluation and Research (CDER), as she opened...

Geriatric Oncology

Clinical Trials Actively Recruiting Geriatric Oncology Patients

THE INFORMATION contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies focused on geriatric oncology. These studies highlight psychological interventions, managing cancer symptoms, the surgical process, fall prevention, and making treatment decisions; as well ...

Geriatric Oncology

Register for the Geriatric Oncology Workshop

On November 6, 2017, ASCO and the U.S. Food and Drug Administration (FDA) will hold a joint Geriatric Oncology Workshop aimed at improving the evidence base for treating the geriatric oncology population.  While more than 60% of cancers in the United States occur in people aged 65 and older, the...

Geriatric Oncology
Issues in Oncology

‘Slow, Incremental Changes’ Are Increasing Participation of Older Adults in Clinical Trials

Older adults continue to be proportionally underrepresented in oncology clinical trials, but the participation rate of adults aged 65 and older is increasing by “slow, incremental changes,” Stuart M. Lichtman, MD, FACP, FASCO, noted in an interview with The ASCO Post. Prompting those changes are...

Geriatric Oncology
Global Cancer Care

Challenges in Geriatric Oncology in Low- and Middle-Income Countries: Focus on Latin America

Virtually every region and country in the world are experiencing population aging. Although developed regions still have the largest proportion of older persons, the absolute number of older adults is higher in developing regions of the world. Globally, more than 60% of all persons aged 65 now...

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, FACP, FASCO, 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...

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 ...

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