|LETTER TO THE EDITOR
|Year : 2021 | Volume
| Issue : 4 | Page : 792-793
Geriatric Assessment- A pressing priority for streamlining care for older patients with cancer
Joyita Banerjee1, Abhijith Rajaram Rao2
1 Department of Geriatric Medicine, All India Institute of Medical Sciences, New Delhi, India
2 Department of Medical Oncology, TMH, Mumbai, Maharashtra, India
|Date of Submission||07-Nov-2021|
|Date of Decision||13-Nov-2021|
|Date of Acceptance||15-Nov-2021|
|Date of Web Publication||29-Dec-2021|
Department of Geriatric Medicine, All India Institute of Medical Sciences, New Delhi - 110 029
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Banerjee J, Rao AR. Geriatric Assessment- A pressing priority for streamlining care for older patients with cancer. Cancer Res Stat Treat 2021;4:792-3
|How to cite this URL:|
Banerjee J, Rao AR. Geriatric Assessment- A pressing priority for streamlining care for older patients with cancer. Cancer Res Stat Treat [serial online] 2021 [cited 2022 Jan 20];4:792-3. Available from: https://www.crstonline.com/text.asp?2021/4/4/792/334208
We found the article written by Noronha et al. interesting as it addresses major concerns in the area of geriatric oncology in India. Following the global change in demographic trends, India too is facing a sudden aging of the population, with 30% of its population presently aged over 60 years. Age is the greatest risk factor for cancer. Thus, it is expected that oncologists will increasingly be attending to a larger number of older patients in future. The important question is whether they are ready to deal with the age-related issues of older patients with cancer, which can pose a challenge in their management.
Interestingly, this article reported that 96.4% of the study participants felt the need for formal training in geriatric assessment (GA) as a routine part of oncology training. This reflects a positive attitude and awareness of the importance of GA among practicing oncologists. However, 74% said that they refer <10% of their geriatric patients for GA. This hesitation for referral might reflect the lack of streamlined geriatric services and limited consensus among clinicians regarding the best GA tools and protocols. These results reflect the lacunae between requirement and presence of trained workforce in geriatric oncology in India and the immense need to streamline geriatric services in the country.
Despite the broad applicability and its potential for aiding a growing population of older adults with cancer, physicians trained in geriatric medicine are few;the number of trained geriatricians is only recently increasing in our country. There will never be enough geriatricians to cater to the burgeoning aged population. Therefore, it is imperative to make the already practicing oncologists aware of the importance and impact of GA in patients with cancer. There must be an impetus to train specialists who can cater to substantial challenges and opportunities in the prevention, early detection, diagnosis, and management of cancer in older adults.
About 90% of the respondents in the study chose quality of life (QoL), followed by reducing treatment toxicity and prolongation of survival as a justification for conducting a GA. Geriatricians globally advocate a comprehensive geriatric assessment (CGA) in older adults, as it encompasses relevant age-related domains and provides scope for interventions in these domains to enhance the QoL of ailing older adults. Cure or prolongation of survival may not be the topmost priority of management in most older patients with cancer, rather maintaining the remaining QoL might be more pertinent.
The best way forward plausibly is to build up a trained, multidisciplinary workforce in geriatric oncology. Oncologists and geriatricians should join force to create training modules incorporating CGA in oncology practice in a feasible and acceptable manner. The International Society of Geriatric Oncology (SIOG), a multidisciplinary membership-based society, with members engaged in more than 80 countries worldwide, focuses on establishing the branch of geriatric oncology globally. SIOG addresses four priority domains, namely education, clinical practice, research, and strengthening collaborations and partnerships, to improve the care of older adults with cancer worldwide. Following the guidelines and priority domains laid down by SIOG, the existing Regional Geriatric Centers and the proposed National Center for Aging under the aegis of the National Program for Health Care of the Elderly can collaborate with cancer centers in the country and establish and strengthen the specialty of geriatric oncology in India.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Noronha V, Kalra D, Ramaswamy A, Gattani SC, Menon N, Patil VM, et al.
Oncologists' perceptions of the need for assessing individual domains in the geriatric assessment and worthwhile outcomes in treating older patients with cancer: A questionnaire-based survey. Cancer Res Stat Treat 2021;4:492-8. [Full text]
Parikh PM, Chaitanya K, Boppana M, Kumar MS, Shankar K. Geriatric oncology landscape in India – Current scenario and future projections. Cancer Res Stat Treat 2020;3:296-9. [Full text]
Soto-Perez-de-Celis E, de Glas NA, Hsu T, Kanesvaran R, Steer C, Navarrete-Reyes AP, et al.
Global geriatric oncology: Achievements and challenges. J Geriatr Oncol 2017;8:374-86.
Rao AR, Mathur A, Dey AB. Health workforce development for geriatric services in India. J Indian Acad Geriatr 2020;16:176-9. [Full text]
Extermann M, Brain E, Canin B, Cherian MN, Cheung KL, de Glas N, et al.
Priorities for the global advancement of care for older adults with cancer: An update of the International Society of Geriatric Oncology priorities initiative. Lancet Oncol 2021;22:e29-36.