Geriatrics for the Oncologist
Exploring Geriatric Assessment Effectiveness: Insights From the 2023 International Society of Geriatric Oncology Conference
Adolfo González Serrano, MD, MSc, PhD
Geriatric assessment has emerged as a pivotal tool in optimizing cancer care for older patients, aiming to mitigate treatment toxicity, enhance treatment adherence, and improve quality of life. The recommended areas for evaluation in a geriatric assessment focus on identifying health issues that cou...
Cancer Susceptibility Germline Pathogenic Variants Among Older Patients
YANIN CHAVARRI-GUERRA, MD, MSc
Hereditary cancer syndromes are caused by a pathogenic variant in cancer susceptibility genes, which overall account for approximately 10% of all cancers. Carriers of pathogenic variants are at an increased risk of developing cancer during their lifetime. Genomic cancer risk assessment makes it poss...
Neighborhood Social Vulnerability and Its Influence on the Availability of Clinical Trials in Multiple Myeloma
Shakira J. Grant, MBBS
Clinical trials set the treatment standards for cancer care. However, for select populations, such as those who are older, Black, or facing socioeconomic challenges, access to clinical trials and health care generally remains limited. Barriers to clinical trial participation are numerous and include...
Geriatric Oncology and Hematology in Singapore
Angela Pang, MD
Globally, the population is aging, with the number of people aged 60 and older projected to double from 1 billion worldwide in 2020 to 2.1 billion by 2050. Given the aging population, coupled with the risk of cancer increasing with age, an exponential rise in cases of older adults diagnosed with c...
Geriatric Assessment: Vital Element in Individualizing Care for Older Patients With Cancer
Amy MacKenzie, MD, FACP, and Grant R. Williams, MD, MSPH
Caring for older adults with cancer is the purview of every oncologist. Over the next 30 years, the older adult population (65 years and older) will represent the fastest-growing segment of the world population. Globally, the number of persons 80 years and older is expected to triple from 143 mi...
SIOG Annual Conference Explores the Past, Present, and Future of Geriatric Oncology
Wendy Wing-Lok Chan, MBBS (HK), FRCR, FHKCR, FHKAM (Radiology), DIP MED (CHUK), MSc
The 2021 Annual Conference of the International Society of Geriatric Oncology (SIOG) was held on November 4–5. Although participants could not join the conference in person, attendees could still stay informed about the latest developments in geriatric oncology through the virtual platform. The the...
2021 Genitourinary Cancers Symposium: Advancements in the Care of Older Adults With Prostate Cancer
Nabiel Mir, MD, and Sindhuja Kadambi, MD
The 2021 Genitourinary (GU) Cancers Symposium was held in a virtual format on February 11–13 and featured the latest developments in the understanding and treatment of genitourinary cancers. The impact of prostate cancer therapies on outcomes in older adults continues to be a growing area of researc...
Cancer in Older Adults: The History of Geriatric Oncology, Part 3
Silvio Monfardini, MD, Lodovico Balducci, MD, Janine Overcash, PhD, APRN-CNP, FAANP, FAAN, Matti S. Aapro, MD
In the preceding two issues of The ASCO Post, we explored the overall history of geriatric oncology from 1980 to 2020. In this concluding part of the series, we focus on the invaluable contributions made by oncology nurses to the field. Over the past several decades, geriatric oncology has ...
Cancer in Older Adults: The History of Geriatric Oncology, Part 2: 1990–2020
Silvio Monfardini, MD; Lodovico Balducci, MD; Janine Overcash, PhD, APRN-CNP, FAANP, FAAN; and Matti S. Aapro, MD
In part 1 of this three-part article, which was published in the October 10, 2020, issue of The ASCO Post, we chronicled the progress made in geriatric oncology up to the decade of the 1990s, which saw an explosion of research activity in the study of aging and cancer. In part 2, we review the activ...
Surgical and Radiation Oncology in Elderly Patients With Cancer
Silvio Monfardini, MD; Lodovico Balducci, MD; Janine Overcash, PhD, APRN-CNP, FAANP, FAAN; and Matti S. Aapro, MD
As one might expect, the focus on older patients developed in surgical and radiation oncology at the same time as in medical oncology. As we have done in our overview of medical oncology, we may recognize a prehistory, past history, and present history in surgical and radiation geriatric oncology. ...
Cancer in Older Adults: The History of Geriatric Oncology, 1980–2015, Part 1
Silvio Monfardini, MD, Lodovico Balducci, MD, Janine Overcash, PhD, APRN-CNP, FAANP, FAAN, and Matti S. Aapro, MD
In this first installment of our history of geriatric oncology, we outline what we consider the most relevant steps in the prehistory and past history of geriatric oncology. In a future issue of The ASCO Post, we will explore the contemporary history of the field. The Prehistory of Geriatric Oncolo...
Cancer in Older Adults: The History of Geriatric Oncology, 1980–2015
Silvio Monfardini, MD, Lodovico Balducci, MD, Janine Overcash, PhD, APRN-CNP, FAANP, FAAN, and Matti S. Aapro, MD
The development of geriatric oncology has been slow but progressive. Thanks to the effort of investigators throughout the world, embattled but undeterred by the objection of a cautious establishment, geriatric oncology has provided a blueprint for the treatment of cancer in the population of patient...
Spotlight on ASCO’s Geriatric Oncology Webpage
Ronald J. Maggiore, MD
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 I...
Fitness-Based Treatment of Older Adults With Multiple Myeloma Who Are Transplant-Ineligible: The Changing Landscape
Shakira J. Grant, MBBS, Tanya M. Wildes, MD, MSCI, and Sonja Zweegman, MD, PhD
Multiple myeloma is a malignant clonal plasma cell malignancy that primarily affects older adults. Although therapeutic advances have led to improvements in disease-specific and overall survival over the past decade, age-related survival disparities continue to exist. The higher prevalence of frailt...
Managing Cancer in Older Adults During the COVID-19 Pandemic
Nicolò Matteo Luca Battisti, MD, and Anna Rachelle Mislang, MD
The COVID-19 pandemic is an additional competing risk to factor in when making decisions about anticancer treatment for older adults. It poses a potential barrier to equal and evidence-based management of cancer in this group of patients. Implementing geriatric assessments in routine clinical prac...
Poster to Bedside: Geriatric Oncology Research Updates From 2019 ASCO Annual Meeting
Rawad Elias, MD
Functional status impairment, limited mobility, comorbidities, polypharmacy, and other aging-related manifestations are common in older individuals. These conditions complicate the oncologic management of older adults, who are underrepresented in clinical trials, even though they form th...
Clinical Trial Design in Older Patients
Stuart M. Lichtman, MD, FACP, FASCO
Geriatrics for the Oncologist is guest edited by Stuart Lichtman, MD, FACP, FASCO, and developed in collaboration with the International Society of Geriatric Oncology (SIOG). Visit SIOG.org for more on geriatric oncology. Increasing age is directly associated with an increasing risk of cancer, a...
SIOG Annual Conference Explores Global Perspectives on Geriatric Oncology and Supportive Care
Stuart M. Lichtman, MD, FACP, FASCO
The 15th Annual Conference of the International Society of Geriatric Oncology (SIOG) took place in Prague, Czech Republic, over 3 days (November 12–14, 2015). At the heart of the meeting were presentations on supportive care, comprehensive geriatric assessment and treatment—so that we fully understa...
ASCO 2015: Geriatric Oncology Highlights
Amy MacKenzie, MD, and Andrew Chapman, DO, FACP
The theme of the 2015 ASCO Annual Meeting, Illumination and Innovation, is especially appropriate as we consider the field of geriatric oncology. For too long, the elderly cancer patient has remained in the dark regarding treatment planning, clinical trial enrollment, and shared decision-making. Ou...
Geriatric Oncology: A Geriatrician’s Perspective
Beatriz Korc-Grodzicki, MD, PhD
“The management of older individuals, including older cancer patients, involves a wisdom developed over a lifetime, thanks to time-consuming listening and painstaking collection and interpretation of clinical details.” —Lodovico Balducci, MD It is not simple to be a geriatrician in a world of onco...
Gynecologic Cancer in the Older Patient: The Activities of the Elderly Working Group of NRG Oncology
Amina Ahmed, MD
Geriatrics for the Oncologist is guest edited by Stuart Lichtman, MD, FACP, FASCO, and developed in collaboration with the International Society of Geriatric Oncology (SIOG). Visit SIOG.org for more on geriatric oncology. The elderly population in the United States is growing, and by the year 20...
Guidelines for the Treatment of Older Cancer Patients: Task Forces of the International Society of Geriatric Oncology
Anita O’Donovan, MD
Geriatrics for the Oncologist is guest edited by Stuart Lichtman, MD, FACP, FASCO, and developed in collaboration with the International Society of Geriatric Oncology (SIOG). Visit SIOG.org for more on geriatric oncology. The Task Forces of the International Society of Geriatric Oncology (SIOG) are...
Our Aging Population: Challenges in Caring for Older Patients With Cancer
Managing older-aged cancer patients represents one of the major challenges to our health-care system. Caring for older cancer patients, with their frequent multiple morbidities and a variable health status, requires special integration of an oncologic and geriatric approach. Moreover, our aging popu...
Improving the Care and Study of Older Patients with Cancer
Stuart M. Lichtman, MD, FACP, FASCO
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 routinel...
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, FACP, FA...
Deconditioning in Older Adults With Cancer: A Cascade to Dependency
Lorraine K. McEvoy, DNP, MSN, RN, OCN
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, ...
Cardio-oncology in the Geriatric Patient
Anne H. Blaes, MD, MS
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 a...
Geriatric Oncology: A Multidisciplinary Approach in a Global Environment
Gouri Shankar Bhattacharyya, MD, and Stuart M. Lichtman, MD, FACP, FASCO
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 Me...
Highlights in Geriatric Hematology From the ASH Annual Meeting & Exposition
Kah Poh (Melissa) Loh, MBBCh, BAO
GUEST EDITOR 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 P...
How Real-World Data Can Help Contextualize New Treatments in Older Patients
Emily Castellanos, MD, MPH, and Neal J. Meropol, MD
Consider a patient who is referred for neoadjuvant therapy for stage IIIA, HER2-positive breast cancer. She is otherwise healthy, with no significant medical history, an Eastern Cooperative Oncology Group performance status of 0, unremarkable baseline labs, and a left-ventricular ejection fraction o...
Older Sexual and Gender Minorities With Cancer: A Population Hidden in the Open
Koshy Alexander, MD, and Smita C. Banerjee, PhD
The term “sexual and gender minorities” encompasses people whose sexual orientation, gender identity and expression, or reproductive development varies from traditional, societal, cultural, or physiologic norms1 and includes lesbian, gay, bisexual, transgender, and queer (LGBTQ) people. More than 3 ...
Geriatric Oncology, a Much Needed Discipline for Future Cancer Care
Ronald Piana
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 multi...
Evaluating and Screening Geriatric Patients for Treatment
Martine Extermann, MD, PhD
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 going...
Addressing the Challenges of an Aging Population
Harvey J. Cohen, MD
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 large...
International Society of Geriatric Oncology: At the Forefront of Physician Education and Research Dissemination in Geriatric Oncology
Stuart M. Lichtman, MD
The ASCO Post announces a new department on geriatric oncology to be published on an occasional basis. Geriatrics for the Oncologist is guest edited by Stuart Lichtman, MD, and developed in collaboration with the International Society of Geriatric Oncology (SIOG). Visit SIOG.org for more on geriatri...
Geriatric Oncology in Europe: A Commitment to Improving Cancer Care for Older Patients
Etienne Brain, MD, PhD
In Europe, the field of geriatric oncology has a long history of development, and its organization and implementation continue to improve every day. This would not have happened without the strong commitment of national authorities to health policies, a critical success factor. Four Missions In Fr...
Management of Advanced Lung Cancer in the Elderly: A Reason to Rejoice or a Cause for Concern?
Ajeet Gajra, MD, FACP
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 underrep...
Geriatric Assessment of Transplant-Ineligible Older Adults With Multiple Myeloma: A Novel Approach in the Era of Novel Agents
Tanya M. Wildes, MD, MSCI
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 ...
Supportive Care in the Older Adult With Cancer: What You Need to Know
Christopher Steer, MBBS, FRACP
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 ...
The Role of Occupational and Physical Therapy in Geriatric Oncology
Jeannine Nonaillada, PhD, OTR/L, BCG
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 interp...
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 h...
Geriatric Oncology in Asia: The Dawn of a New Era in Cancer Care
Ravindran Kanesvaran, MD
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...
Assessment of Fitness, Function, and Quality of Life Essential in Treatment of Older Patients With CLL
Vicki A. Morrison, MD
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, w...
Safety Concerns Weigh Heavily in Elderly Patients With Cancer
Ronald Piana
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 i...
ASCO 2016: Geriatric Oncology Highlights
William P. Tew, MD
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 i...
Co-occurrence of Cancer and Cognitive Impairment in Older Adults
Allison M. Magnuson, DO
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 th...
Falls in Older Patients With Cancer: Recognizing and Reducing the Risk
Aminah Jatoi, MD
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 older...
Tailoring Treatment for Older Adults With Colorectal Cancer
Joleen Hubbard, MD
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. ...
Future Perspectives in Geriatric Oncology: How the Young Can Care for the Old
Nienke A. de Glas, MD, PhD, on behalf of the Young SIOG Committee
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...
SIOG 2017 Advanced Course in Treviso, Italy
The ASCO Post
The International Society of Geriatric Oncology (SIOG) has a workshop to educate young investigators in geriatric oncology research. The SIOG Advanced Course, which is held in Treviso, Italy (June 28–July 1, 2017), is our unique continuing medical education–accredited training program led by interna...
