As the global population ages, oncology faces an urgent challenge: ensuring that health-care professionals are adequately trained to address the unique complexities of cancer care for older adults. Despite the increasing prevalence of cancer in this demographic, geriatric oncology education remains insufficiently developed in many regions. Expanding education in this field is essential to improving patient outcomes and ensuring that treatment decisions are guided by physiologic and functional status rather than chronologic age alone.
The Need for Geriatric Oncology Training in Medical Education
Geriatric oncology training is included in the ASCO–European Society for Medical Oncology (ESMO) global curriculum in medical oncology.1 However, surveys indicate that structured training in this field remains limited. A national study by ASCO of hematology-oncology trainees found that fewer than half had attended lectures on geriatric oncology, and only a small proportion had received formal training in comprehensive geriatric assessment.2
Filipe Coutinho, MD
Older adults with cancer frequently present with multiple comorbidities, functional impairments, cognitive decline, and polypharmacy—all of which influence treatment decisions. However, structured geriatric oncology training is seldom integrated into undergraduate, postgraduate, and continuing education curricula. Bridging these educational gaps is imperative to equipping health-care providers with the skills to deliver comprehensive, individualized care to this growing patient population.3
Undergraduate Education: Establishing a Strong Foundation
Introducing fundamental principles of geriatrics and oncology at the undergraduate level is essential, since both aging and cancer are prevalent in health care. Medical students should develop a strong foundation in these areas, with an awareness of how aging influences cancer prevalence and treatment responses. A structured approach should include exposure to the following core concepts:
- The biological impact of aging on health and disease, including cancer
- Key principles of geriatric assessment, including functional and cognitive evaluation
- Fundamental oncologic principles, including cancer biology and treatment modalities
- The role of screening tools such as the Geriatric 8 (G8) questionnaire and the Vulnerable Elders Survey-13 (VES-13) in identifying vulnerabilities in older adults.
Interactive teaching methods, including case-based discussions, problem-solving exercises, and clinical rotations in oncology and geriatrics, may enhance knowledge retention and engagement. Structured lectures, such as those integrated into existing medical school programs, provide valuable introductory insights into the field. Expanding these efforts to incorporate standardized geriatrics modules and exposure to oncology within medical curricula will ensure a robust foundation in geriatric oncology from the outset.4 An emphasis on the pivotal role aging plays in the increasing prevalence of cancer may help to lay the groundwork for how physicians approach and manage older adults with cancer in the future.
The Value of Early Exposure to Geriatric Oncology
In Portugal, I have integrated a 1-hour lecture in geriatric oncology for fifth-year medical students into my class in medical oncology at the Health Sciences Faculty of the University of Beira Interior, incorporating key geriatric oncology principles such as comprehensive geriatric assessment, functional and cognitive evaluation, and treatment decision-making frameworks. This lecture, designed to be interactive and clinically relevant, has led to improvements in students’ knowledge and self-reported confidence in managing older adults with cancer, as demonstrated by assessments before and after the class.
However, challenges such as curriculum constraints and limited faculty training in geriatric oncology highlight the need for continued institutional support and resource allocation to sustain and expand these initiatives, focusing on the fundamental aspects of geriatric oncology.
Postgraduate Education: Advancing Specialized Training
Although early exposure to geriatric oncology is essential, advanced specialization must also occur at the postgraduate level. Oncology and allied specialties’ residency and fellowship programs should systematically incorporate training in geriatric assessment methodologies, decision-making frameworks for older adults with cancer, management of treatment-related toxicities in aging populations, and multidisciplinary collaboration with geriatricians and allied specialists.
Professional societies are instrumental in addressing these gaps. The Advanced Course in Geriatric Oncology, organized by the International Society of Geriatric Oncology (SIOG; https://siog.org/events/siog-events/siog-2025-advanced-course-treviso-italy/), exemplifies how structured postgraduate education enhances oncologists’ competencies in treating older adults.
Similarly, initiatives led by ASCO and supported by the Hartford Foundation have played a pivotal role in training leaders in geriatric oncology. These programs have fostered expertise through dedicated fellowships, research grants, and leadership development opportunities.
However, ensuring the widespread adoption of geriatric oncology principles requires formal recognition by educational accreditation bodies. Training programs should systematically incorporate these principles into curricula, competency frameworks, and certification requirements. Additionally, integrating geriatric oncology topics into board exams and professional assessments will reinforce their importance and drive competency-based learning.
Persistent gaps in postgraduate education emphasize the necessity for dedicated training initiatives tailored to oncologists at various career stages. Expanding fellowship opportunities, mentorship programs, and specialized continuing medical education courses will ensure that oncology professionals remain abreast of the latest developments in geriatric oncology.
The Role of Professional Societies and Global Collaboration
Organizations such as the International Society of Geriatric Oncology (SIOG) and ASCO have spearheaded efforts to advance geriatric oncology education, but lasting progress depends on the formal integration of these initiatives into academic curricula and professional training pathways. Key steps include accrediting geriatric oncology training, incorporating it into residency and fellowship programs, and ensuring its inclusion in board certification exams.5
Additionally, expanding access to geriatric oncology education across diverse health-care settings remains a challenge. SIOG’s and ASCO’s online educational resources and mentorship programs provide valuable continuous learning opportunities, but ensuring equitable access—particularly in regions with limited training—will be essential for standardizing knowledge and practice globally.
International collaboration is vital for harmonizing educational efforts, sharing best practices, and equipping oncology professionals worldwide with high-quality geriatric oncology training. Joint initiatives, cross-border training programs, and global mentorship networks will be instrumental in bridging educational gaps and fostering a more standardized approach in geriatric oncology care.
The Portuguese Experience in Geriatric Oncology Education
Portugal has made significant strides in geriatric oncology education, with the Geriatric Oncology Working Group (GTOG) of the Portuguese Society of Oncology (SPO) leading the way. Despite challenges such as limited institutional resources and the need for broader interdisciplinary collaboration, the GTOG of SPO has successfully launched several key educational initiatives.
These efforts include incorporating geriatric oncology into postgraduate curricula, organizing national training workshops, and fostering partnerships with both national and international organizations like SIOG. GTOG and SPO have played a pivotal role in integrating geriatric oncology into both medical education and clinical practice. Key initiatives have focused on developing comprehensive training programs for health-care professionals, raising awareness about the unique needs of older adults with cancer, and emphasizing the importance of the use of the Comprehensive Geriatric Assessment tool in guiding treatment decisions. Notable efforts also include the organization of national courses and conferences aimed at oncologists, nurses, and other health-care providers.
By fostering a multidisciplinary approach and prioritizing geriatric oncology in medical education, the GTOG of SPO is setting a precedent for a future in which older adults with cancer receive individualized, evidence-based care. These efforts underscore the importance of national leadership in advancing geriatric oncology education and serve as a model for other countries seeking to implement similar initiatives.
A Call to Action
Expanding geriatric oncology education is not merely a necessity, it is an ethical imperative, and it has been advocated as one of the top priorities by SIOG.6 As cancer care becomes increasingly personalized, educational frameworks must evolve to ensure that oncologists are equipped to treat older adults effectively and compassionately. Governments, medical schools, professional societies, and health-care institutions must collaborate to integrate geriatric oncology into standard medical education pathways.
By prioritizing education in this field, policymakers, medical institutions, and professional societies can play a pivotal role in ensuring that older adults with cancer receive evidence-based, individualized care that enhances both survival and quality of life. A concerted effort is required to integrate geriatric oncology into medical curricula, develop specialized training programs, and allocate resources to support ongoing education.
The time to act is now. By embracing this commitment, we can shape a future in which comprehensive cancer care truly addresses the unique needs of an aging population.
DISCLOSURE: Dr. Coutinho reported no conflicts of interest.
REFERENCES
1. Cufer T, Kosty MP: ESMO/ASCO recommendations for a Global Curriculum in Medical Oncology Edition 2023. JCO Glob Oncol 9:e2300277, 2023.
2. Maggiore RJ, Dale W, Hurria A, et al: Hematology-oncology fellows’ training in geriatrics and geriatric oncology: Findings from an American Society of Clinical Oncology–sponsored national survey. J Oncol Pract 13:e900-e908, 2017.
3. Hsu T, Kenis C, Haase K, et al: International consensus on the optimal management of geriatric oncology education and training. Lancet Oncol 21:e456-e467, 2020.
4. Gregorio DJ, Lucero K, Arora SP, et al: An introductory course on geriatric oncology. MedEdPORTAL 20:11471, 2024.
5. Diaz FC, Hamparsumian A, Loh KP, et al: Geriatric oncology: A 5-year strategic plan. Am Soc Clin Oncol Educ Book 44:e100044, 2024.
6. Extermann M, Brain E, Canin B, 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 22:e29-e36, 2021.
Dr. Coutinho is a medical oncologist and palliative care physician at the Médio Ave Local Health Unit in Santo Tirso and in Vila Nova de Famalicão, in Portugal; Coordinator and Guest Professor in Medical Oncology at the Faculty of Health Sciences of the University of Beira Interior, Covilhã, Portugal; Founder and Chair of the Geriatric Oncology Working Group for the Portuguese Society of Oncology; National Representative for the SIOG; member of the Young SIOG Goverance Team (2024-2026); and member of the Cancer and Aging Research Group.
