Geriatric assessment for oncologists

• Published in: Cancer biology & medicine Vol. 12; no. 4; pp. 261 - 274
• Main Authors: Korc-Grodzicki, Beatriz, Holmes, Holly M, Shahrokni, Armin
• Format: Journal Article
• Language: English
• Published: China Chinese Anti-Cancer Association (CACA), Cancer Biology & Medicine 01.12.2015; Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY 10065, USA%Division of Geriatric and Palliative Medicine, The University of Texas Health Science Center at Houston, Houston, TX 77030, USA; Chinese Anti-Cancer Association; China Anti-Cancer Association
• Subjects: Adults; Age; Aging; Cancer; Cancer therapies; Chemotherapy; Chronic illnesses; Decision making; Frailty; geriatric assessment (GA); Geriatric oncology; Geriatrics; Life span; Mitochondrial DNA; Older people; Patients; Physiology; Population; Review; Smartphones; Tumors; 临床医生; 健康评估; 器官功能; 生理变化; 癌症患者; 肿瘤; 衰老过程; 遗传算法; geriatric assessment (GA); frailty; Geriatric oncology
• ISSN: 2095-3941; 2095-3941
• DOI: 10.7497/j.issn.2095-3941.2015.0082

The world is experiencing aging of its population. Age-specific incidence rates of cancer are higher and cancer is now recognized as a part of aging. Treating older patients can be challenging. The clinical behavior of some tumors changes with age and the aging process itself brings physiological changes leading to decline in the function of organs. It is essential to identify those patients with longer life expectancy, potentially more likely to benefit from aggressive treatment vs. those that are more vulnerable to adverse outcomes. A primary determination when considering therapy for an older cancer patient is a patient＇s physiologic, rather than chronologic age. In order to differentiate amongst patients of the same age, it is useful to determine if a patient is fit or frail. Frail older adults have multiple chronic conditions and difficulties maintaining independence. They may be more vulnerable to therapy toxicities, and may not have substantial lasting benefits from therapy. Geriatric assessment（GA） may be used as a tool to determine reversible deficits and devise treatment strategies to mitigate such deficits. GA is also used in treatment decision making by clinicians, helping to risk stratify patients prior to potentially high-risk therapy. An important practical aspect of GA is the feasibility of incorporating it into a busy oncology practice. Key considerations in performing the GA include： available resources, patient population, GA tools to use, and who will be responsible for using the GA results and develop care plans. Challenges in implementing GA in clinical practice will be discussed.