January - April 2008 Issue
Older Adults with Cancer Have Special Needs
Kathryn A. Bylow, MDMedical College of Wisconsin Geriatric Oncologist
More than 60 percent of new cancers occur in people over age 65. Older adults with cancer have special needs, and many social, cultural and medical issues can affect the care they receive. Dr. Kathryn Bylow explains her approach to care for older adults with cancer.
Q. What is the field of geriatric oncology?Geriatric oncology focuses on care for older patients with cancer. The specialty combines geriatrics, which focuses on disease and disability in later life, and oncology, which is concerned with cancer prevention, diagnosis and treatment.
To determine an individualized treatment plan for an older patient, I use a comprehensive geriatric assessment, an in-depth evaluation tool. This assessment evaluates physical health, functioning (doing everyday tasks), cognition (thinking ability), emotions, social environment, nutrition and medications. I also talk to family members. The results of this assessment help us to tailor an individualized treatment plan for each patient.
Q. Why is this specialty becoming more important?Cancer is a disease of aging. Due to the increase in life expectancy, cancer in older people is becoming increasingly common. The number of Americans over the age of 65 is expected to double by the year 2030. Geriatric oncologists are needed to address the unique issues of older patients with cancer.
Q. How does cancer care differ for an older patient?Cancer care for older patients is more complex. Older adults are more likely to have other medical problems that may affect their cancer treatment. They may be less able to tolerate certain cancer treatments, or they may tolerate cancer treatment just as well as younger patients. They may also have limited access to transportation, social support or financial resources, which can affect their care.
Q. How does this focus improve care and outcomes?Geriatric oncology is a newer specialty, and while more data needs to be collected, it’s believed that the comprehensive geriatric assessment contributes to a better understanding of an older patient’s health-related needs and the selection of appropriate treatment. If someone is highly functional, I would treat him or her as I would a younger patient. Cancer treatment should not be based solely on age, but instead by the overall health and functional status of a person. There are no data to suggest otherwise.
Source: Every Day
Date: Jan - April 2008 Issue