With a rapidly aging population shifting the spotlight to geriatric oncology, research in this area is also quickly changing and improving. On this page, you can review the latest updates on cancer in older people. The resources have been gathered from research and publications presented at the 2016 ASCO Annual Meeting, articles in the Journal of Clinical Oncology and the JCO Oncology Practice, and features in The ASCO Post. Also check out the International Society of Geriatric Oncology’s (SIOG’s) clinical guidelines for treating older patients with cancer. In addition, visit the Portal of Geriatrics Online Education’s free digital resources focused on gerontology and cancer in older adults.
ASCO Annual Meeting
Held annually in June, the ASCO Annual Meeting brings together more than 30,000 oncology professionals from around the world to debut the newest, cutting-edge, multidisciplinary research in the oncology world and to share ideas and network. Many publications and other resources are produced for the meeting each year, and they prove to be valuable and effective long after each meeting ends. Below are a sampling of these resources, with a description of the specific geriatric oncology research they provide.
ASCO Educational Book
Each year, ASCO Annual Meeting faculty and other invited speakers provide written synopses of their upcoming Annual Meeting Educational Session topics. These synopses are then published in the peer-reviewed, NLM-indexed ASCO Educational Book. The articles encompass the most up-to-date and timely research in all areas of oncology. Below are several articles focused on current updates in geriatric oncology, including targeted therapies, the use of geriatric assessments, and survivorship issues for this population.
- Improving Quality and Value of Cancer Care for Older Adults: Quality and value have become ubiquitous in discussions about cancer care, yet they remain difficult to encapsulate, particularly in the care of older adults with cancer. Older adults are heterogeneous and often excluded from clinical trials. Moreover, many frameworks for quality and value focus on traditional outcomes of survival and toxicity and neglect goals that may be more meaningful for older adults, such as quality of life and functional independence. New models of care would be advantageous for older adults with cancer, facilitating collaboration, communication, and patient-centeredness and minimizing the fragmentation that impairs the current provision of cancer care. The authors discuss the work needed to achieve relevant outcomes for this vulnerable and growing population.
- Screening and Treating Prostate Cancer in the Older Patient: Decision Making Across the Clinical Spectrum: Caring for elderly men with prostate cancer requires knowledge of aspects of disease presentation, screening strategies, treatment approaches, and survivorship care considerations unique to the geriatric population. In this article, the authors review characteristics of prostate cancer screening and treatment decision making for localized disease in elderly men, including a discussion of the biology of disease in this population. The articles reviews best practices for providing treatment for localized and recurrent disease, including engaging in a basic geriatric assessment to determine fitness for treatment, eliciting information about patient preferences and support systems, and balancing treatment decisions in the context of these factors using the resources of a multidisciplinary care team.
- Caring for the Older Population with Advanced Lung Cancer: The average age of a newly diagnosed patient with advanced lung cancer remains around age 70. Caring for the older adult with advanced cancer differs from the care of younger adults. Chronologic age often does not accurately reflect the physiologic and functional status of older adults. Addressing issues such as multiple chronic conditions, polypharmacy, geriatric syndromes, and heterogeneity in functional status among an expanding menu of treatment options for advanced disease is increasingly difficult, particularly among older adults historically underrepresented in clinical trials. In this article, the authors highlight key issues in caring for the older adult with advanced non–small cell lung cancer and the continued need for data supporting current and emerging treatment options.
- Myeloma in Elderly Patients: When Less is More and More is More: Multiple myeloma is a plasma cell malignancy that occurs among older adults and accounts for 15% of all hematologic malignancies in the United States. Novel therapeutics and routine use of autologous stem cell transplantation have led to substantial improvements in patient survival, although improvements have been more impressive among patients younger than age 65. Finding the balance between under- and over-treating elderly patients is one of the biggest challenges facing patients with MM and their healthcare providers. Consideration of quality of life for these patients is paramount. Although there is a growing list of tools to aid in treatment decision-making, a fully integrated approach has not yet been finely tuned, leaving work to be done.
- Endometrial Cancer: Is This a New Disease?: The incidence of endometrial cancer is increasing, and the age of onset is younger than in prior years. Although endometrial cancer is still more common in older women, for whom the mortality rate is increasing, it also is being diagnosed in younger women. The underlying cause of the increase in incidence is the epidemic of obesity and the resulting hyperinsulinemia. Conservative treatment may be indicated for younger women who wish to retain their fertility. Lifestyle modifications such as diet and exercise can modulate the risk of developing endometrial cancer as well as prevent recurrence and other comorbidities associated with obesity.
- Age and Sex in Non-Hodgkin Lymphoma Therapy: It’s Not All Created Equal, or Is It?: Age is the most prominent factor for survival in all patients diagnosed with lymphoma, and male sex implies an increased and independent risk for a worse progression-free survival and overall survival in most lymphomas, possibly with the exception of mantle cell lymphoma. The worse outcome for elderly patients is only partially explained by decreased tolerance to treatment regimens associated with the increasing number and severity of comorbidities. Little is known about specific differences in lymphoma biology with respect to age and sex, and this is changing only slowly despite the recent rise in interest about these issues.
Journal of Clinical Oncology
The Journal of Clinical Oncology (JCO) is the official journal of the American Society of Clinical Oncology. Available digitally and in print, JCO publishes clinical oncology research articles aimed at an audience of medical professionals from all areas of oncology. More than 25,000 oncologists from over 120 countries receive JCO each month, and its online component receives more than 3.2 unique visits annually. The journal maintains a collection of geriatric oncology journal articles on its website and provides the ability to subscribe to an RSS feed.
- Use of a Comprehensive Geriatric Assessment for the Management of Elderly Patients With Advanced Non–Small-Cell Lung Cancer: The Phase III Randomized ESOGIA-GFPC-GECP 08-02 Study: Doctors typically use performance status (PS) to determine chemotherapy allocation in older adults with advanced non-small cell lung cancer (NSCLC). But in this Journal of Clinical Oncology article, researchers detail findings from their study in which they used comprehensive geriatric assessment (CGA) instead of PS. The researchers conducted a multicenter, open-label, phase III trial in patients age 70 and older with stage IV NSCLC. The team discovered that neither treatment failure-free survival nor overall survival improved with CGA treatment allocation, but use of CGA did somewhat decrease treatment toxicity.
- Burden of Geriatric Events Among Older Adults Undergoing Major Cancer Surgery: This JCO article explores the occurrence of geriatric events, including delirium, dehydration, falls and fractures, and pressure ulcers, during major surgical treatment for cancer. The research team found that these events occur often among older adults undergoing major surgery for the treatment of cancer—especially gastric cancer. Additionally, these events are most likely due to operative morbidity, prolonged hospitalization, and more expensive health care. Future research must focus on remedying these geriatric events for these surgical patients and providing the best health care possible.
JCO Oncology Practice
ASCO publishes the JCO Oncology Practice (JCO OP) with the aim of helping oncology professionals provide the highest-quality care to patients. In its monthly issues, JCO OP delivers the most up-to-date and cutting-edge information on oncology practice in the form of clinical reviews, commentaries, editorials, and more. The journal houses a collection of its published geriatric oncology resources and provides the ability to subscribe to an RSS feed.
- Breast Cancer in Women Older Than 80 Years: The population of adults age 80 and older is growing quickly, currently making up 9 million of the US population. At the same time, breast cancer is the most common cancer among women and is primarily diagnosed after age 60. In this JCO OP article, researchers review the current literature on treating breast cancer in women age 80 and older. In addition, they discuss the importance of geriatric assessment and the patient’s own goals in choosing the right treatment.
- Falls in Older Adults With Cancer: Evaluation by Oncology Providers: Falls are common among older adults, and they also increase the morbidity and mortality rates of older patients with cancer. Researchers in this JCO OP article reviewed data on how oncology providers recognize and respond to falls among their older patients with cancer. The study found that only 10% of the falls among older patients with cancer were documented after being reported to the oncology provider. The authors call for increased attention and reporting of falls among older patients with cancer.
The ASCO Post
Available digitally and in print, The ASCO Post provides up-to-date oncology news and clinical research. It covers a wide range of oncology topics important to clinicians, ASCO members, and other health care professionals, and includes a focus on geriatric oncology. The ASCO Post also publishes expert op-eds, webcasts and videos, and oncology meeting coverage.
- “Geriatrics for the Oncologist”: is a monthly column in The ASCO Post produced in collaboration with the International Society for Geriatric Oncology. Guest authors pen op-eds on various important topics in the field, including supportive care for older adults with cancer, clinical trial design for older adults, and the state of specific types of cancer in this population.
Founded in 2000, SIOG strives to improve cancer care for the older population through effectively developing and equipping geriatric oncology health professionals. As part of its many contributions to this field, SIOG provides clinical guidelines for treating older patients with cancer. These guidelines focus on many topics, including geriatric assessments, surgery and radiation treatments, and how to approach different types of cancer in older adults.
Visit the Portal of Geriatrics Online Education (POGOe) to find free digital education materials in the field of geriatrics and gerontology. These expert-contributed learning tools and videos are geared toward both teachers and students to promote better understanding of geriatric principles and skills.