Cancer in the older person

2008 ◽  
Vol 18 (4) ◽  
pp. 313-321
Author(s):  
Peter Stephens
Keyword(s):  
Cancer Patients ◽  
Clinical Oncology ◽  
Older Patients ◽  
Malignant Disease ◽  
Task Force ◽  
Annual Conference ◽  
Older Person ◽  
European Organisation ◽  
Older Cancer Patients ◽  
American Society

The challenges of treating malignant disease in the older population are gaining greater prominence. In the last 10 years the European Organisation for Research and Treatment of Cancer (EORTC) has established a task force to examine challenges of managing older cancer patients. As an indication of their importance, the American Society of Clinical Oncology (ASCO) specifically addressed the issues raised by older patients at their annual conference in 2004.

American Society of Clinical Oncology Guideline: Recommendations for Venous Thromboembolism Prophylaxis and Treatment in Patients With Cancer

2007 ◽  
Vol 25 (34) ◽  
pp. 5490-5505 ◽  
Author(s):  
Gary H. Lyman ◽  
Alok A. Khorana ◽  
Anna Falanga ◽  
Daniel Clarke-Pearson ◽  
Christopher Flowers ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Cancer Patients ◽  
Clinical Oncology ◽  
Malignant Disease ◽  
Major Surgery ◽  
Thromboembolism Prophylaxis ◽  
Patients With Cancer ◽  
Prevention And Treatment ◽  
American Society ◽  
The Impact

Purpose To develop guideline recommendations for the use of anticoagulation in the prevention and treatment of venous thromboembolism (VTE) in patients with cancer. Methods A comprehensive systematic review of the medical literature on the prevention and treatment of VTE in cancer patients was conducted and reviewed by a panel of content and methodology experts. Following discussion of the results, the panel drafted recommendations for the use of anticoagulation in patients with malignant disease. Results The results of randomized controlled trials of primary and secondary VTE medical prophylaxis, surgical prophylaxis, VTE treatment, and the impact of anticoagulation on survival of patients with cancer were reviewed. Recommendations were developed on the prevention of VTE in hospitalized, ambulatory, and surgical cancer patients as well as patients with established VTE, and for use of anticoagulants in cancer patients without VTE to improve survival. Conclusion Recommendations of the American Society of Clinical Oncology VTE Guideline Panel include (1) all hospitalized cancer patients should be considered for VTE prophylaxis with anticoagulants in the absence of bleeding or other contraindications; (2) routine prophylaxis of ambulatory cancer patients with anticoagulation is not recommended, with the exception of patients receiving thalidomide or lenalidomide; (3) patients undergoing major surgery for malignant disease should be considered for pharmacologic thromboprophylaxis; (4) low molecular weight heparin represents the preferred agent for both the initial and continuing treatment of cancer patients with established VTE; and (5) the impact of anticoagulants on cancer patient survival requires additional study and cannot be recommended at present.

The assessment and management of older cancer patients: A SIOG surgical task force survey on surgeons' attitudes

2016 ◽  
Vol 42 (2) ◽  
pp. 297-302 ◽  
Author(s):  
F. Ghignone ◽  
B.L. van Leeuwen ◽  
I. Montroni ◽  
M.G. Huisman ◽  
P. Somasundar ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Task Force ◽  
Older Cancer Patients

scholarly journals Immunotherapy and Radiotherapy for Older Cancer Patients during the COVID-19 Era: Proposed Paradigm by the International Geriatric Radiotherapy Group

Gerontology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Nam Phong Nguyen ◽  
Brigitta G. Baumert ◽  
Eromosele Oboite ◽  
Micaela Motta ◽  
Gokula Kumar Appalanaido ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Local Control ◽  
Older Patients ◽  
Locally Advanced ◽  
The Elderly ◽  
New Paradigm ◽  
Radiotherapy Group ◽  
Potential Synergy ◽  
Physician Bias ◽  
Older Cancer Patients

<b><i>Background:</i></b> Older cancer patients with locally advanced or metastatic disease may benefit from chemotherapy alone or combined with radiotherapy. However, chemotherapy is often omitted either because of physician bias or because of its underlying comorbidity, thus compromising their survival. The coronavirus disease 19 (COVID-19) pandemic is compounding this issue because of the fear of immunosuppression induced by chemotherapy on the elderly which makes them more vulnerable to the virus. <b><i>Summary:</i></b> Immunotherapy has less effect on the patient bone marrow compared to chemotherapy. The potential synergy between radiotherapy and immunotherapy may improve local control and survival for older patients with selected cancer. Preliminary data are encouraging because of better survival and local control in diseases which are traditionally resistant to radiotherapy and chemotherapy such as melanoma and renal cell carcinoma. <b><i>Key Message:</i></b> We propose a new paradigm combining immunotherapy at a reduced dose and/or extended dosing intervals and hypofractionated radiotherapy for older patients with selected cancer which needs to be tested in future clinical trials.

Palliative Cancer Care a Decade Later: Accomplishments, the Need, Next Steps—From the American Society of Clinical Oncology

2009 ◽  
Vol 27 (18) ◽  
pp. 3052-3058 ◽  
Author(s):  
Frank D. Ferris ◽  
Eduardo Bruera ◽  
Nathan Cherny ◽  
Charmaine Cummings ◽  
David Currow ◽  
...  
Keyword(s):  
Palliative Care ◽  
Clinical Oncology ◽  
Cancer Care ◽  
Task Force ◽  
Life Quality ◽  
Term Care ◽  
The Board Of Directors ◽  
American Society ◽  
Definition Of ◽  
Private Homes

Purpose In 1998, the American Society of Clinical Oncology (ASCO) published a special article regarding palliative care and companion recommendations. Herein we summarize the major accomplishments of ASCO regarding palliative cancer and highlight current needs and make recommendations to realize the Society's vision of comprehensive cancer care by 2020. Methods ASCO convened a task force of palliative care experts to assess the state of palliative cancer care in the Society's programs. We reviewed accomplishments, assessed current needs, and developed a definition of palliative cancer. Senior ASCO members and the Board of Directors reviewed and endorsed this article for submission to Journal of Clinical Oncology. Results Palliative cancer care is the integration into cancer care of therapies that address the multiple issues that cause suffering for patients and their families and impact their life quality. Effective provision of palliative cancer care requires an interdisciplinary team that can provide care in all patient settings, including outpatient clinics, acute and long-term care facilities, and private homes. Changes in current policy, drug availability, and education are necessary for the integration of palliative care throughout the experience of cancer, for the achievement of quality improvement initiatives, and for effective palliative cancer care research. Conclusion The need for palliative cancer care is greater than ever notwithstanding the strides made over the last decade. Further efforts are needed to realize the integration of palliative care in the model and vision of comprehensive cancer care by 2020.

scholarly journals Preoperative Inflammatory Markers as a Predictor of Three-Year Overall Survival in Older Cancer Patients Undergoing Oncologic Surgery

Cancers ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1824
Author(s):  
Baukje Brattinga ◽  
Abraham Rutgers ◽  
Jacco J. De Haan ◽  
Anthony R. Absalom ◽  
Hanneke van der Wal-Huisman ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factor ◽  
Plasma Level ◽  
Cancer Patients ◽  
Inflammatory Markers ◽  
Older Patients ◽  
Specific Group ◽  
Oncologic Surgery ◽  
Older Cancer Patients ◽  
Multivariate Hazard Ratio

Oncologic surgery results in substantially higher morbidity and mortality rates in older patients compared to younger patients, yet little is known about the relation between the preoperative inflammatory state and postoperative outcome in the specific group of older cancer patients. The aim of this study was to examine whether preoperative inflammatory markers could be a predictor of overall survival in older patients undergoing elective surgery for a solid malignant tumor. Patients 65 years and older undergoing surgery for a solid malignant tumor were included in a prospective cohort study. Inflammatory markers C-reactive protein (CRP), interleukin-1 beta (IL-1β), IL-6, IL10, IL-12 and tumor necrosis factor-alpha (TNF-α) were measured in plasma samples preoperatively. The main outcome was overall survival three years after surgery. Between 2010 and 2016, 328 patients with a median age of 71.5 years (range 65–89) were included. A significantly higher mortality rate three years after surgery, was found in patients with high preoperative plasma levels of CRP and IL-6 (p = 0.013 and p = 0.046, respectively). In multivariate analysis, corrected for variables such as age, disease stage, frailty, comorbidities, type of surgery and complications, a preoperative plasma level of CRP ≥ 10 mg/L was an independent prognostic factor for inferior overall survival three years after surgery (multivariate hazard ratio 1.50, 95% confidence interval 1.04–2.16, p = 0.031). Also, for the specific group of patients with colorectal cancer, a preoperative plasma level of CRP ≥ 10 mg/L was a prognostic factor for inferior survival three years after surgery (multivariate hazard ratio 2.40, 95% confidence interval 1.20–4.81, p = 0.014). Preoperative elevated plasma level of CRP is an independent unfavorable prognostic factor for overall survival three years after oncologic surgery. This gives more insight into the relationship between inflammation and survival in older cancer patients, and might contribute to risk stratification for poor outcome after surgery in older cancer patients.

scholarly journals Recent advances in cancer surgery in older patients

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 1242 ◽  
Author(s):  
Siri Rostoft ◽  
Riccardo A. Audisio
Keyword(s):  
Cancer Patients ◽  
Older Patients ◽  
Postoperative Morbidity ◽  
Gynecological Cancer ◽  
Functional Limitations ◽  
Preoperative Evaluation ◽  
Cognitive Status ◽  
Frailty Assessment ◽  
Older Cancer Patients

Age is the most important risk factor for the occurrence of cancer, and a declining mortality from heart disease and other non-cancer causes leaves an older population that is at high risk of developing cancer. Choosing the optimal treatment for older cancer patients may be a challenge. Firstly, older age and associated factors such as comorbidities, functional limitations, and cognitive impairment are risk factors for adverse effects of cancer treatment. Secondly, older patients are often excluded from clinical trials, and current clinical guidelines rarely address how to manage cancer in patients who have comorbidities or functional limitations. The importance of incorporating frailty assessment into the preoperative evaluation of older surgical patients has received increasing attention over the last 10 years. Furthermore, studies that include endpoints such as functional status, cognitive status, and quality of life beyond the standard endpoints, i.e. postoperative morbidity and mortality, are starting to emerge. This review looks at recent evidence regarding geriatric assessment and frailty in older surgical cancer patients and provides a summary of newer studies in colorectal, liver, pancreatic, and gynecological cancer and renal and central nervous system tumors.

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