Unravelling the complexity of assessment in older patients
Dr Trine Lembrecht Jørgensen - University of Southern Denmark
Bringing the meeting to Copenhagen has been important for Denmark too since we don’t have a specific geriatric oncology strategy in Denmark and we need that. 45% of all incident cancer cases are in patients aged 70 years and more, 60% of cancer related deaths are seen in patients aged 70 years and more and this is in Denmark only. With the elderly population growing here too it’s important to have more focus on that.
How do you deal with elderly patients?
Like any other patient, of course, we evaluate them, we look at their functional status and treat them but we have the same guidelines as for every adult cancer person and perhaps we need to look more into having special focus on the elderly patient with the problems they might have in the form of more comorbidity, polypharmacy and those things.
How do you respond to the criticism of the geriatric assessment being time consuming?
A full geriatric assessment is 40-50 minutes and we don’t have that in our clinical every day. So we do need tools that are more practical and this has developed and I’m looking very much forward to seeing this being taken further into the decision making of how to treat the elderly patients so that we can have strategies and guidelines how to treat these patients best.
What are the important points that need to be addressed?
This meeting is very broad; it has been divided into five scientific tracts. Of course solid tumours in elderly patients and focussing on what treatments are best. Yesterday there was a good session on breast cancer and the speakers talked about who do not need extensive radiation therapy, who do not need medical treatment. Maybe we could take care of our patients, maybe some of them might be undertreated because of age alone but some of them might also be overtreated. That’s one issue, that there might be a different treatment of these patients. Today there is a session on colorectal cancer where they highlight the issues of prehabilitation. We’ve talked a lot about rehabilitation after treatment but they talk about prehabilitation before cancer surgery; I think that might also be a very important issue. Also yesterday there was a good session on socioeconomic status and this seems to be very important too. So the overall theme of this meeting is a multidisciplinary approach towards the elderly cancer patient and I think all the sessions highlight the importance of this multidisciplinary approach.
Is there support for the elderly cancer patient once they are discharged?
We have our welfare system in Denmark and healthcare is free so socioeconomic status might not have the same implication as in other countries but still it might mean something for when do patients contact their physicians. So there might still be differences. But there is a support system and we do follow our patients in the hospital setting and also as outpatients.