Advertisement

Organizing the Clinical Integration of Geriatrics and Oncology

  • Silvio MonfardiniEmail author
Living reference work entry

Abstract

The management of cancer in the elderly requires attention to the oncological aspects as well as to those age-associated. Due to the complexity of the clinical aspects on both sides, the practice of the interdisciplinarity involving Clinical Oncologists, Geriatricians, and other actors is needed, but this is difficult to be achieved without a proper organization with dedicated time and space, since this integrated activity cannot rely only on good will.

A structured approach to the problem has been attempted through the so-called Geriatric Oncology Programs with different characteristics in various Countries, on the basis of the local health organization and available resources.

No uniform universal model can then be proposed; therefore, here the most common models have been presented as possible alternatives to those who would like to enter in this field. A description of the activities carried out in various countries may also help in suggesting solutions for situations similar to those described.

Keywords

Integrating oncology and geriatrics Organizing the clinical activity Geriatric Oncology Programs 

References

  1. Brechot JM. Aging and cancer – addressing a nation’s challenge. In: Extermann M, editor. Cancer and aging. From bench to clinics. Basel: Karger; 2013. p. 158–63.Google Scholar
  2. Brechot JM, Balandier C. Monitoring of the scheme for care and clinical research in oncogeriatrics/January 2015, support for the decision, INCa, March 2015. e-cancer.fr. Accessed 5 Dec 2018.
  3. Cohen HJ. A model for the shared care of elderly patients with cancer. J Am Geriatr Soc. 2009;57(Suppl 2): 300–2.CrossRefGoogle Scholar
  4. Colloca G, Monfardini S. A contribution to the future of geriatric oncology training. J Geriatr Oncol. 2017;8:387–8.CrossRefGoogle Scholar
  5. Cutolo GL, Santacroce G, Sandri R, Viti N, Pirri F, Ricciardi T, Cantatore A, Cossovich P, De Domenico D, Rebecchi I, Galetti G, Monfardini S. Cancer in five Italian nursing homes. J Geriatr Oncol. 2012;3(Suppl 1):S1–S102.Google Scholar
  6. De Coster L, Van Puyvelde K, Mohile S, Wedding U, Basso U, Colloca G, Rostoft S, Overcash J, Wildiers H, Kimmick G, Kanesvaran R, Luciani A, Terret C, Hurria A Kenis C, Audisio R, Extermann M. Screening tools for multidimensional health problems warranting a geriatric assessment in older cancer patients: an update on SIOG recommendations. Ann Oncol. 2014;26:288–300.CrossRefGoogle Scholar
  7. Extermann M, Aapro M, Audisio R, Balducci L, Droz JP, Steer C, Wildiers H, Zulian G, on behalf of the International Society of Geriatric Oncology. Main priorities for the development of geriatric oncology: a worldwide expert perspective. J Geriatr Oncol. 2011;2:270–3.CrossRefGoogle Scholar
  8. Extermann M, Boler I, Reich RR, Lyman GH, Brown RH, DeFelice J, Levine RM, Lubiner ET, Reyes P, Schreiber FJ III, Balducci L. Predicting the risk of chemotherapy toxicity in older patients: the Chemotherapy Risk Assessment Scale for High-Age Patients (CRASH) score. Cancer. 2012;118:3377–86.CrossRefGoogle Scholar
  9. Holmes HM, Allbrand G. Organizing the geriatrician/oncologist partnership: one size fits all? Practical solutions. In: Extermann M, editor. Cancer and aging. From bench to clinics. Basel: Karger; 2013. p. 132–8.Google Scholar
  10. Hurria A. The facts and the need for a multidisciplinary approach. J Geriatr Oncol. 2014;5:51–7.Google Scholar
  11. Hurria A. Multidisciplinary approach in a global environment. In: North America 16th conference of the International Society of Geriatric Oncology, Milan, November 18, 2016. No abstract available.Google Scholar
  12. Hurria A, Togawa K, Mohile SG, Owusu C, Klepin HD, Gross CP, Lichtman SM, Gajra A, Bhatia S, Katheria V, Klapper S, Hansen K, Ramani R, Lachs M, Wong FL, Tew WP. Predicting chemotherapy toxicity in older adults with cancer: a prospective multicenter study. J Clin Oncol. 2011;29(25):3457–65.  https://doi.org/10.1200/JCO.2011.34.7625.CrossRefPubMedPubMedCentralGoogle Scholar
  13. Hurria A, Dale W, Mooney M, Rowland JH, Ballman KV, Cohen HJ, Muss HB, Schilsky RL, Ferrell B, Extermann M, Schmader KE, Mohile S. Designing therapeutic clinical trials for older and frail adults with cancer: U13 conference recommendations. J Clin Oncol. 2014;32:2587–94.CrossRefGoogle Scholar
  14. Karnakis T, Gattás-Vernaglia I, Saraivaa MD, Gil-Juniora LA, Kanajia AL, Jacob-Filhoa W. The geriatrician’s perspective on practical aspects of the multidisciplinary care of older adults with cancer. J Geriatr Oncol. 2016;7:341–5.CrossRefGoogle Scholar
  15. Lazarovici C, Khodabakhshi R, Leignel D, Fabre-Guillevin E, Minard A, Gisselbrecht M. Factors leading oncologists to refer elderly cancer patients for geriatric assessment. J Geriatr Oncol. 2011;2:194–9.CrossRefGoogle Scholar
  16. Magnuson A, Dale W, Mohile S. Models of care in geriatric oncology. Curr Geriatr Rep. 2014;3:182–9.CrossRefGoogle Scholar
  17. Mohile S, Hurria A, Dale W. Introduction to U13 supplement. J Geriatr Oncol. 2016;4:223–2.CrossRefGoogle Scholar
  18. Monfardini S, Aapro MS. Cancer treatment in the elderly: the need for a better organization. Ann Oncol. 2007;18:1283–4.CrossRefGoogle Scholar
  19. Monfardini S, Aapro MS, Bennett JM, Mori M, Regenstreif D, Rodin M, Stein B, Zulian GB, Droz JP. Organization of the clinical activity of geriatric oncology: report of a SIOG task force. Crit Rev Oncol Hematol. 2007;62:62–73.CrossRefGoogle Scholar
  20. Monfardini S, Gridelli C, Biganzoli L, Arnoldi E, Colloca G, Gambardella A, Falci C, Leo S, Tralongo P, Castagneto B, Martoni A, Madaio R, Fratino L. An Italian enquiry on the organisation of the clinical activity of geriatric oncology: a preliminary analysis. J Geriatr Oncol. 2012a;3(Suppl 1):S77–8.CrossRefGoogle Scholar
  21. Monfardini S, Giordano G, Sandri R, Gnocchi PL, Galetti G. Bringing geriatrics into oncology or also oncology into geriatrics? Ann Oncol. 2012b;23:801.CrossRefGoogle Scholar
  22. Monfardini S, Terret C, Hurria A, Kristjianson S, Kunkler I, Aapro M, Devi B, Van Leeuwen B, Steer C. Worldwide geriatric oncology organisation: a preliminary report from the SIOG task force. J Geriatr Oncol. 2013;4(Suppl 1):99–S100.CrossRefGoogle Scholar
  23. Monfardini S, Morlino S, Valdagni R, Catanzaro M, Tafa A, Bortolato B, Petralia G, Bonetto E, Villa E, Picozzi S, Locatelli MC, Galetti G, Millul A, Albanese Y, Bianchi E, Panzarino C, Gerardi F, Beghi E. Follow-up of elderly patients with urogenital cancers: evaluation of geriatric care needs and related actions. J Geriatr Oncol. 2017;8:289–95.CrossRefGoogle Scholar
  24. Overcash J. Geriatric oncology nursing: beyond standard care. In: Extermann M, editor. Cancer and aging. From bench to clinics. Basel: Karger; 2013. p. 139–45.Google Scholar
  25. Rowland J, Bellizzi KM. Cancer survivorship issues: life after treatment and implications for an aging population. J Clin Oncol. 2014;24:2262–668.Google Scholar
  26. Sifer-Rivière L, Saint-Jean O, Gisselbrecht M, Cudennec T, Girre V. What the specific tools of geriatrics and oncology can tell us about the role and status of geriatricians in a pilot geriatric oncology program. Ann Oncol. 2011;22:2325–9.CrossRefGoogle Scholar
  27. Soto-Perez-de-Celis E, de Glas NA, Hsu T, Kanesvaran R, Steer C, Navarrete-Reyes AP, Battisti NML, Chavarri-Guerra Y, O’Donovan A, Avila-Funes JA, Hurria A. Global geriatric oncology: achievements and challenges. J Geriatr Oncol. 2017;8:374–86.CrossRefGoogle Scholar
  28. Soubeyran P, Bellera C, Goyard J, Heitz D, Curé H, Rousselot H, Albrand G, Servent V, Saint Jean O, van Praagh I, Kurtz JE, Périn S, Verhaeghe JL, … Rainfray M. Screening for vulnerability in older cancer patients: the ONCODAGE Prospective Multicenter Cohort Study. PLoS One. 2014;9(12):e115060.CrossRefGoogle Scholar
  29. Wildiers H, Heeren P, Puts M, Topinkova E, Janssen-Heijnen M, Extermann M, Falandry C, Artz A, Brain E, Colloca G, Flamaing J, Karnakis T, Kenis C, Audisio RA, Mohile S, Repetto L, Van Leeuwen B, Milisen K, Hurria A. International Society of Geriatric Oncology consensus on geriatric assessment in older patients with cancer. J Clin Oncol. 2014;32:2595–604.CrossRefGoogle Scholar
  30. Yancic R, Ries RA. Aging and cancer in America. Demographic and epidemiologic perspectives. Hematol Oncol Clin North Am. 2000;14:17–23.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Geriatric Oncology ProgramIstituto Palazzolo, Fondazione Don GnocchiMilanItaly

Section editors and affiliations

  • William Dale
    • 1
  1. 1.Department of Supportive Care MedicineCity of Hope Duarte - Comprehensive Cancer CenterDuarteUSA

Personalised recommendations