95:. Older patients have unique needs because of their often complex medical histories, numerous drugs they are taking, their social situations, possible problems with cognitive dysfunction related to age, and general diminution of organ function that occurs naturally in the older population. For these reasons, it is important that older patients (especially if frail, or have multiple medical problems) being considered for cancer treatment should undergo
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rapidly growing group. This is compounded by the fact that the majority of cancer patients will be in this age group. Age in itself is one of the most important risk factors for developing cancer. Currently, 60% of newly diagnosed malignant tumors and 70% of cancer deaths occur in people aged 65 years or older. Many cancers are linked to aging; these include breast, colorectal, prostate, pancreatic, lung, bladder and stomach cancers.
115:(ASCO) has played a vital role in promoting the field of geriatric oncology in the United States. B.J. Kennedy, MD was one of the fathers of this field. In the late 1980s, the ASCO Annual Meetings started including educational sessions and presentations pertaining to this field. The Journal of Clinical Oncology started publishing more articles pertaining to geriatric oncology. ASCO has also funded training for oncology fellows.
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fellowship training program in medical oncology and geriatrics. Graduates of this program will be eligible to be board certified in both specialties. Some fellows opt to also obtain additional training and certification in hematology as well. 10 institutions were identified and a curriculum was designed and instituted.
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to withstand the therapy necessary to treat his or her cancer. A number of validated screening tools are recommended have been identified to aid this process. Following the initial assessment, the team meets to evaluate the patient's fitness for therapy. The team's decisions and recommendations are
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dedicated to addressing the age based disparities in research, education and treatment in the older adult cancer population. It is leader in developing and conducting research in older adults and providing older adult cancer education to medical professionals, patients, caregivers and the general
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In the last few years, this particular subspecialty has received a lot of attention. A large proportion of the population of developed countries are aging. In the United States, 20% of the population will be older than 65 years of age by the year 2030. Those 85 years and older will be the most
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Lee SM Schulz C Prabhash K et al. First-line atezolizumab monotherapy versus single-agent chemotherapy in patients with non-small-cell lung cancer ineligible for treatment with a platinum-containing regimen (IPSOS): a phase 3, global, multicentre, open-label, randomised controlled study. Lancet.
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Training programs specifically in the geriatric oncology subspeciality have been established. In the United States, the ASCO Geriatric
Oncology Fellowship program was developed with funding from the John A. Hartford Foundation. The American Board of Internal Medicine approved a 3-year combined
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for treatment of cancer were mainly based on the younger population. A lot of research in this area is needed. For lung cancer specific research has been conducted. For geriatric lung cancer patients the IPSOS trial and a related
Cochrane showed that older and frail patients require a specific
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or Société Internationale d'Oncologie Gériatrique in French, hence the acronym SIOG, was founded in 2000 and was officially registered as a Not-for-profit organisation under the Swiss law in
October 2012. SIOG is a multidisciplinary society, including physicians in the fields of oncology and
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Rosemary Yancik first organized a symposium on geriatric oncology sponsored by the
National Cancer Institute and the National Institute on Aging. A 1988 ASCO Presidential Address published in the Journal of Clinical Oncology by Dr. B.J. Kennedy encouraged the study of aging and cancer.
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then presented to the patient and his or her family as well as to the patient's primary physician when appropriate. After these discussions, and ideally with shared decision-making, treatment for the patient's cancer is decided on and initiated.
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geriatrics, and allied health professionals and has over 1000 members in more than 40 countries around the world. The major risk factor for cancer is age, and with the aging of the world population, a major epidemiologic challenge is before us.
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Gijtenbeek RG de Jong K Venmans BJ et al. Best first-line therapy for people with advanced non-small cell lung cancer, performance status 2 without a targetable mutation or with an unknown mutation status. Cochrane
Database Syst Rev. 2023;
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Typically, new patients meet with either a geriatric oncologist (or sometimes a medical oncologist and geriatrician separately), a psychosocial professional, and a nutritionist, all of whom work together to provide a
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The goal of SIOG is to foster the development of health professionals in the field of geriatric oncology, in order to optimize treatment of older adults with cancer. SIOG promotes efforts in 3 strategic directions:
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Immunotherapy in frail non-small-cell lung cancer patients. Gijtenbeek RG, Noordhof AL, Asmara OD, Groen HJ, van Geffen WH. Lancet. 2024 May 18;403(10440):1986. doi: 10.1016/S0140-6736(24)00792-X. PMID:
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May have functional problems, such as the ability to do basic activities (dressing, bathing, eating) or more advanced activities (such as using transportation, going shopping or handling finances).
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One of a handful of people around the world who created the field of geriatric oncology during the 1980s was
Lodovico Balducci. He was co-editor of the first major medial textbook on the subject,
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The
American Society of Clinical Oncology (ASCO) has started a geriatric oncology subspeciality. A webpage dedicated to article and resources about geriatric oncology is available.
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30:, usually defined as aged 65 and older. This fairly young but increasingly important subspecialty incorporates the special needs of the elderly into the treatment of
122:, published in 1982, and has been honored with the B.J. Kennedy Award for Scientific Excellence in Geriatric Oncology from the American Society of Clinical Oncology.
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Because most non-pediatric cancer patients are older, there is a saying that all oncologists who are not pediatric oncologists are geriatric oncologists.
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Integrate geriatric oncology in the curricula for medical and nursing education to ensure a high standard of qualification for healthcare professionals
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For many reasons, older adults with cancer have different needs than younger adults with the disease. For example, older adults:
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Yancik R (ed): Perspectives on
Prevention and Treatment of Cancer in the Elderly. New York, Raven Press, 1983.
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Examples of
Recipients of the ASCO-Hartford Foundation Geriatrics/Oncology Training Program Development Grant
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The World oncology network has established a directory for geriatric oncology to promote this subspeciality.
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Address the shortage of specialist oncologists/geriatricians & allied health staff in geriatric oncology
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Improve the quality of prevention, diagnosis, treatment, and follow-up of older patients with malignancies
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Disseminate knowledge in order to maintain a high common standard of healthcare in older cancer patients
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Integrate geriatric evaluation (including co morbidities) into oncology decision-making and guidelines
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Yancik R, Ries LA (2000). "Aging and cancer in
America. Demographic and epidemiologic perspectives".
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SIOG - International Society of Geriatric Oncology or Société Internationale d'Oncologie Gériatrique
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Balducci L, Lyman GH, Ershler WB: Geriatric Oncology. New York, NY, J.B. Lippincott, 1992, 1-409.
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Promote multidisciplinary, basic/translational research on the interface of aging and cancer
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Create a clear and operational definition of vulnerability/frailty applicable to oncology
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The Oldest Old. Suzman RM Manton KG (eds.).New York, NY, Oxford University Press, 1992.
505:"Practice Guideline: Comprehensive Geriatric Assessment (CGA) in oncological patients"
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421:"Underrepresentation of patients 65 years of age or older in cancer-treatment trials"
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Internationally, a diploma in geriatric oncology has now been established in France.
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May not always have access to transportation, social support or financial resources.
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664:"Comprehensive Geriatric Assessment (CGA) of the older patient with cancer | SIOG"
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An example of a geriatric oncology fellowship training curriculum can be found
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91:. An older patient with cancer will benefit from the expertise of a geriatric
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Have a decreased reserve (the capacity to respond to disease and treatment).
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Increase public awareness of the worldwide cancer in the elderly epidemic
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Address issues of access to care, including the needs of the caregiver
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that is concerned with the diagnosis and treatment of cancer in the
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Hackensack University Medical Center Geriatric Oncology Division
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University of Chicago Medical Center Geriatric Oncology Clinic
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Increase the relevance of clinical trials for older patients
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May have different views of quality versus quantity of life
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Rao AV, Hurria A, Kimmick G, Pinheiro S, Seo PH (2008).
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Hutchins LF; Unger JM; Crowley JJ; et al. (1999).
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May be less able to tolerate certain cancer treatments.
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Boston medical center Fellowship in Geriatric Oncology
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May have other medical problems in addition to cancer.
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641:"A Commitment to Geriatric Oncology ASCO Foundation"
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Develop interdisciplinary geriatric oncology clinics
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Improve research in the field of geriatric oncology
297:Develop, test and disseminate easy screening tools
87:for medical care, an older patient should go to a
395:"Indirect Influences on Health in Older People"
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75:usually exclude the elderly, and therefore,
747:Cleveland Clinic, Geriatric oncology clinic
578:"Geriatric oncology: past, present, future"
512:International Society of Geriatric Oncology
382:Cleveland Clinic, Geriatric oncology clinic
243:International Society of Geriatric Oncology
757:World oncology network, Geriatric oncology
711:World oncology network, Geriatric oncology
99:, to take all these factors into account.
80:treatment different than other patients.
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45:Unique concerns of older cancer patients
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541:Kennedy BJ (1988). "Aging and cancer".
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625:Kevin Begos, "Personalized Medicine",
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113:American Society of Clinical Oncology
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762:AACR Task Force on Aging and Cancer
731:Management of Cancer in the Elderly
208:comprehensive geriatric assessment
97:comprehensive geriatric assessment
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193:The first textbook in the field,
149:Boston University Medical Center
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154:Duke University Medical Center
126:Training and education programs
371:Geriatric oncology specialists
338:Hematol. Oncol. Clin. North Am
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689:Geriatric Oncology Consortium
350:10.1016/S0889-8588(05)70275-6
83:Just as a child would see a
438:10.1056/nejm199912303412706
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700:Geriatric oncology at ASCO
555:10.1200/JCO.1988.6.12.1903
219:Organization and societies
159:Johns Hopkins University
184:University of Rochester
164:Northwestern University
229:non-profit organization
223:The Geriatric Oncology
179:University of Michigan
174:University of Colorado
493:Geriatric oncology org
169:University of Chicago
273:2. Clinical practice
594:10.1200/JOP.0846001
460:2023; 402: 451-463
195:Geriatric Oncology
120:Geriatric Oncology
20:Geriatric oncology
16:Branch of medicine
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627:CR Magazine
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292:3. Research
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404:21 January
399:MSD Manual
314:References
225:Consortium
201:Assessment
93:oncologist
77:guidelines
480:7CD013382
799:Oncology
783:Medicine
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358:10680069
232:public.
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103:Origins
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