NCCN Guidelines Insights: Older Adult Oncology, Version 2.2016 (original) (raw)
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NCCN Guidelines® Insights: Older Adult Oncology, Version 1.2021
Journal of the National Comprehensive Cancer Network
The NCCN Guidelines for Older Adult Oncology address specific issues related to the management of cancer in older adults, including screening and comprehensive geriatric assessment (CGA), assessing the risks and benefits of treatment, preventing or decreasing complications from therapy, and managing patients deemed to be at high risk for treatment-related toxicity. CGA is a multidisciplinary, in-depth evaluation that assesses the objective health of the older adult while evaluating multiple domains, which may affect cancer prognosis and treatment choices. These NCCN Guidelines Insights focus on recent updates to the NCCN Guidelines providing specific practical framework for the use of CGA when evaluating older adults with cancer.
Geriatric oncology: questions, answers and guidelines
memo - Magazine of European Medical Oncology, 2020
Summary Background With the aging of populations, the number of elderly persons with cancer will increase. Due to the high individuality of elderly persons and their varying patterns of resources and disabilities, cancer treatment for elderly cancer patients needs to be individually adapted. To achieve this, geriatric medicine has established the comprehensive geriatric assessment (CGA). This short review presents the evidence of feasibility and impact of CGA on cancer treatment in elderly patients, as recommended by the American Society of Clinical Oncology (ASCO) in 2018. Methods A systematic review of the literature and a Delphi Consensus with a panel of experts cooperated to compile the evidence for choosing the most adequate treatment for elderly cancer patients. Results There is evidence that CGA makes it possible to predict the occurrence of complications of chemotherapy and of health deterioration, as well as death within 1 year. Conclusion The ASCO has recognized the optimi...
Mohile, Dale, Hurria, Geriatric Oncology Research to Improve Clinical Care, 2012
| Cancer incidence increases with advanced age. The Cancer and Aging Research Group, in partnership with the National Institute on Aging and NCI, have summarized the gaps in knowledge in geriatric oncology and made recommendations to close these gaps. One recommendation was that the comprehensive geriatric assessment (CGA) should be incorporated within geriatric oncology research. Information from the CGA can be used to stratify patients into risk categories to better predict their tolerance of cancer treatment, and to follow functional consequences from treatment. Other recommendations were to design trials for older adults with study end points that address the needs of the older and/or vulnerable adult with cancer and to build a better infrastructure to accommodate the needs of older adults to improve their representation in trials. We use a case-based approach to highlight gaps in knowledge regarding the care of older adults with cancer, discuss our current state of knowledge of best practice patterns, and identify opportunities for research in geriatric oncology. More evidence regarding the treatment of older patients with cancer is urgently needed.
American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting, 2018
Older adults represent the majority of patients diagnosed with cancer, yet the evidence base used to guide therapy for this growing segment of the population is limited compared with data available for younger adults. Information is particularly limited for adults commonly seen in practice, including those over age 75 and those with comorbidity or frailty. Efforts have been underway to raise awareness of this substantial gap in evidence and identify strategies to build an evidence base for older adults. Recently, the ASCO and the U.S. Food and Drug Administration convened a public workshop to address this issue. There is a need for innovative trial design to test the efficacy and tolerability of therapies among generalizable older adult populations. Incorporation of endpoints such as functional independence and quality of life as well as investigation of geriatric assessment-based treatment allocation strategies will be needed to individualize care planning. Strategies to increase t...
Clinical and Translational Oncology
Population aging is associated with greater numbers of older people with cancer. Thanks to treatment advances, not only are more seniors diagnosed with cancer, but there are also more and more older cancer survivors. This upward trend will continue. Given the heterogeneity of aging, managing older patients with cancer poses a significant challenge for Medical Oncology. In Spain, a Geriatric Oncology Task Force has been set up within the framework of the Spanish Society for Medical Oncology (SEOM). With the aim of generating evidence and raising awareness, as well as helping medical oncologists in their training with respect to seniors with cancer, we have put together a series of basic management recommendations for this population. Many of the patients who are assessed in routine clinical practice in Oncology are older. CGA is the basic tool by means of which to evaluate older people with cancer and to understand their needs. Training and the correct use of recommendations regarding treatment for comorbidities and geriatric syndromes, support care, and drug-drug interactions and toxicities, including those of antineoplastic agents, as detailed in this article, will ensure that this population is properly managed.
Senior Adult Oncology, Version 2.2014
Journal of the National Comprehensive Cancer Network, 2014
Cancer is the leading cause of death in women and men aged 60 to 79 years. 1 More than 50% of all cancers and more than 70% of cancer-related deaths in the United States occur in patients who are 65 years or older. 2 Experts estimate that by 2030 approximately 70% of all cancers will be diagnosed in adults aged 65 years or older. 3 Older adults are more prone to develop cancer than younger adults. Furthermore,
Followup recommendations Part 9 Considerations in the elderly post definitive cancer therapy
I n North America, two-thirds of all malignancies occur in the elderly. Fully 80% of prostate cancers, 74% of colon cancers and 72% of pancreatic cancers are in people over age 65. 1,2,3 Unfortunately, these absolute numbers are increasing alongside the aging demographics of Western societies. Emphasis on treatment in the elderly has recently moved away from chronologic age, toward an individualized approach integrating tools for assessing fitness and quality of life, patient treatment preferences and shared decision-making. 3,4,5 It also seems logical that followup considerations in the elderly post definitive cancer therapy should be similarly individualized. As there exist virtually no data from randomized controlled trials in this area, this article, like earlier articles in this series, takes a literature-based approach and emphasizes practical recommendations.