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Geriatric assessments improve communication during elderly patient visits

Key clinical point: Oncologists’ awareness of elderly patients’ geriatric assessments could help address aging-related concerns.

Major finding: Integrating geriatric assessments into oncology consultations increases the number of conversations about aging-related concerns.

Study details: Clinical trial involving 541 elderly cancer patients.

Disclosures: The study was supported by funding and individual research grants from the Patient-Centered Outcomes Research Institute, the University of Rochester, the National Institute of Aging, and the National Cancer Institute. Two authors declared funding from the pharmaceutical sector outside the study.

Citation:

Mohile S et al. JAMA Oncol 2019 Nov 7. doi: 10.1001/jamaoncol.2019.4728.

Commentary:

Around half of all cancer cases and 70% of all cancer deaths occur in individuals aged over 65 years; this is a very heterogeneous population with a range of impairments, comorbidities, polypharmacy, geriatric syndromes, and other issues. There is limited evidence to guide management of cancer in this group.

This study provides further support for a worldwide consensus on the importance of incorporating geriatric assessments into oncology practice, although it did not find an improvement in quality of life associated with this. This may be because improved communication doesn’t necessarily translate into implementation of the management recommendations that might have benefited quality of life in these patients. There is a need for multidisciplinary care in the older population, not just at assessment but throughout the entire care pathway.

Laura Biganzoli, MD, and Amelia McCartney, MBBS, are from the “Sandro Pitigliani” medical oncology department, Hospital of Prato (Italy), and Nicolò Matteo Luca Battisti, MD, is from the department of medicine–breast unit, The Royal Marsden National Health Service Foundation Trust, Sutton, England. These comments are adapted from their editorial (JAMA Oncol. 2019 Nov 7. doi: 10.1001/jamaoncol.2019.4708). Dr Battisti declared personal fees and nonfinancial support from the pharmaceutical sector unrelated to the submitted work. No other conflicts of interest were declared.