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Cancers
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Current Challenges in Geriatric Oncology
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Current Challenges in Geriatric Oncology

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Survivorship and Quality of Life".

Deadline for manuscript submissions: closed (15 March 2024) | Viewed by 10563

Special Issue Editors

Prof. Dr. Kwok-Leung Cheung

E-Mail Website
Guest Editor
School of Medicine, University of Nottingham, Derby DE22 3DT, UK
Interests: breast cancer; breast surgery; non-operative therapy; endocrine therapy; geriatric oncology
Special Issues, Collections and Topics in MDPI journals
Dr. Holly M. Holmes

E-Mail Website
Guest Editor
Division of Geriatric and Palliative Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
Interests: geriatrics; pharmacoepidemiology

Special Issue Information

Dear Colleagues,

The majority of cancers are diagnosed in the older adult population, which is expanding globally. Unfortunately, older adults with cancer are often under-served in their clinical care and under-represented in research studies. On the other hand, there is emerging evidence suggesting that tumour biology and the specific needs of individuals in this population are different from those of their younger counterparts. Furthermore, treatment goals may be different given the increased incidence of co-morbidities leading to deaths from competing causes. 

In this Anniversary Issue, we invite submissions of original research articles and narrated or systematic reviews looking at all fields of interest in relation to the care of older adults with cancer, with a focus on the challenges encountered, and how they may be overcome. We especially welcome manuscripts authored by more than one discipline involved in the clinical care and/or research in geriatric oncology.

Prof. Dr. Kwok-Leung Cheung
Dr. Holly M. Holmes
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cancer
  • older adults
  • geriatric oncology
  • geriatrics
  • oncology
  • tumour biology
  • quality of life
  • functional status

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Published Papers (5 papers)

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Research

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15 pages, 1346 KiB  
Article
Defining an Abnormal Geriatric Assessment: Which Deficits Matter Most?
by Anthony Carrozzi, Rana Jin, Susie Monginot, Martine Puts and Shabbir M. H. Alibhai
Cancers 2023, 15(24), 5776; https://doi.org/10.3390/cancers15245776 - 9 Dec 2023
Cited by 2 | Viewed by 1026
Abstract
At present, there is no clear definition of what constitutes an abnormal geriatric assessment (GA) in geriatric oncology. Various threshold numbers of abnormal GA domains are often used, but how well these are associated with treatment plan modification (TPM) and whether specific GA [...] Read more.
At present, there is no clear definition of what constitutes an abnormal geriatric assessment (GA) in geriatric oncology. Various threshold numbers of abnormal GA domains are often used, but how well these are associated with treatment plan modification (TPM) and whether specific GA domains are more important in this context remains uncertain. A retrospective review of the geriatric oncology clinic database at Princess Margaret Cancer Centre in Toronto, Canada, including new patients seen for treatment decision making from May 2015 to June 2022, was conducted. Logistic regression modelling was performed to determine the association between various predictor variables (including the GA domains and numerical thresholds) and TPM. The study cohort (n = 736) had a mean age of 80.7 years, 46.1% was female, and 78.3% had a VES-13 score indicating vulnerability (≥3). In the univariable analysis, the best-performing threshold number of abnormal domains based on area under the curve (AUC) was 4 (AUC 0.628). The best-performing multivariable model (AUC 0.704) included cognition, comorbidities, and falls risk. In comparison, the multivariable model with the sole addition of the threshold of 4 had an AUC of 0.689. Overall, an abnormal GA may be best defined as one with abnormalities in the domains of cognition, comorbidities, and falls risk. The optimal numerical threshold to predict TPM is 4. Full article
(This article belongs to the Special Issue Current Challenges in Geriatric Oncology)
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21 pages, 2012 KiB  
Article
End-of-Life Care in the Last Three Months before Death in Older Patients with Cancer in Belgium: A Large Retrospective Cohort Study Using Data Linkage
by Victoria Depoorter, Katrijn Vanschoenbeek, Lore Decoster, Geert Silversmit, Philip R. Debruyne, Inge De Groof, Dominique Bron, Frank Cornélis, Sylvie Luce, Christian Focan, Vincent Verschaeve, Gwenaëlle Debugne, Christine Langenaeken, Heidi Van Den Bulck, Jean-Charles Goeminne, Wesley Teurfs, Guy Jerusalem, Dirk Schrijvers, Bénédicte Petit, Marika Rasschaert, Jean-Philippe Praet, Katherine Vandenborre, Harlinde De Schutter, Koen Milisen, Johan Flamaing, Cindy Kenis, Freija Verdoodt and Hans Wildiersadd Show full author list remove Hide full author list
Cancers 2023, 15(13), 3349; https://doi.org/10.3390/cancers15133349 - 26 Jun 2023
Cited by 1 | Viewed by 2118
Abstract
This study aims to describe end-of-life (EOL) care in older patients with cancer and investigate the association between geriatric assessment (GA) results and specialized palliative care (SPC) use. Older patients with a new cancer diagnosis (2009–2015) originally included in a previous multicentric study [...] Read more.
This study aims to describe end-of-life (EOL) care in older patients with cancer and investigate the association between geriatric assessment (GA) results and specialized palliative care (SPC) use. Older patients with a new cancer diagnosis (2009–2015) originally included in a previous multicentric study were selected if they died before the end of follow-up (2019). At the time of cancer diagnosis, patients underwent geriatric screening with Geriatric 8 (G8) followed by GA in case of a G8 score ≤14/17. These data were linked to the cancer registry and healthcare reimbursement data for follow-up. EOL care was assessed in the last three months before death, and associations were analyzed using logistic regression. A total of 3546 deceased older patients with cancer with a median age of 79 years at diagnosis were included. Breast, colon, and lung cancer were the most common diagnoses. In the last three months of life, 76.3% were hospitalized, 49.1% had an emergency department visit, and 43.5% received SPC. In total, 55.0% died in the hospital (38.5% in a non-palliative care unit and 16.4% in a palliative care unit). In multivariable analyses, functional and cognitive impairment at cancer diagnosis was associated with less SPC. Further research on optimizing EOL healthcare utilization and broadening access to SPC is needed. Full article
(This article belongs to the Special Issue Current Challenges in Geriatric Oncology)
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Review

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14 pages, 298 KiB  
Review
Geriatric Oncology as an Unmet Workforce Training Need in the United Kingdom—A Narrative Review by the British Oncology Network for Undergraduate Societies (BONUS) and the International Society of Geriatric Oncology (SIOG) UK Country Group
by Emma G. Khoury, Thitikorn Nuamek, Sophie Heritage, Taylor Fulton-Ward, Joanna Kucharczak, Cassandra Ng, Tania Kalsi, Fabio Gomes, Michael J. Lind, Nicolò M. L. Battisti, Kwok-Leung Cheung, Ruth Parks, Jessica Pearce and Mark A. Baxter
Cancers 2023, 15(19), 4782; https://doi.org/10.3390/cancers15194782 - 28 Sep 2023
Cited by 2 | Viewed by 2230
Abstract
Cancer is a disease associated with ageing. Managing cancer in older adults may prove challenging owing to pre-existing frailty, comorbidity, and wider holistic needs, as well as the unclear benefits and harms of standard treatment options. With the ongoing advances in oncology and [...] Read more.
Cancer is a disease associated with ageing. Managing cancer in older adults may prove challenging owing to pre-existing frailty, comorbidity, and wider holistic needs, as well as the unclear benefits and harms of standard treatment options. With the ongoing advances in oncology and the increasing complexity of treating older adults with cancer, the geriatric oncology field must be a priority for healthcare systems in education, research, and clinical practice. However, geriatric oncology is currently not formally taught in undergraduate education or postgraduate training programmes in the United Kingdom (UK). In this commentary, we outline the landscape of geriatric oncology undergraduate education and postgraduate training for UK doctors. We highlight current challenges and opportunities and provide practical recommendations for better preparing the medical workforce to meet the needs of the growing population of older adults with cancer. This includes key outcomes to be considered for inclusion within undergraduate and postgraduate curricula. Full article
(This article belongs to the Special Issue Current Challenges in Geriatric Oncology)
13 pages, 1020 KiB  
Review
Accuracy of Delirium Screening Tools in Older People with Cancer—A Systematic Review
by Francisco Miguel Martínez-Arnau, Andrea Puchades-García and Pilar Pérez-Ros
Cancers 2023, 15(10), 2807; https://doi.org/10.3390/cancers15102807 - 17 May 2023
Cited by 4 | Viewed by 2586
Abstract
Background: The increase in life expectancy worldwide has led to a larger population of older people, which in turn entails a rising prevalence of cancer. One of the main complications of cancer is delirium, especially in advanced stages. Objective: To determine which delirium [...] Read more.
Background: The increase in life expectancy worldwide has led to a larger population of older people, which in turn entails a rising prevalence of cancer. One of the main complications of cancer is delirium, especially in advanced stages. Objective: To determine which delirium screening instrument is the most accurate in older people with cancer. Methods: A systematic review was designed. A literature search was performed in MEDLINE, EBSCO and SCOPUS; additional records were identified by handsearching. Selection criteria were studies involving people with cancer and a mean sample age of 60 years or older, assessing delirium, and reporting the metric properties of the assessment instrument. Studies with post-surgical patients and substance abuse delirium were excluded. Results: From 2001 to 2021, 14 eligible studies evaluated 13 different assessment tools, reporting an incidence of delirium ranging from 14.3% to 68.3%. The Delirium Observation Screening Scale (DOSS) showed the best metric properties, followed by the Nursing Delirium Screening Scale (NuDESC), Confusion Assessment Method (CAM) and Memorial Delirium Assessment Scale (MDAS). Only two studies were considered to be at low risk of bias using the QUADAS-2 Tool. No study exclusively examined this population group. Conclusions: Screening tools for delirium are heterogeneous for older people with cancer, and there is a need to analyze metric properties exclusively in the older population. Registered on PROSPERO ID: CRD42022303530. Full article
(This article belongs to the Special Issue Current Challenges in Geriatric Oncology)
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Other

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8 pages, 234 KiB  
Commentary
Pitfalls in Oncogeriatrics
by Silvio Monfardini, Francesco Perrone and Lodovico Balducci
Cancers 2023, 15(11), 2910; https://doi.org/10.3390/cancers15112910 - 25 May 2023
Cited by 3 | Viewed by 1565
Abstract
An oncogeriatric interdisciplinary activity exists only in a minority of high-income countries, and it is almost absent in those with lower incomes. Considering topics, sessions, and tracks in the main meetings and conferences of the major Oncological Societies in Europe and worldwide, the [...] Read more.
An oncogeriatric interdisciplinary activity exists only in a minority of high-income countries, and it is almost absent in those with lower incomes. Considering topics, sessions, and tracks in the main meetings and conferences of the major Oncological Societies in Europe and worldwide, the USA excluded, little attention has thus far been paid to the problem of cancer in the elderly. Again, with the exception of the USA, the major cooperative groups, for example, the EORTC in Europe, have only dedicated marginal attention to the research of cancer in the elderly. Despite major shortcomings, professionals interested in geriatric oncology have taken a number of important initiatives to highlight the benefits of this particular activity, including the organization of an international society (Société Internationale de Oncogeriatrie, or SIOG). In spite of these efforts, the authors believe that the management of cancer in the older population is still encountering several important and generalized pitfalls. The main obstacle is the grossly inadequate number of geriatricians and clinical oncologists necessary to an integrated care of the ever-expanding aging population, but other hurdles have been reported. Additionally, the prejudice of ageism can lead to missing potential resources for the development of a generalized oncogeriatric approach. Full article
(This article belongs to the Special Issue Current Challenges in Geriatric Oncology)
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