By Ramy Sedhom, MD
There is no one-size-fits-all approach for treating cancer.
This is especially true for older adults, who typically face different challenges than younger adults during cancer care.
At Penn Medicine Princeton Cancer Center, the Older Adult Oncology Program provides personalized cancer treatment, navigation, and supportive services to better meet the specialized needs of older patients.
Goals and Preferences May Differ
Federal statistics show that the number of adults aged 65 and over in the United States is larger than at any time in the previous century. And as that number continues to grow, so does the number of older adults diagnosed with cancer.
In fact, according to the National Institutes of Health, people 65 and older make up almost 60% of all new cancer diagnoses.
However, cancer care has historically tended to reflect the needs, desires and values of younger adults which may not align with those of older adults.
Consider that some cancers may present differently in older adults than younger ones. The disease may be more aggressive in older adults, or in some instances may pose less of a risk to older adults than younger adults.
In addition, older adults may be dealing with other issues that may make care more complicated, such as living alone, living on a fixed income or caring for a loved one themselves.
They may be dealing with physical age-related declines, which can impact an older patient’s ability to tolerate cancer treatments. Further, older adults with cancer often have other illnesses or conditions that can complicate treatment, and even those who are generally healthy may not be able to recover as easily as a younger patient.
Lastly, but importantly, older adults often have different goals and preferences for treatment than younger patients. In many cases, quality of life is more important than quantity of life.
Due to these unique challenges, older adults require specialized care to ensure they are receiving appropriate treatment that reflects their needs, goals and wants.
What is a Geriatric Assessment?
A geriatric assessment is an evidence-based tool that doctors are increasingly using to evaluate an older adult’s health and well-being prior to cancer treatment.
It can help uncover the unique health and lifestyle challenges faced by older adults that are not normally identified during traditional exams that are performed during cancer care, making it an ever more important tool as the country ages.
A geriatric assessment looks at factors such as physical functioning, nutrition, fall risk, depression and cognitive impairment, all of which can influence treatment decisions and outcomes.
During a geriatric assessment, the doctor will also discuss goals, values, and end-of-life preferences with the patient and caregivers to ensure the quality of care matches the patient’s needs.
Based on these assessments, a multidisciplinary care team with the Older Adult Oncology Program at Penn Medicine Princeton Health makes recommendations for treatment modifications and referrals for additional support, which can help patients better tolerate treatment and improve outcomes and quality of life.
The team collaborates closely with social work, palliative care, spiritual care, nutrition, rehabilitation, geriatrics, pharmacy, and genetic counseling.
Research shows that geriatric assessments have a variety of benefits for older adults with cancer, including improved communication, fewer unplanned hospital and emergency room visits, and improved quality of life and well-being.
Both the American Society of Clinical Oncology (ASCO) and the National Comprehensive Cancer Network (NCCN) recommend geriatric assessments for people 65 or older with cancer and who are considering cancer treatment.
If you are an older adult and have been diagnosed with cancer, talk with your oncologist about performing a geriatric assessment to ensure your treatment plan meets your specific needs.
Transforming Cancer Care for Older Adults
The Geriatric Oncology Program at Penn Medicine, the first of its kind in the region, is focused on providing comprehensive cancer care to people 65 and over.
The program is transforming cancer treatment and supportive care for older adults by expanding research opportunities, enhancing professionals’ expertise in geriatrics and increasing outreach to seniors in central New Jersey.
A grant from the Bristol Meyers Squibb Foundation has helped the program build the research infrastructure necessary to design and implement clinical trials that address the unique challenges of care for older adults with cancer. It has also helped support an array of other crucial activities, such as:
- Recruiting multidisciplinary teams of professionals with expertise in geriatrics, including clinicians, supportive care staff, and community health navigators.
- Testing new treatments and care delivery models by bringing new research from Penn Medicine’s Abramson Cancer Center to patients in central New Jersey.
- Expanding geriatric competencies of Princeton Health staff through education and increasing outreach to seniors through community health navigators.
Additionally, the Hematology-Oncology practice at Penn Medicine Princeton Health has achieved special recognition as an Age-Friendly Health System — Committed to Care Excellence by the Institute for Healthcare Improvement.
When it comes to cancer care for older adults, it’s vital to look beyond the diagnosis and consider the whole person. Personalized treatment plans—especially those informed by a geriatric assessment—can ensure care is tailored to each individual’s unique health needs, priorities, and goals.
For more information about Penn Medicine Princeton Cancer Center or to find a physician affiliated with Penn Medicine Princeton Health, call 1 (888) 742-7496, or visit www.princetonhcs.org.
Ramy Sedhom, MD, is a board-certified oncologist and palliative care physician on the medical staff of Penn Medicine Princeton Health. He is an assistant professor of Hematology-Oncology in the Perelman School of Medicine at the University of Pennsylvania and Director for the Program in Geriatric Oncology and Supportive Care Innovation at the Penn Center for Cancer Care Innovation (PC3I).
