Congratulations to Professor Shane O’Hanlon on his recently published collaborative research in the Journal of Geriatric Oncology. The paper is titled ‘Personalized palliative care for older adults with cancer: A call for action on oncogeriatric palliative care’.
Key findings
Personalised palliative care for older adults with cancer:
- Palliative care needs of older patients differ substantially from younger
- Advance care planning should be supported at an early stage
- Older adults often have multiple specialists involved in care; a holistic overview is needed
Introduction
As the global population ages, the number of older adults with cancer is projected to increase substantially, reaching an estimated 35 million new cancer cases annually by 2050, a 77% rise compared to 2022.
Physiological aging, cancer, co-morbidity, and their interactions can contribute to significant physical and psychological symptom burden in older adults. The complex management of older adults with cancer requires involvement and coordinated collaboration between healthcare providers at all stages of the patient's cancer journey, from the primary care sector to facilities providing specialist care, e.g., palliative care units and hospices. Yet, this complex approach demands human and economic resources that are often scarce even in high-income countries.
Palliative care aims to maintain quality of life by addressing patient (and caregiver) goals and preferences, while providing symptom management, relief, and comfort through targeted interventions during the disease trajectory in patients with incurable conditions, such as metastatic cancer or organ failure. According to the World Health Organization, 56.8 million people need palliative care each year, almost half of those (25.7 million) during the last year of their life. Of these patients, 40% are ≥70 years old and 34% have cancer. Currently, palliative care is only available for about 14% of those who need it.
Appropriate personalized care of older adults with cancer requires input from numerous specialties, particularly during treatment and towards the end of life. With increasing tumor and symptom burden, accumulating toxicities due to systemic anticancer treatments, and deteriorating general condition, input from geriatricians and palliative care specialists is essential. However, the availability, collaboration, and distribution of tasks between specialties often invites challenges despite the numerous common features geriatric and palliative care share.
A Call for Action
Being able to provide tailored palliative care for older adults with cancer demands a coordinated effort between geriatric medicine, oncology, and palliative care. The establishment of an Oncogeriatric Palliative Care Task Force under the International Society of Geriatric Oncology (SIOG), where geriatricians already closely collaborate with like-minded oncologists, would be a proper first step.
The involvement of palliative care specialists and the establishment of strategic partnerships with leading societies involved in the management of older adults with cancer, e.g., European Geriatric Medicine Society (EuGMS), the European Society for Medical Oncology (ESMO), and the European Association for Palliative Care (EAPC), is desirable. Further strategic collaboration with the World Health Organization and key stakeholders, such as the American Society of Clinical Oncology (ASCO), would strengthen the impact of this initiative. These collaborations would ensure wider recognition of oncogeriatric palliative care and the establishment of a consensus framework for optimal palliative care for older adults with incurable cancer.
For the full paper, click here.