Half of all cancers in the US occur in people 65 and older, so it’s surprising—and in fact shocking—that cancer doctors may not be accounting for the special needs of seniors when suggesting a treatment plan.
That’s about to change thanks to a new guideline from the American Society of Clinical Oncology that recommends every cancer patient 65 and older get a geriatric assessment—a questionnaire either done by the patient’s own regular doctor and then shared with the oncologist or done by the oncologist him/herself—before beginning chemotherapy.
We asked Arti Hurria, MD, cochair of the panel that produced the recommendation, how it will help improve patients’ quality of life during cancer treatment and what actions our readers with cancer should take to make sure they get these benefits. Here’s what she told us…
Weighing the risks and benefits of therapy involves more than its effect on your cancer. For example, if you have a separate chronic condition, such as high blood pressure, diabetes or even a balance issue, how chemo affects it also needs to be considered. In addition to your medical conditions, a geriatric assessment includes questions about your activity level, diet, social support, depression and anxiety, memory issues and other information about your daily life.
Having the results of your geriatric assessment enables your cancer doctor to know you better, more precisely tailor your treatment plan to you, help predict how severe the side effects of chemotherapy will be, and determine what additional help you might need to get through cancer therapy with the best outcome.
For instance, research has shown that people who suffer from depression can have increased trouble functioning while on chemotherapy. Or, your balance may be worsened by chemo. So, part of your treatment plan may include working with a physical therapist to improve your balance and an occupational therapist to help make your home safer. If you don’t have social support, a social worker may be the additional resource you need.
The assessment will help your doctor give you a more accurate prognosis and life expectancy by taking into account not only your cancer, but also your other medical conditions. This, too, may influence your choice of treatment.
TAKING THE INITIATIVE
More and more physicians are using geriatric assessment, Dr. Hurria said, but you don’t have to wait for your doctor to get the process started. You can take the geriatric assessment at the Cancer and Aging Research Group website.
Dr. Hurria recommends filling it out online and printing out the results to bring to your oncologist. It can start a conversation about what’s important in your life and your goals for treatment.
As you progress through treatment, keep your doctor informed about how you’re tolerating the drugs. If something changes, such as if you need to be hospitalized, it’s time to repeat the assessment, Dr. Hurria said.