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Geriatric consultation can aid in complex treatment decisions for elderly cancer patients
Author(s) -
Schiphorst A.H.W.,
Ten Bokkel Huinink D.,
Breumelhof R.,
Burgmans J.P.J.,
Pronk A.,
Hamaker M.E
Publication year - 2016
Publication title -
european journal of cancer care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.849
H-Index - 67
eISSN - 1365-2354
pISSN - 0961-5423
DOI - 10.1111/ecc.12349
Subject(s) - medicine , psychological intervention , geriatric oncology , intensive care medicine , geriatrics , cancer , cancer treatment , geriatric care , nursing , psychiatry
Treatment decisions for elderly cancer patients can be challenging. A geriatric assessment may identify unknown medical conditions, give insight on patients' ability to tolerate treatment and guide treatment decisions. Our aim was to study the value of a geriatric consultation in oncological decision‐making. Data on cancer patients referred for geriatric consultation for clinical optimisation or due to uncertainty regarding their optimal treatment strategy were prospectively analysed. Outcome of geriatric evaluations, non‐oncological interventions and suggested adaptations of oncological treatment proposals were evaluated. Seventy‐two patients were referred for consultation, over half of which in a curative treatment setting. Prevalence of geriatric syndromes was 93%, previously undiagnosed conditions were identified in 49% of patients and non‐oncological interventions were initiated in 56%. Time was spent discussing patients' priorities (53% of consultations), expectations on treatment (50%) and advance care planning (14%). For 82% of patients, suggestions were made regarding the optimal treatment decision: a more intensive treatment was recommended in 39%, a less intensive therapy for 42% and in 19% only supportive care was suggested. The results demonstrate that a geriatric consultation can aid in complex treatment decisions and may allow for a reduction in over‐ and undertreatment of elderly cancer patients.