Clinical Perspectives

Important Considerations in Treating Senior Adults

November 08, 2017

Important-Considerations-in-Treating-Senior-Adults.jpg The Senior Adult Oncology Program at Moffitt is the country’s oldest geriatric cancer program

Dr. Martine Extermann
Dr. Martine Extermann

Over half of all cancers occur in people age 70 and older and 60% of cancer deaths occur in this population. Moffitt’s Senior Adult Oncology Program is aimed at preventing and treating cancer in older people, as well as improving their quality of life.

The number of people in the United States who are 65 or older is 3 times higher than it was 100 years ago. As life expectancy increases, this group is expected to further double during the next 50 years.

Moreover, seniors have highly variable health and support statuses. Therefore, in treating their cancer, one size does not fit all. Moffitt’s multispecialty Senior Adult Oncology team specializes in geriatric oncology with the goal of prolonging life’s enjoyment.  

Here are some tips to facilitate optimal management of the patient age 70 and older:

Important Considerations in Treating Senior Adults:

  • Even a simple geriatric screening modifies the treatment plan in 25% of older cancer patients
  • Rather than just chronologic age, get a more accurate life expectancy assessment using a tool such as ePrognosis
  • To help with dilemmas in choosing chemotherapy, determine a CRASH score (Chemotherapy Risk Assessment Scale for High-Age patients) employing calculators 
  • Always calculate the creatinine clearance in older patients, even if the creatinine is normal
  • Consider the direct impact of comorbidities, including dual cancers, on risk and behavior of the cancer in elderly patients
  • Check for hearing, vision and memory impairments initially and regularly to ensure good communication

At Moffitt, we have developed the CRASH score calculator to determine the risk associated with treatments -- one element of assessment tools available online. Several other institutions have also contributed to this work.

For further recommendations from the task force on Comprehensive Geriatric Assessment of the International Society of Geriatric Oncology, click here.

With the steady growth in our “graying” population and the higher rates of cancer in this group, healthcare providers need to be cognizant and focus attention on evidence-based approaches to the treatment and care of the older adult with cancer.

Florida has long attracted snowbirds and retirees. According to the Pew Research Center, 19% of the Sunshine State’s population is 65 and older, the highest percentage in the nation. Therefore, physicians are uniquely positioned to provide these older Floridians with strong primary healthcare and, when appropriate, access to geriatric specialty support. 

To refer a patient to the Senior Adult Oncology program, call 1-888-MOFFITT, complete the online form or reach out to a physician liaison.

Martine Extermann, MD, PhD, a senior member of Moffitt Cancer Center, was recently appointed program leader of Senior Adult Oncology, having served effectively as interim chair for several months, during which an international search was conducted.