Care For Older Patients

Hester Hill Schnipper, LICSW, OSW-C Program Manager, Oncology Social Work

OCTOBER 24, 2017

One area of Cancer World that has changed a great deal is treatment for older people. Not so long ago, it was assumed that an elderly (and pick your definition of what that means) person could not tolerate many aggressive treatments. The unspoken part of the equation was the belief that the individual likely had a short life expectancy anyway, so it didn't seem right to damage existing QOL.

There are still authentic concerns about some treatments for some older people. To some extent, those same concerns apply to younger people, too. If someone has other complicated medical problems, it can be counter-productive to introduce certain chemotherapy drugs or expose someone to radical surgery. But, increasingly, careful decisions are made on a case by case basis. We all know that some people in their 80s are in quite fine health and would opt for anything that might effectively treat their cancer.

There is a specialty of geriatric oncology, and Dr. Hyman Muss is one of the leaders. From Cancer Net comes this interview and a link to a video.

Cancer Care for Older Adults An Introduction

What is Geriatric Oncology?

Hyman Muss, MD; Member, American Society of Clinical Oncology: Geriatric oncology is what is emerging as a subspecialty of cancer care, really focused on older patients. And why it’s important is older patients are very variable as far as their healthcare status when they get cancer. And it’s really a challenge to know how to best care for them. So, our branch of oncology, geriatric oncology, is really focused on learning more about older people, what their goals of treatment are, how to best care for them, minimize toxicity, and what might be the most appropriate treatments – smaller doses, larger doses of medicine, etc. So, it’s a very new and emerging and extremely important area of cancer care.

What Does “Health Status” Mean?

Dr. Muss: One thing that’s different about older people is there’s great differences in health status as we get older among people of the same age group. So, you can have a 75 year old
woman or an 80 year old woman who walks in. They’re going to the gym every day, doing guitar lessons, and are extremely functional. And on the other hand, you can have someone, identical age, maybe living in the same apartment complex, who is wheelchair-bound, on multiple medications, maybe have mild cognitive loss. And yet, they’re both the same age. So, factoring in the comorbid illnesses, and then deciding is cancer a major illness? And if it’s a major illness, how do the background illnesses of that patient affect your management of the cancer?

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