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Patel R, Kwon D, Hovstadius M, Tiersten A. Patterns in use of palliative care in older patients with metastatic breast cancer: A National Cancer Database analysis. J Geriatr Oncol 2024:101840. [PMID: 39095312 DOI: 10.1016/j.jgo.2024.101840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 05/14/2024] [Accepted: 07/25/2024] [Indexed: 08/04/2024]
Abstract
INTRODUCTION Timely incorporation of palliative care (PC) during treatment of patients with metastatic cancers can improve symptom management and quality of life. Older age has been associated with lower PC use in patients with cancer. The frequency by which older patients with metastatic breast cancer (MBC) receive PC is unknown. The goal of this study was to use the National Cancer Database (NCDB) to describe national patterns in PC use in older adults over 75 years of age with MBC. MATERIALS AND METHODS Females with a diagnosis of MBC at age ≥ 75 years from 2010 to 2019 were identified from the NCDB. The NCDB defined PC as any surgery, radiation, systemic therapy, and/or pain management that was administered with noncurative intent. Multivariable logistic regression models were performed to assess associations between PC receipt and study covariates. RESULTS Of 17,325 eligible participants included in the final analysis, 39.4% were 75-79, 30.1% 80-84, and 30.4% ≥ 85 years of age. Overall, 22.1% (N = 3824) of patients utilized PC, of whom 14.3% received pain management, while the remainder received palliative intent surgery, radiation, and/or systemic therapy. Patients who were Hispanic were less likely to receive zzPC (AOR: 0.62, 95% CI: 0.48-0.79), p < 0.001). In the overall population, the use of PC increased from 19.2% in 2010 to 25.3% in 2019, though this was primarily driven by the statistically significant increase in the 75-79 age group (19.9% to 28.1%, p = 0.001). DISCUSSION In this patient population from the NCDB, we observed an increase in PC utilization over the last decade in older adults with MBC, though the increase was lowest in patients who were 85 years and older. Barriers to PC in older adults with cancer need to be further explored.
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Affiliation(s)
- Rima Patel
- Department of Medicine, Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, Tisch Cancer Institute, New York, NY, USA.
| | - Deukwoo Kwon
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Malin Hovstadius
- Frank H. Netter School of Medicine at Quinnipiac University, Hamden, CT, USA
| | - Amy Tiersten
- Department of Medicine, Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, Tisch Cancer Institute, New York, NY, USA
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Castelo-Loureiro A, Perez-de-Acha A, Torres-Perez AC, Cunha V, García-Valdés P, Cárdenas-Reyes P, Soto-Perez-de-Celis E. Delivering Palliative and Supportive Care for Older Adults with Cancer: Interactions between Palliative Medicine and Geriatrics. Cancers (Basel) 2023; 15:3858. [PMID: 37568674 PMCID: PMC10417379 DOI: 10.3390/cancers15153858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 07/27/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
The world's population is aging rapidly, with projections indicating that by 2050 one in six people will be aged ≥65 years. As a result, the number of cancer cases in older people is expected to increase significantly. Palliative care is an essential component of cancer care with a direct impact on quality of life. However, older adults with cancer often suffer from multiple comorbidities, cognitive impairment, and frailty, posing unique challenges in the delivery of palliative care. The complex healthcare needs of older patients with cancer therefore require a comprehensive assessment, including a geriatric evaluation. Collaboration between geriatrics and palliative care can offer a solution to the challenges faced by older people with cancer, since this is a population with overlapping concerns for both disciplines. This review highlights the importance of palliative care for older adults with cancer and the benefits of a multidisciplinary approach. It also addresses the coordination of palliative care and geriatrics for specific symptom management and decision making.
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Affiliation(s)
| | - Andrea Perez-de-Acha
- Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico
| | - Ana Cristina Torres-Perez
- Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico
| | - Vanessa Cunha
- School of Medicine, University of Toronto, Toronto, ON M5S 3G5, Canada
| | - Paola García-Valdés
- Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico
- Department of Palliative Care, Hospital Gea González, Mexico City 14080, Mexico
| | - Paula Cárdenas-Reyes
- Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico
| | - Enrique Soto-Perez-de-Celis
- Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico
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Parajuli J, Chen ZJ, Walsh A, Williams GR, Sun V, Bakitas M. Knowledge, beliefs, and misconceptions about palliative care among older adults with cancer. J Geriatr Oncol 2023; 14:101378. [PMID: 36182659 DOI: 10.1016/j.jgo.2022.09.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 08/30/2022] [Accepted: 09/14/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Older adults with cancer have high symptom burden and unmet needs and may benefit from palliative care (PC). However, little is known about their knowledge and understanding of PC. This study examined the knowledge, beliefs, and misconceptions about PC in older adults with cancer in the United States. MATERIALS AND METHODS We used data from National Cancer Institute's 2018 wave of the Health Information National Trends Survey (HINTS). A total of 370 individuals aged 65 and older with a diagnosis of cancer were included in this study. The outcomes included PC knowledge, goals, and misconceptions. The main predictors included general health status, chronic conditions, functional limitations, and types of cancer. RESULTS About two thirds of the sample (65.31%) did not have any knowledge of PC. Among those who had some knowledge, they had good understanding of PC goals, but also had many misconceptions about PC. Multiple regression analysis showed that older age (p < .001), racial minority (p = .021), and lower education (p = .001) was associated with lacking knowledge of PC. Individuals with some functional limitations tended to have better understanding and fewer misconceptions of PC. DISCUSSION The knowledge about PC is low in older adults with cancer in the US. Educational interventions need to be implemented to increase knowledge and reduce the misconceptions about PC in this population. Increasing knowledge of PC may ultimately lead to increased access to PC and improve the quality of life in this population.
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Affiliation(s)
- Jyotsana Parajuli
- University of North Carolina at Charlotte, School of Nursing, Address: 9201 University City Blvd, Charlotte, NC 28223, United States of America.
| | - Zhuo Job Chen
- University of North Carolina at Charlotte, School of Nursing, Address: 9201 University City Blvd, Charlotte, NC 28223, United States of America.
| | - Amanda Walsh
- University of North Carolina at Charlotte, Department of Public Health Sciences, Address: 9201 University City Blvd, Charlotte, NC 28223, United States of America.
| | - Grant R Williams
- University of Alabama at Birmingham School of Medicine, Address: 1600 7th Ave S, Lowder 500, Birmingham, AL 35233, United States of America.
| | - Virginia Sun
- Division of Nursing Research and Education, City of Hope, Address: 1500 East Duarte Road, Duarte, CA 91010, United States of America.
| | - Marie Bakitas
- University of Alabama at Birmingham School of Nursing, Address: 1720 2(nd) Avenue South, NB 486, Birmingham, AL 35294-1210, United States of America.
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Giger AKW, Ditzel HM, Jørgensen TL, Ditzel HJ, Mohammadnejad A, Ewertz M, Pfeiffer P, Lund CM, Ryg J. Predictive value of geriatric oncology screening and geriatric assessment of older patients with cancer: A randomized clinical trial protocol (PROGNOSIS-RCT). J Geriatr Oncol 2021; 13:116-123. [PMID: 34362713 DOI: 10.1016/j.jgo.2021.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 07/22/2021] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Comprehensive geriatric assessment (CGA) has been shown to reduce frailty in older patients in general. In older patients with cancer, frailty affects quality of life (QoL), physical function, and survival. However, few studies have examined the effect of CGA as an additional intervention to antineoplastic treatment. This protocol presents a randomized controlled trial, which aims to evaluate the effects of CGA-based interventions in older patients with cancer and Geriatric 8 (G8) identified frailty. MATERIALS AND METHODS This randomized controlled trial will include patients, age 70+ years, with solid malignancies and G8 frailty (G8 ≤ 14). Patients will be separated into two groups, with different primary endpoints, depending on palliative or curative antineoplastic treatment initiation, and subsequently randomized 1:1 to either CGA with corresponding interventions or standard of care, along with standardized antineoplastic treatment. A geriatrician led CGA with corresponding interventions and clinical follow-up will be conducted within one month of antineoplastic treatment initiation. The interdisciplinary CGA will cover multiple geriatric domains and employ a standard set of validated assessment tools. Primary endpoints will be physical decline measured with the 30-s Chair-Stand-Test at three months (palliative setting) and unplanned hospital admissions at six months (curative setting). Additional outcomes include QoL, treatment toxicity and adherence, occurrence of polypharmacy, potential drug interactions, potential inappropriate medications, and survival. The primary outcomes will be analyzed using a mixed model regression analysis (30-s chair stand test) and linear regression models (unplanned hospitalizations), with an intention to treat approach. Power calculations reveal the need to enroll 134 (palliative) and 188 (curative) patients. DISCUSSION The present study will examine whether CGA, as an additional intervention to antineoplastic treatment, can improve endpoints valued by older patients with cancer. Inclusion began November 2020 and is ongoing, with 37 and 29 patients recruited April 15th, 2021. Registration:NCT04686851.
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Affiliation(s)
- Ann-Kristine Weber Giger
- Department of Geriatric Medicine, Odense University Hospital, Denmark; Department of Clinical Research, University of Southern Denmark, Denmark; Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Denmark.
| | - Helena Møgelbjerg Ditzel
- Department of Clinical Research, University of Southern Denmark, Denmark; Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Denmark; Department of Oncology, Odense University Hospital, Denmark
| | - Trine Lembrecht Jørgensen
- Department of Clinical Research, University of Southern Denmark, Denmark; Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Denmark; Department of Oncology, Odense University Hospital, Denmark
| | - Henrik Jørn Ditzel
- Department of Clinical Research, University of Southern Denmark, Denmark; Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Denmark; Department of Oncology, Odense University Hospital, Denmark
| | | | - Marianne Ewertz
- Department of Clinical Research, University of Southern Denmark, Denmark; Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Denmark
| | - Per Pfeiffer
- Department of Clinical Research, University of Southern Denmark, Denmark; Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Denmark; Department of Oncology, Odense University Hospital, Denmark
| | - Cecilia Margareta Lund
- Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Denmark; Department of Medicine, Copenhagen University Hospital, Herlev and Gentofte, Denmark; CopenAge, Copenhagen Center for Clinical Age research, University of Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Jesper Ryg
- Department of Geriatric Medicine, Odense University Hospital, Denmark; Department of Clinical Research, University of Southern Denmark, Denmark; Academy of Geriatric Cancer Research (AgeCare), Odense University Hospital, Denmark
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Perrot A, Facon T, Plesner T, Usmani SZ, Kumar S, Bahlis NJ, Hulin C, Orlowski RZ, Nahi H, Mollee P, Ramasamy K, Roussel M, Jaccard A, Delforge M, Karlin L, Arnulf B, Chari A, He J, Ho KF, Van Rampelbergh R, Uhlar CM, Wang J, Kobos R, Gries KS, Fastenau J, Weisel K. Health-Related Quality of Life in Transplant-Ineligible Patients With Newly Diagnosed Multiple Myeloma: Findings From the Phase III MAIA Trial. J Clin Oncol 2021; 39:227-237. [PMID: 33326255 PMCID: PMC8078427 DOI: 10.1200/jco.20.01370] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
PURPOSE To evaluate the effects of daratumumab, lenalidomide, and dexamethasone (D-Rd) versus lenalidomide and dexamethasone (Rd) on patient-reported outcomes (PROs) in the phase III MAIA study. PATIENTS AND METHODS PROs were assessed on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30-item and the EuroQol 5-dimensional descriptive system at baseline and every 3 months during treatment. By mixed-effects model, changes from baseline are presented as least squares means with 95% CIs. RESULTS A total of 737 transplant-ineligible (TIE) patients with newly diagnosed multiple myeloma were randomly assigned to D-Rd (n = 368) or Rd (n = 369). Compliance with PRO assessments was high at baseline (> 90%) through month 12 (> 78%) for both groups. European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30-item global health status scores improved from baseline in both groups and were consistently greater with D-Rd at all time points. A global health status benefit was achieved with D-Rd, regardless of age (< 75 and ≥ 75 years), baseline Eastern Cooperative Oncology Group (ECOG) performance status score, or depth of response. D-Rd treatment resulted in significantly greater reduction in pain scores as early as cycle 3 (P = .0007 v Rd); the magnitude of change was sustained through cycle 12. Reductions in pain with D-Rd were clinically meaningful in patients regardless of age, ECOG status, or depth of response. Similarly, PRO improvements were observed with D-Rd and Rd on the EuroQol 5-dimensional descriptive system visual analog scale score. CONCLUSION D-Rd compared with Rd was associated with faster and sustained clinically meaningful improvements in PROs, including pain, in transplant-ineligible patients with newly diagnosed multiple myeloma regardless of age, baseline ECOG status, or depth of treatment response.
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Affiliation(s)
- Aurore Perrot
- Hematology Department, Cancer University Institute Oncopole, Toulouse, France
- Aurore Perrot, MD, PhD, Institut Universitaire du Cancer Toulouse- Oncopole, 1 avenue Irène Joliot-Curie, 31059 Toulouse Cedex 9, France; e-mail:
| | - Thierry Facon
- Service des Maladies du Sang, Hôpital Claude Huriez, Lille, France
| | - Torben Plesner
- Vejle Hospital and University of Southern Denmark, Vejle, Denmark
| | | | - Shaji Kumar
- Department of Hematology, Mayo Clinic Rochester, Rochester, MN
| | - Nizar J. Bahlis
- University of Calgary, Arnie Charbonneau Cancer Research Institute, Calgary, AB, Canada
| | - Cyrille Hulin
- Department of Hematology, Hospital Haut Leveque, University Hospital, Pessac, France
| | - Robert Z. Orlowski
- Department of Lymphoma-Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Hareth Nahi
- Division of Hematology, Department of Medicine, Karolinska Institute, Karolinska University Hospital at Huddinge, Stockholm, Sweden
| | - Peter Mollee
- Princess Alexandra Hospital and University of Queensland, Brisbane, Australia
| | - Karthik Ramasamy
- Oxford University Hospital and NIHR BRC Blood Theme, Oxford, United Kingdom
| | - Murielle Roussel
- Hematology Department, Cancer University Institute Oncopole, Toulouse, France
| | | | - Michel Delforge
- Department of Hematology, University Hospital Leuven, Belgium
| | - Lionel Karlin
- Centre Hospitalier Lyon-Sud Hematologie (HCL), Pierre—Benite Cedex, France
| | | | - Ajai Chari
- Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY
| | | | | | | | | | | | | | | | | | - Katja Weisel
- Department of Oncology, Hematology, BMT with Department of Pneumology, University Medical Center Hamburg, Hamburg, Germany
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Abstract
Diarrhea, an illness of both the developed and developing world, involves the burdensome characteristics of frequent bowel movements, loose stools, and abdominal discomfort. Diarrhea is a long-standing challenge in palliative care and can have a myriad of causes, making symptomatic treatment pertinent when illness evaluation is ongoing, when there is no definitive treatment approach, or when effective treatment cannot be attained. Symptomatic therapy is a common approach in palliative care settings. Bismuth is a suitable agent for symptomatic therapy and can be effectively employed for management of chronic diarrhea. The objective of this narrative review is to examine the role of bismuth in management of diarrheal symptoms. To explore this, PubMed (including Medline) and Embase were used to search the existing literature on bismuth and diarrhea published from 1980 to 2019. It was found that bismuth has potential utility for diarrheal relief in multiple settings, including microscopic colitis, traveler's diarrhea, gastrointestinal infection, cancer, and chemotherapy. It also has great potential for use in palliative care patients, due to its minimal side effects. Overall, the antisecretory, anti-inflammatory, and antibacterial properties of bismuth make it a suitable therapy for symptomatic treatment of diarrhea. The limited range of adverse side effects makes it an appealing option for patients with numerous comorbidities. Healthcare providers can explore bismuth as an adjunct therapy for diarrhea management in an array of conditions, especially in the palliative care setting.
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Affiliation(s)
- Helen Senderovich
- Geriatrics & Pain Medicine & Palliative Care Physician, Baycrest Health Sciences, Toronto, Ontario, Canada
- Assistant Professor at the Department of Family and Community Medicine, Division of Palliative Care, University of Toronto, Toronto, Ontario, Canada
| | - Megan Vierhout
- Geriatrics & Pain Medicine & Palliative Care Physician, Baycrest Health Sciences, Toronto, Ontario, Canada
- McMaster University, Faculty of Health Sciences, Hamilton, Ontario, Canada
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Scotté F, Bossi P, Carola E, Cudennec T, Dielenseger P, Gomes F, Knox S, Strasser F. Addressing the quality of life needs of older patients with cancer: a SIOG consensus paper and practical guide. Ann Oncol 2019; 29:1718-1726. [PMID: 30010772 DOI: 10.1093/annonc/mdy228] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Around 60% of people living with cancer are aged 65 years or older. Older cancer patients face a unique set of age-associated changes, comorbidities and circumstances that impact on their quality of life (QoL) in ways that are different from those affecting younger patients. A Task Force of the International Society of Geriatric Oncology recommends and encourages all healthcare professionals involved in cancer care to place greater focus on the QoL of older people living with cancer. This paper summarizes current thinking on the key issues of importance to addressing QoL needs of older cancer patients and makes a series of recommendations, together with practical guidance.
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Affiliation(s)
- F Scotté
- Department of Medical Oncology and Supportive Care, Foch Hospital, Suresnes, France.
| | - P Bossi
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - E Carola
- Groupe Hospitalier Public Sud de L'Oise, Creil, France
| | - T Cudennec
- Service de Médecine Gériatrique, HU-PIFO site Ambroise Paré, AP-HP, Boulogne Billancourt, France
| | - P Dielenseger
- Département des Innovations Thérapeutiques et Essais Précoces, Gustave Roussy Cancer Campus, French Oncology Nursing Society, Paris, France
| | - F Gomes
- Medical Oncology Department, The Christie Hospital NHS Foundation Trust, Manchester, UK
| | - S Knox
- EUROPA DONNA - The European Breast Cancer Coalition, Milan, Italy
| | - F Strasser
- Oncological Palliative Medicine, Clinic Medical Oncology and Hematology, Department of Internal Medicine, Cantonal Hospital St Gallen, St Gallen, Switzerland
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Feliu J, Heredia-Soto V, Gironés R, Jiménez-Munarriz B, Saldaña J, Guillén-Ponce C, Molina-Garrido MJ. Management of the toxicity of chemotherapy and targeted therapies in elderly cancer patients. Clin Transl Oncol 2019; 22:457-467. [PMID: 31240462 DOI: 10.1007/s12094-019-02167-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 06/16/2019] [Indexed: 12/22/2022]
Abstract
The elderly form a very heterogeneous group in relation to their general health state, degree of dependence, comorbidities, performance status, physical reserve and geriatric situation, so cancer treatment in the older patient remains a therapeutic challenge. The physiological changes associated with aging increase the risk of developing a serious toxicity induced by chemotherapy treatment, as well as other undesirable consequences as hospitalizations, dependence and non-compliance with treatment, that can negatively affect survival, quality of life and treatment efficacy. The use of hematopoietic growth factors and other active supportive interventions in the elderly can help prevent and/or alleviate these toxicities. However, we have little data on the efficacy and tolerance of support treatments in the older patient. The objective of this work is to review the most frequent toxicities of oncological treatments in the elderly and their management.
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Affiliation(s)
- J Feliu
- Medical Oncology Department, H. Universitario La Paz, CIBERONC, Paseo de la Castellana 261, 28046, Madrid, Spain.
| | - V Heredia-Soto
- Medical Oncology Department, H. Universitario La Paz, CIBERONC, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - R Gironés
- Medical Oncology Department, H. Lluís Alcanyís. Xàtiva, Valencia, Spain
| | - B Jiménez-Munarriz
- Medical Oncology Department, H. Universitario Clara Campal, Madrid, Spain
| | - J Saldaña
- Medical Oncology Department, Instituto Catalán de Oncología, Hospitalet, Barcelona, Spain
| | - C Guillén-Ponce
- Medical Oncology Department, H. Universitario Ramón Y Cajal, Madrid, Spain
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General recommendations paper on the management of older patients with cancer: the SEOM geriatric oncology task force's position statement. Clin Transl Oncol 2018; 20:1246-1251. [PMID: 29633183 PMCID: PMC6153856 DOI: 10.1007/s12094-018-1856-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Accepted: 03/02/2018] [Indexed: 01/03/2023]
Abstract
Population aging is associated with greater numbers of older people with cancer. Thanks to treatment advances, not only are more seniors diagnosed with cancer, but there are also more and more older cancer survivors. This upward trend will continue. Given the heterogeneity of aging, managing older patients with cancer poses a significant challenge for Medical Oncology. In Spain, a Geriatric Oncology Task Force has been set up within the framework of the Spanish Society for Medical Oncology (SEOM). With the aim of generating evidence and raising awareness, as well as helping medical oncologists in their training with respect to seniors with cancer, we have put together a series of basic management recommendations for this population. Many of the patients who are assessed in routine clinical practice in Oncology are older. CGA is the basic tool by means of which to evaluate older people with cancer and to understand their needs. Training and the correct use of recommendations regarding treatment for comorbidities and geriatric syndromes, support care, and drug–drug interactions and toxicities, including those of antineoplastic agents, as detailed in this article, will ensure that this population is properly managed.
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