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Sankarapillai J, Krishnan S, Ramamoorthy T, Sudarshan KL, Das P, Chaturvedi M, Mathur P. Epidemiology of cancers among older adults in India: findings from the National Cancer Registry Programme. Public Health 2023; 223:230-239. [PMID: 37683494 DOI: 10.1016/j.puhe.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 07/04/2023] [Accepted: 08/01/2023] [Indexed: 09/10/2023]
Abstract
OBJECTIVE This study describes the epidemiology, clinical extent of disease at diagnosis and treatment modalities of cancer among older adults (aged 60 years and older) in India. STUDY DESIGN Secondary data analysis of the National Cancer Registry Programme, which includes 28 Population-Based Cancer Registries (PBCRs) and 96 Hospital-Based Cancer Registries (HBCRs). METHODS PBCR data were used to estimate the incidence in terms of crude rate (CR), age-adjusted incidence rate (AAR), age-specific rate (ASpR) and cumulative risk. Trends in the AAR were calculated with the Annual Percentage Change (APC) using join-point regression. HBCR data were used to describe the clinical extent of the disease at diagnosis and the treatment modalities. RESULTS There is a wide heterogeneity across the country for the incidence of cancer and for the leading cancer sites among older adults. Males had a higher incidence rate compared to females in the majority of the registries. Aizawl had the highest AARs among both genders (males: 1388.8; females: 1033.0). Females had the highest ASpR at 65-69 years (482.8), whereas for males it was above 75 years (710.4). Cervical, stomach and oesophageal cancers were on the decline. The incidence of cancer among older adults was estimated to increase by 13.5% in 2025 as compared to 2020. CONCLUSION The increasing cancer incidence among older adults in India poses a huge burden on the health system. There is a need to increase their participation in clinical trials, advocating comprehensive geriatric assessment and strengthening geriatric oncology within programs addressing older adult's care to deal with the rising cancer burden on the health system borne by them.
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Affiliation(s)
- J Sankarapillai
- Indian Council of Medical Research - National Centre for Disease Informatics and Research, Nirmal Bhawan-ICMR Complex (II Floor), Poojanahalli, Kannamangala Post, Bengaluru, Karnataka, 562110, India(a)
| | - S Krishnan
- Indian Council of Medical Research - National Centre for Disease Informatics and Research, Nirmal Bhawan-ICMR Complex (II Floor), Poojanahalli, Kannamangala Post, Bengaluru, Karnataka, 562110, India(a)
| | - T Ramamoorthy
- Indian Council of Medical Research - National Centre for Disease Informatics and Research, Nirmal Bhawan-ICMR Complex (II Floor), Poojanahalli, Kannamangala Post, Bengaluru, Karnataka, 562110, India(a)
| | - K L Sudarshan
- Indian Council of Medical Research - National Centre for Disease Informatics and Research, Nirmal Bhawan-ICMR Complex (II Floor), Poojanahalli, Kannamangala Post, Bengaluru, Karnataka, 562110, India(a)
| | - P Das
- Indian Council of Medical Research - National Centre for Disease Informatics and Research, Nirmal Bhawan-ICMR Complex (II Floor), Poojanahalli, Kannamangala Post, Bengaluru, Karnataka, 562110, India(a)
| | - M Chaturvedi
- Indian Council of Medical Research - National Centre for Disease Informatics and Research, Nirmal Bhawan-ICMR Complex (II Floor), Poojanahalli, Kannamangala Post, Bengaluru, Karnataka, 562110, India(a)
| | - P Mathur
- Indian Council of Medical Research - National Centre for Disease Informatics and Research, Nirmal Bhawan-ICMR Complex (II Floor), Poojanahalli, Kannamangala Post, Bengaluru, Karnataka, 562110, India(a).
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Menon N, Patil VM, Ramaswamy A, Gattani S, Castelino R, Dhekale R, Gota V, Sekar A, Deodhar J, Mahajan SG, Daptardar A, Prabhash K, Banavali SD, Badwe RA, Noronha V. Caregiver burden in older Indian patients with cancer- Experience from a tertiary care center. J Geriatr Oncol 2022; 13:970-977. [PMID: 35750629 DOI: 10.1016/j.jgo.2022.05.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 03/21/2022] [Accepted: 05/23/2022] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Most of the long-term care for older adults with chronic or debilitating illnesses is provided by unpaid family members or informal caregivers. There is limited information on caregiver burden among caregivers of older patients with cancer in India. Hence, we assessed the prevalence and severity of caregiver burden among caregivers of older Indian patients with cancer. METHODS This was an observational study conducted at the geriatric oncology clinic at Tata Memorial Centre, Mumbai, India. Caregivers of patients aged 60 years and over with a diagnosis of cancer were assessed for caregiver burden using the Zarit Burden Interview. Descriptive statistics were used for demographic and clinical variables. Factors impacting caregiver burden were analyzed using multiple linear regression analysis. RESULTS Caregiver burden was assessed among 127 caregivers of older Indian patients with cancer. The median patient age was 69 years (range 60-90). Most patients were men (75.6%). There were 33 female caregivers (26%), and 94 male caregivers (74%). The median caregiver burden score was 12 (IQR 6-20). Caregiver burden was "little/none" in 97 (76.4%), "mild-moderate" in 25 (19.7%), "moderate-severe" in four (3.1%) and "severe" in one (0.8%) of the caregivers assessed. On multivariate analysis, factors that significantly impacted caregiver burden scores were the presence of psychological issues in the patient and the caregiver's educational level. CONCLUSION Caregiver burden was low among caregivers of older Indian patients with cancer seen at a single center. Caregivers of patients with psychological disorders, and those who had less schooling reported higher caregiver burden.
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Affiliation(s)
- Nandini Menon
- Department of Medical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Vijay M Patil
- Department of Medical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Anant Ramaswamy
- Department of Medical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Shreya Gattani
- Department of Medical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Renita Castelino
- Department of Clinical Pharmacology, ACTREC, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | | | - Vikram Gota
- Department of Clinical Pharmacology, ACTREC, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Anbarasan Sekar
- Department of Medical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Jayita Deodhar
- Department of Palliative Care, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Sarika G Mahajan
- Department of Physiotherapy, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Anuradha Daptardar
- Department of Physiotherapy, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Kumar Prabhash
- Department of Medical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Shripad D Banavali
- Department of Medical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Rajendra A Badwe
- Department of Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Vanita Noronha
- Department of Medical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.
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Mittal A, Rangaraju RR, Agarwal A, Chandragouda D, Batra S, Qureshi S. Estimating the Risk of Chemotherapy Toxicity in Indian Geriatric Patient Population and Utility of Chemotherapy Risk Assessment Scale for High Age Patients (CRASH) Score. South Asian J Cancer 2021; 10:161-166. [PMID: 34938678 PMCID: PMC8687865 DOI: 10.1055/s-0041-1729447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background
Aging is a heterogeneous process, and elderly population is diverse in health status and functional reserve. The present study was undertaken to predict severe chemotherapy toxicity using the Chemotherapy Risk Assessment Scale for High-Age Patients’ (CRASH) score.
Materials and Methods
Elderly patients (age ≥65 years) with malignancy, who were planned to be treated with a new course of cytotoxic chemotherapy, were enrolled. The CRASH score was calculated, and patients were stratified into four categories, that is, low (0–3), intermediate (Int)-low (4–6), Int-high (7–9), and high (<9). Patients developing grade 3/4/5 nonhematologic (NH) or grade 4/5 hematologic (H) toxicity were taken as the development of severe toxicity.
Results
Of 100 enrolled patients, 64 (64%) were able to complete their prescribed treatment. Forty-four percent of patients (44 patients) of our study cohort experienced grade-4 H or grade 3/4 NH toxicity. The highest score in each category (heme/nonheme/CRASH) predicts nearly 100% toxicity risk. At a critical value of CRASH ≥ 6.5, the sensitivity is calculated as 100%, while specificity is 89.09%. The accuracy of prediction is 93.88%. The median time taken to develop toxicity was 39.5 days.
Conclusion
CRASH score utilizes clinical assessment and basic laboratory values. Yet, it accurately predicts severe chemotherapy toxicity above a critical value of 6.5. Based on the above study, the first 30 days are crucial as 45% of patients experienced toxicity in this time frame. With the help of these clinical predictive markers, the care of elderly will be optimized.
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Affiliation(s)
- Aditi Mittal
- Department of Medical Oncology, Sawai Man Singh Medical College, Jaipur, Rajasthan, India
| | - Ranga R Rangaraju
- Department of Medical Oncology, Max Super Speciality Hospital, Shalimar Bagh, New Delhi, India
| | - Amit Agarwal
- Department of Medical Oncology, B.L. Kapur Super Speciality Hospital, Rajendra Place, New Delhi, India
| | - D Chandragouda
- Department of Medical Oncology, B.L. Kapur Super Speciality Hospital, Rajendra Place, New Delhi, India
| | - Sandeep Batra
- Department of Medical Oncology, Max Super Speciality Hospital, Saket, Delhi, India
| | - Suhail Qureshi
- Department of Medical Oncology, B.L. Kapur Super Speciality Hospital, Rajendra Place, New Delhi, India
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Nethan S, Cherian M, Brain E, Ganguli A, Tullu F, Musolino N, Hariprasad R, Sullivan R, Mehrotra R. Cancer in the older Indian population: Understanding the current context in an emerging economy. J Geriatr Oncol 2021; 13:273-281. [PMID: 34776381 DOI: 10.1016/j.jgo.2021.10.013] [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: 01/21/2021] [Revised: 08/30/2021] [Accepted: 10/25/2021] [Indexed: 10/19/2022]
Abstract
India is considered a demographically young country with over 65% of the population aged below 35 years. However, improvements in maternal and child health, and infectious diseases, have created a rapid epidemiological transition with an aging population (8.6% in 2011) with a projected increase (19% by 2050), equating to 104 million. In addition to the well-articulated issues surrounding the care of the older patients with cancer, the Indian context as an emerging economy provides additional social, political, economic and clinical challenges. This review addresses the key issues and possible solutions germane to both policymakers in India and other emerging economies. Extension of cancer prevention, equal, optimal treatment opportunities, and inclusion in clinical trials, akin to the younger population, must be encouraged. Various national health initiatives require effective implementation, to provide uniform, evidence-based, cancer care across India. Designated geriatric oncology departments, and required care at the primary healthcare level are essential.
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Affiliation(s)
- Suzanne Nethan
- Project ECHO (Extension for Community Healthcare Outcomes) - India, Building No 76 (2nd Floor), Okhla Phase III, Okhla Industrial Area, New Delhi 110020, India.
| | - Meena Cherian
- International Society of Geriatric Oncology (SIOG), International Environmental House 2, Chemin de Balexert 7-9, 1219 Chatelaine, Switzerland.
| | - Etienne Brain
- Department of Clinical Research & Medical Oncology, Institut Curie (Hôpital René Huguenin), 35 Rue Dailly, 92210 St Cloud, France.
| | - Atreyi Ganguli
- WHO India Country Office, 537, A Wing, Nirman Bhawan, Maulana Azad Road, New Delhi 110011, India.
| | - Fikru Tullu
- WHO India Country Office, 537, A Wing, Nirman Bhawan, Maulana Azad Road, New Delhi 110011, India.
| | - Najia Musolino
- International Society of Geriatric Oncology (SIOG), International Environmental House 2, Chemin de Balexert 7-9, 1219 Chatelaine, Switzerland.
| | - Roopa Hariprasad
- Division of Clinical Oncology, Indian Council of Medical Research (ICMR), National Institute of Cancer Prevention & Research (NICPR), I-7, Sector 39, Noida 201301, Uttar Pradesh, India.
| | | | - Ravi Mehrotra
- India Cancer Research Consortium (ICMR-DHR), Ministry of Health and Family Welfare, Department of Health Research, First Floor, Indian Red Cross Society (IRCS) Building, 1, Red Cross Road, New Delhi 110001, India; Centre for Health Innovation and Policy (CHIP) Foundation, 361, Sector 15A, Noida, Uttar Pradesh 201301, India.
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Mittal A, Agrawal A, Batra S, Dodagoudar C, Qureshi S. Chemotherapy Toxicity in Elderly Population ≥65 Years: A Tertiary Care Hospital Experience from India. Indian J Med Paediatr Oncol 2019. [DOI: 10.4103/ijmpo.ijmpo_62_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Abstract
Context: Trials in the elderly have established that older individuals may benefit from chemotherapy to the same extent as younger individuals. Although the elderly patient is a prototype for cancer, very few clinical trials focus on the therapeutic decisions most directly facing older adults. Aims: This study was undertaken to study the chemotherapy-induced severe toxicity among elderly. Settings and Design: This study was a prospective, observational cohort study. The study commenced in October 2014 after obtaining clearance from the hospital ethics and protocol committee. Subjects and Methods: A total of 100 patients were included in the study. All patients were of age ≥65 years, had malignancy, and were planned to start with chemotherapy. Development of Grade 3/4/5 nonhematologic (NH) or Grade 4/5 hematologic (H) toxicities was taken as the development of severe toxicity. Statistical Analysis Used: The quantitative variables were expressed as a mean ± standard deviation and compared using unpaired t-test. P < 0.05 was considered statistically significant. Results: Overall, 64 (64%) patients were able to complete their prescribed treatment. Forty-four patients (44%) of our study cohort experienced Grade 4 H or Grade 3/4 NH toxicity. The most common H Grade 4 toxicities were neutropenia (6%) and thrombocytopenia (5%). The most common NH toxicities were fatigue (18%), infection (10%), and cardiac abnormalities (4%). Conclusions: Less than 50% of elderly patients experience severe chemotherapy-related toxicity. First 30 days are most important for toxicity assessment as 45% of patients experienced toxicity in this time frame.
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Affiliation(s)
- Aditi Mittal
- Department of Medical Oncology, Dr. BL Kapur Memorial Hospital, New Delhi, India
| | - Amit Agrawal
- Department of Medical Oncology, Dr. BL Kapur Memorial Hospital, New Delhi, India
| | - Sandeep Batra
- Department of Medical Oncology, MAX Super Specialty Hospital, New Delhi, India
| | | | - Suhail Qureshi
- Department of Medical Oncology, Dr. BL Kapur Memorial Hospital, New Delhi, India
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Sneha SG, Simhadri K, Subeesh VK, Sneha SV. Predictors of adverse drug reactions in geriatric patients: An exploratory study among cancer patients. South Asian J Cancer 2019; 8:130-133. [PMID: 31069198 PMCID: PMC6498717 DOI: 10.4103/sajc.sajc_218_18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objectives: The objective of this study was to study the predictors of adverse drug reactions (ADRs) among geriatric patients in the Department of Medical Oncology. Methods: A hospital-based prospective observational study was carried out among 153 inpatients in the Department of Medical Oncology for 6 months. Patients above 60 years of age with a confirmed history of malignancy were included in the study. The potential risk factors for ADR were defined in relation to the patient and chemotherapeutic regimen and relationship between them was assessed by univariate and multivariate logistic regression analysis. Results: Among 153 patients, 94 (64.43%) experienced ADRs. The mean ADR per patient was 0.88 ± 1.2. The common ADRs found were alopecia (30.18%) and diarrhea (28.68%). Risk estimates revealed that there was a significant association between smokers (odds ratio [OR] = 10.326; 95% confidence interval [CI] 2.345–45.47, P = 0.001), alcoholics (OR = 10.897; 95% CI 2.479–47.902, P = 0.001), increasing age (OR = 2.22; 95% CI 1.698–2.909, P = 0.001), overweight (OR = 16.68; 95% CI 2.179–127.741, P = 0.001), and male participants (OR = 0.143; 95% CI 0.05–0.390 P = 0.001) with the development of ADRs. The risk of carboplatin (OR = 13.359; 95% CI 3.056–58.406 P = 0.001) and 5-fluorouracil (OR = 1.938 95% CI 1.266–2.935 P = 0.001) use and occurrence of ADRs were also found to be high. Conclusion: The study findings showed that smoking, alcohol consumption, age more than 70 years, and overweight had a high risk for developing ADRs in geriatric patients who underwent chemotherapy. The independent risk factors identified should be targeted for preventive measures to improve anticancer agent prescription and reduce the risk of ADRs.
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Affiliation(s)
- S George Sneha
- Department of Pharmacy Practice, Faculty of Pharmacy, M. S. Ramaiah University of Applied Sciences, Bengaluru, Karnataka, India
| | - Kalpana Simhadri
- Department of Pharmacy Practice, Faculty of Pharmacy, M. S. Ramaiah University of Applied Sciences, Bengaluru, Karnataka, India
| | - Viswam K Subeesh
- Department of Pharmacy Practice, Faculty of Pharmacy, M. S. Ramaiah University of Applied Sciences, Bengaluru, Karnataka, India
| | - S Varghese Sneha
- Department of Pharmacy Practice, Faculty of Pharmacy, M. S. Ramaiah University of Applied Sciences, Bengaluru, Karnataka, India
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Reddy A, Mullapudi NA, Kabeer KK, Nimmagadda R, Radhakrishna S. Treatment of elderly breast cancer patients in a breast center in India. Indian J Cancer 2019; 56:45-49. [PMID: 30950444 DOI: 10.4103/ijc.ijc_237_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
CONTEXT The management of breast cancer in older patients is challenging due to factors such as comorbidities, limited mobility, functional dependence, cognitive functions, and socioeconomic aspects. Data about the outcomes in elderly patients with breast cancer in our country are sparse. AIMS The aim of this study was to evaluate and compare the clinical and pathological variables, treatment, and survival outcomes of elderly women (those of 70 years and above) with women under 50 years and those between the ages of 50 and 69 years treated at our center. SUBJECTS AND METHODS Prospectively collected clinical and pathological data from January 2007 to December 2014 were recorded and entered into OncoCollect™ software. Statistical analysis was done using Microsoft R Open software. Survival analysis was estimated using Kaplan-Meier curves. RESULTS A total of 1226 Stage I-III breast cancer patients were treated between January 2007 and December 2014. Of these, 11.3% (139) were aged 70 years and above. Invasive ductal carcinoma was predominant and majority had Stage II disease and grade 1 tumors. Receptor positivity was observed in 79% of elderly patients and 9% had triple-negative disease. Primary hormone therapy was given to 7% of the patients and chemotherapy was administered to 12%. The 5-year overall survival for patients 70 years and older is 85%. CONCLUSIONS Elderly patients are more likely to have an indolent course with low grade and estrogen receptor-positive tumors. For healthy older women, treatment according to standard guidelines including surgery, chemotherapy, and radiation should be followed. However, for those who are unfit and cannot tolerate surgery, primary endocrine therapy is a suitable option.
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Affiliation(s)
- Asha Reddy
- Chennai Breast Centre, MRC Nagar, Raja Annamalai Puram, Chennai, Tamil Nadu, India
| | | | | | - Ramesh Nimmagadda
- Ramesh Nimmagadda Cancer Foundation, Kamaraj Avenue 1st Street, Kasturibai Nagar, Adyar, Chennai, Tamil Nadu, India
| | - Selvi Radhakrishna
- Chennai Breast Centre, MRC Nagar, Raja Annamalai Puram, Chennai, Tamil Nadu, India
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Demographic transition - Cancer trends in geriatric population of North India. J Geriatr Oncol 2018; 10:362-364. [PMID: 30104157 DOI: 10.1016/j.jgo.2018.07.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 05/17/2018] [Accepted: 07/23/2018] [Indexed: 11/20/2022]
Abstract
Developing countries like India are witnessing a demographic transition resulting in population ageing. This population expansion will in future increase the burden of diseases more prevalent in older patients. Since cancer incidence increases with age, a surge in geriatric patients with cancer will soon overburden the health care system of our country. In anticipation of this change, present retrospective study done at a tertiary care centre highlights the cancer spectrum in all age groups with emphasis on geriatric patients. We stress upon the need for specialised care of these patients in India.
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Predictors of Chemotherapy Related Toxicities in Elderly Lymphoma Patients: Experience from a Tertiary Cancer Centre. Indian J Hematol Blood Transfus 2017; 33:470-476. [PMID: 29075056 DOI: 10.1007/s12288-017-0794-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 02/18/2017] [Indexed: 10/20/2022] Open
Abstract
Identification of baseline parameters that predict chemotherapy related morbidities in elderly lymphoma patients can help in tailoring treatment. However, there is a paucity of tools to predict the risk of chemotherapy related toxicity in elderly lymphoma patients from India. We retrospectively analyzed 203 lymphoma patients more than 60 years of age for predictors of grade III or higher haematological and non-haematological toxicity due to chemotherapy. Eighty-five (42%) and seventy-one (35%) lymphoma patients developed grade III or IV haematological and non-haematological toxicities respectively. On multivariate analysis baseline absolute lymphocyte counts (ALC) less than 1300/µl, chemotherapy with anthracyclines and presence of two co-morbid conditions were significant in predicting serious haematological toxicities. For non-haematological toxicities baseline ALT levels more than 40 U/l was the only significant factor. This is the first report from India on the study of factors predicting serious chemotherapy related adverse effects in elderly lymphoma patients. Patients with low ALC, elevated ALT, multiple co-morbidities and receiving anthracyclines should be closely monitored for chemotherapy related toxicities.
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Third Symposium on Primary Breast Cancer in Older Women. Future Oncol 2015; 11:1-23. [DOI: 10.2217/fon.15.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Joshi A, Ishi SV, Noronha V, Prabhash K. Geriatric oncology: The need of the hour. South Asian J Cancer 2014; 2:200-1. [PMID: 24455628 PMCID: PMC3889031 DOI: 10.4103/2278-330x.119900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Affiliation(s)
- Amit Joshi
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Sandeep V Ishi
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Vanita Noronha
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Kumar Prabhash
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
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