Geriatric oncology

Geriatric oncology is a branch of medicine that is concerned with the diagnosis and treatment of cancer in the elderly, usually defined as aged 65 and older. This fairly young but increasingly important subspecialty incorporates the special needs of the elderly into the treatment of cancer.

In the last few years, this particular subspecialty has received a lot of attention. A large proportion of the population of developed countries are aging. In the United States, 20% of the population will be older than 65 years of age by the year 2030. Those 85 years and older will be the most rapidly growing group. This is compounded by the fact that the majority of cancer patients will be in this age group. Age in itself is one of the most important risk factors for developing cancer. Currently, 60% of newly diagnosed malignant tumors and 70% of cancer deaths occur in people aged 65 years or older. Many cancers are linked to aging; these include breast, colorectal, prostate, pancreatic, lung, bladder and stomach cancers.

Because most non-pediatric cancer patients are older, there is a saying that all oncologists who are not pediatric oncologists are geriatric oncologists.

For many reasons, older adults with cancer have different needs than younger adults with the disease. For example, older adults:

Clinical trials usually exclude the elderly, and therefore, guidelines for treatment of cancer were mainly based on the younger population. A lot of research in this area is needed.

Just as a child would see a pediatrician for medical care, an older patient should go to a geriatrician. An older patient with cancer will benefit from the expertise of a geriatric oncologist. Older patients have unique needs because of their often complex medical histories, numerous drugs they are taking, their social situations, possible problems with cognitive dysfunction related to age, and general diminution of organ function that occurs naturally in the older population.

Rosemary Yancik first organized a symposium on geriatric oncology sponsored by the National Cancer Institute and the National Institute on Aging. A 1988 ASCO Presidential Address published in the Journal of Clinical Oncology by Dr. B.J. Kennedy encouraged the study of aging and cancer.

The American Society of Clinical Oncology (ASCO) has played a vital role in promoting the field of geriatric oncology in the United States. B.J. Kennedy, MD was one of the fathers of this field. In the late 1980s, the ASCO Annual Meetings started including educational sessions and presentations pertaining to this field. The Journal of Clinical Oncology started publishing more articles pertaining to geriatric oncology. ASCO has also funded training for oncology fellows.

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