Geriatric assessment by default for every patient over 70 starting cancer treatment
A short structured check of memory, mobility, nutrition and medicines before treatment cuts serious side effects in older patients without reducing benefit. It should be automatic, not optional.
Randomised trials (GAP70+, GAIN, and others) showed that geriatric assessment with management recommendations reduces grade 3 or higher toxicity in older patients receiving chemotherapy, and ASCO guidelines recommend it. Uptake remains low because it is seen as extra work. Embedding a validated screening tool (such as G8) in intake, with automatic full assessment and management recommendations for positive screens, delivered by nurses, would make it the default.
- Older and multimorbid patients are excluded and undertreated · Most people with cancer are over 65 but most trial patients are younger and fitter. We guess how to treat the majority.
- Toxicity and quality of life are undervalued · Trials measure how long people live, not how they live. Side-effects are under-reported and under-treated.
Pages like this
not linked directly; found by shared links- IdeaGeriatric assessment by default for every older patient, and trials that admit them
Shares GAP70+: a geriatric assessment before chemotherapy cut serious toxicity in older adults by a fifth, Geriatric assessment, Older and multimorbid patients are excluded and undertreated.
- IdeaDose-finding in older and frail patients, not extrapolation from fit ones
Shares GAP70+: a geriatric assessment before chemotherapy cut serious toxicity in older adults by a fifth, Geriatric assessment, Older and multimorbid patients are excluded and undertreated.
- InstitutionWilmot Cancer Institute, University of Rochester
Shares Geriatric assessment, Older and multimorbid patients are excluded and undertreated, Toxicity and quality of life are undervalued.
- IdeaGeriatrician co-management for older patients having cancer surgery
Shares Geriatric assessment, Older and multimorbid patients are excluded and undertreated.
- IdeaParallel real-world cohorts for sicker patients alongside every pivotal trial
Shares Geriatric assessment, Older and multimorbid patients are excluded and undertreated.
- IdeaStop screening by life expectancy, not birthday, with a tool in the record
Shares Geriatric assessment, Older and multimorbid patients are excluded and undertreated.
- IdeaUpfront reduced-dose regimens tested head-to-head in frail older patients
Shares GAP70+: a geriatric assessment before chemotherapy cut serious toxicity in older adults by a fifth, Older and multimorbid patients are excluded and undertreated.
- IdeaPragmatic trials in patients over 75 with function, not just survival, as the primary endpoint
Shares Geriatric assessment, Older and multimorbid patients are excluded and undertreated.