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Decision
Geriatric oncology assessment
Age is not a number that decides treatment. Function is.
What it is
Older patients are simultaneously under-treated, denied curative treatment because of a birth date , and over-treated, given regimens they cannot tolerate because nobody assessed them. A comprehensive geriatric assessment measures function, cognition, nutrition, medication burden, social support and comorbidity.
It predicts chemotherapy toxicity better than the oncologist's impression does, and it frequently changes the plan in both directions.
When it is used
- Any patient over 70 facing systemic treatment
- Where a family is being told 'too old for treatment'
- Before major cancer surgery in an older patient
- Where polypharmacy or falls are present
How the decision is made
- Fitness for the intended treatment, measured rather than eyeballed.
- What is correctable before starting, anaemia, nutrition, medication burden, deconditioning.
- Whether a modified regimen achieves most of the benefit at much less cost to the patient.
Assessed here across clinics; the assessment travels with the case to whoever treats.
Who does what
What we handle, and what happens elsewhere
KPCIRC handles
- A structured geriatric assessment, written up
- A toxicity-risk estimate for the proposed regimen
- A medication review and de-prescribing plan
- A prehabilitation plan where time allows
- A dose and schedule recommendation to the treating team
Performed and billed elsewhere
- Treatment delivery
- Specialist geriatric medicine input where needed
- If an older relative has been refused treatment on the basis of age alone, that is a reason for a second opinion, not a conclusion.
Questions to ask your own doctor
Take these with you. They work whether or not you are treated here.
- Has my fitness actually been assessed, or estimated?
- What is my risk of serious side effects?
- Is there a modified regimen with most of the benefit?
- What can we fix before starting?
Support that goes with it
Where this is used
Cancers this commonly forms part of
Colorectal cancer
Colon and rectal cancer, bowel cancer
Lung & thoracic cancer
Non-small cell and small cell lung cancer, mesothelioma, thymic tumours
Breast cancer
Including hormone-receptor positive, HER2-positive and triple-negative disease
Prostate cancer
Cancer of the prostate gland
Stomach cancer
Gastric cancer
Lymphoma
Hodgkin and non-Hodgkin lymphoma
Not sure this is the right option for you?
That is exactly what a second opinion is for. Bring what you have, we will tell you what is missing and what the alternatives actually are, in writing.