Dr. Nancy Reid
Purpose: The purpose of this article is to describe the patient centered reasons to perform a geriatric assessment in older adults who may be offered chemotherapy.
Method: A PubMed literature search was conducted with search terms geriatric assessment, cancer, chemotherapy, and older adults. 29 pertinent articles were retrieved and serve as the basis for this clinical review.
Results: Geriatric assessments examine life expectancy outside of cancer, risk of severe toxicity, functional and cognitive impairments, falls, depression, and nutrition issues that are unlikely to be revealed in a typical oncologic consult.1-3 The availability of this data allows for the opportunity to have a patient centered, rather than a primarily disease centered discussion about the impact of treatment on the older adult.3 The needs, preferences, and values of patients are central to shared decision making. The assessments are predictive for functional decline, morbidity and mortality, hospitalizations, risk of severe toxicity in treatment, and completion of treatment.
Conclusion: There is variability in how oncologists make treatment decisions for older adults.1,8,13 Geriatric assessments are fundamental in rendering patient centered care that takes into consideration not only the cancer diagnosis, but also non-cancer factors can be compromised by treatment and worsen outcomes. They provide essential information to patients and their oncologists to guide treatment and facilitate early interventions which may improve outcomes.
Webb TL. Patient Centered Arguments for Geriatric Assessments in Oncology. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2020; 2(2).
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