Development of a senior oncology clinic for geriatric cancer patients.

Abstract

134 Background: By 2030, more than 70% of all new cancer diagnoses will affect patients older than 65. The National Comprehensive Cancer Network recommends performing a Comprehensive Geriatric Assessment for elderly patients with cancer. Levine Cancer Institute (LCI) has developed a Senior Oncology Clinic to address the unique needs of geriatric oncology patients. Methods: Prior to the clinic visit, the patient completes a standardized questionnaire. During the visit, the patient is evaluated by a pharmacist, physical or occupational therapist, geriatrician and oncologist. The pharmacist reviews the vaccination history, prescription and non-prescription medications, and supplements. The therapist assesses balance, strength, and fatigue. The geriatrician assesses cognition, medical comorbidities, and geriatric syndromes. The oncologist screens for depression, and reviews oncologic treatment options. Final recommendations are sent by the team to the referring provider and primary care physician. Results: The Senior Oncology Clinic at LCI saw 31 survivors in 2015, and has seen 24 survivors in 2016. Patients receive referrals to a variety of services such as outpatient therapy, nutrition services, and social work. Recommendations are shared with referring providers to address common conditions in older adults as well as cancer-specific treatment recommendations. Due to the success of the program, the clinic has recently been expanded to a second site, LCI-Albemarle. This site utilizes a telemedicine model to provide the clinic at a rural location. Challenges to the program’s effectiveness include provider scheduling, clinic space, data management, and administrative management. A Program Coordinator was recently hired to oversee these aspects of the clinic. Patient challenges include transportation, medical complexity of the population, and missed appointments. Conclusions: A Senior Oncology Clinic is an effective way to perform a multidisciplinary assessment to guide cancer treatment in the geriatric population. These assessments can improve treatment decisions, detect geriatric syndromes, and recommend interventions to help improve the quality of life.