Memorial Sloan-Kettering Cancer Center program of cancer and aging. Experience of the 65+ Clinical Geriatric Program in the evaluation of older cancer patients

Abstract

20728 The aging of the population and the increased incidence of cancer with age have resulted in a marked increase in older cancer patients. In addition to their cancer they have increased comorbidity making treatment decisions and their care more complicated. The older patients are at increased risk to suffer cancer treatment related toxicities. Therefore a coordinated approach is required to optimize care by giving the patients the opportunity to benefit from treatment and at the time minimize suffering from toxicities. The Memorial Sloan-Kettering Cancer Center as part of the Cancer and Aging program has organized the 65+ Clinical Geriatric Group to achieve this goal. The group consists of participants with expertise in geriatrics, finance, nutrition, occupational therapy, music therapy, pharmacy, physical therapy, psychiatry, social work, palliative care, medical and surgical oncology. The group meets on a monthly basis to plan on an ongoing basis the building of an infrastructure for multidisciplinary geriatric oncology care in the institution. A database has been organized to assess the group’s activity and evaluate outcomes. In the 3rd quarter of 2007 there were 1202 patient visits by team members with the majority visits in nutrition (22%), physical therapy (22%), occupational therapy (14%), psychiatry (16%) and social work (16%). In the period Oct-Dec 2007 69 geriatric pharmacy consultations were performed (mean 75.5; median age 76 years; male-55%; female-45%). A comprehensive medication review was conducted which included evaluation of drug compliance, and unnecessary prescription drug evaluation (using Beer’s Criteria). In the same period 305 geriatric nutritional consultations were provided (male-40%; female-60%; 71% over 70 years; 39.8% were overweight/obese based on BMI). The referral pattern for the nutrition consults was: physician referral-32%; referral administration-50%; patient self referral-17.6%. The activity of the group demonstrates that a geriatric evaluation and support program can be conducted in the setting of a Comprehensive Cancer Center. Future activities will include development of institutional guidelines for multidisciplinary geriatric care. No significant financial relationships to disclose.