Geriatric medical oncology in the care of elderly cancer patients.
Most cancers are diagnosed after 70 years of age but standard management and treatment for elderly cancer patients remain to be established. To determine whether the availability and recognition of medical oncology may influence cancer care in this population, five successive periods were studied. The number of formal written consultations given at the geriatric hospital and at the center for continuous care was measured. Over a period of 36 months, the number of consultations rose from an initial 1.5% (n=26) and 3.8% (n=25) to 3% (n=71) and 12.5% (n=103) of the respective total number of admissions. As expected, the increase exactly matched both main geographical location and functional position of the single appointed medical oncologist. However, following the definitive establishment of the medical oncologist at the center for continuous care, the number of formal written consultations markedly decreased. At the geriatric hospital, medical oncology returned to the 'status quo ante' whereas it was quite simply incorporated in the daily care of all cancer patients at the center for continuous care. Thus, improvement of cancer care in the elderly may first depend on human resources such as trained specialists to make a true difference with the prior situation.
Zulian
Gilbert B
GB
Cesco (Center for Continuous Care), Department of Geriatrics, Geneva University Hospitals, 11 Chemin de la Savonnière, CH-1245, Collonge-Bellerive, Switzerland. gilbert.zulian@hcuge.ch
D000368:Aged; D000369:Aged, 80 and over; D019468:Disease Management; D006299:Health Services for the Aged / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D008495:Medical Oncology / Q000458:organization & administration / Q000706:statistics & numerical data; D009369:Neoplasms / Q000628:therapy*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D000078329:Workforce