title: Geriatric consultation can aid in complex treatment decisions for elderly cancer patients.
abstract: Treatment decisions for elderly cancer patients can be challenging. A geriatric assessment may identify unknown medical conditions, give insight on patients' ability to tolerate treatment and guide treatment decisions. Our aim was to study the value of a geriatric consultation in oncological decision-making. Data on cancer patients referred for geriatric consultation for clinical optimisation or due to uncertainty regarding their optimal treatment strategy were prospectively analysed. Outcome of geriatric evaluations, non-oncological interventions and suggested adaptations of oncological treatment proposals were evaluated. Seventy-two patients were referred for consultation, over half of which in a curative treatment setting. Prevalence of geriatric syndromes was 93%, previously undiagnosed conditions were identified in 49% of patients and non-oncological interventions were initiated in 56%. Time was spent discussing patients' priorities (53% of consultations), expectations on treatment (50%) and advance care planning (14%). For 82% of patients, suggestions were made regarding the optimal treatment decision: a more intensive treatment was recommended in 39%, a less intensive therapy for 42% and in 19% only supportive care was suggested. The results demonstrate that a geriatric consultation can aid in complex treatment decisions and may allow for a reduction in over- and undertreatment of elderly cancer patients.
authors.affiliation: Department of Colorectal Surgery, Diakonessenhuis, Utrecht, the Netherlands.
authors.forename: A H W
authors.initials: AH
authors.lastname: Schiphorst
authors.affiliation: Department of Medical Oncology, Diakonessenhuis, Utrecht, the Netherlands.
authors.forename: D
authors.initials: D
authors.lastname: Ten Bokkel Huinink
authors.affiliation: Department of Gastroenterology, Diakonessenhuis, Utrecht, the Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Breumelhof
authors.affiliation: Department of Surgical Oncology, Diakonessenhuis, Utrecht, the Netherlands.
authors.forename: J P J
authors.initials: JP
authors.lastname: Burgmans
authors.affiliation: Department of Colorectal Surgery, Diakonessenhuis, Utrecht, the Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Pronk
authors.affiliation: Department of Geriatric Medicine, Diakonessenhuis, Utrecht, the Netherlands.
authors.forename: M E
authors.initials: ME
authors.lastname: Hamaker
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003657:Decision Making; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology / Q000628:therapy*; D010166:Palliative Care / Q000379:methods; D011446:Prospective Studies; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012307:Risk Factors
keywords: cancer; evaluation; management; older person; therapy