title: Supportive Care in Older Adults with Cancer: Across the Continuum.
abstract: Supportive care is an essential component of anticancer treatment regardless of age or treatment intent. As the number of older adults with cancer increases, and supportive care strategies enable more patients to undergo treatment, greater numbers of older patients will become cancer survivors. These patients may have lingering adverse effects from treatment and will need continued supportive care interventions. Older adults with cancer benefit from geriatric assessment (GA)-guided supportive care interventions. This can occur at any stage across the cancer treatment continuum. As a GA commonly uncovers issues potentially unrelated to anticancer treatment, it could be argued that the assessment is essentially a supportive care strategy. Key aspects of a GA include identification of comorbidities, assessing for polypharmacy, screening for cognitive impairment and delirium, assessing functional status, and screening for psychosocial issues. Treatment-related issues of particular importance in older adults include recognition of increased bone marrow toxicity, management of nausea and vomiting, identification of anemia, and prevention of neurotoxicity. The role of physical therapy and cancer rehabilitation as a supportive care strategy in older adults is important regardless of treatment stage or intent.
authors.affiliation: Internal Medicine Division of Geriatric Medicine, University of Nebraska Medical Center, 986155 Nebraska Medical Center, Omaha, 68198-6155, NE, USA.
authors.forename: Thuy
authors.initials: T
authors.lastname: Koll
authors.affiliation: Cancer Outcomes Research Group, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Mackenzi
authors.initials: M
authors.lastname: Pergolotti
authors.affiliation: Division of Geriatric and Palliative Medicine, UTHealth, The University of Texas Health Science Center at Houston, McGovern Medical School, 6431 Fannin, MSB 5.116, Houston, 77030, TX, USA.
authors.forename: Holly M
authors.initials: HM
authors.lastname: Holmes
authors.affiliation: School of Nursing, UCLA, Los Angeles, USA.
authors.forename: Huibrie C
authors.initials: HC
authors.lastname: Pieters
authors.affiliation: University of Pittsburgh, S. 140 Cooper Pavilion, 5115 Centre Ave., Pittsburgh, 15232, PA, USA.
authors.forename: G J
authors.initials: GJ
authors.lastname: van Londen
authors.affiliation: University of Washington, 1959 NE Pacific Ave, H375G, Box 357630, Seattle, 98195, WA, USA.
authors.forename: Zachary A
authors.initials: ZA
authors.lastname: Marcum
authors.affiliation: Department of Medical Oncology, Division of Regional Cancer Care, Thomas Jefferson University, 925 Chestnut St., 4th floor, Philadelphia, 9107, PA, USA.
authors.forename: Amy R
authors.initials: AR
authors.lastname: MacKenzie
authors.affiliation: Border Medical Oncology, Suite 1, 69 Nordsvan Drive, Wodonga, 3690, VIC, Australia. csteer@bordermedonc.com.au.
authors.forename: Christopher B
authors.initials: CB
authors.lastname: Steer
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D016330:Frail Elderly; D015577:Geriatric Assessment / Q000379:methods*; D006299:Health Services for the Aged / Q000592:standards* / Q000639:trends; D006801:Humans; D009369:Neoplasms / Q000517:prevention & control / Q000523:psychology / Q000534:rehabilitation / Q000628:therapy*; D012944:Social Support; D017741:Survivors / Q000523:psychology / Q000706:statistics & numerical data
keywords: Cancer; Geriatric assessment-guided intervention; Geriatric oncology; Older adults; Supportive care; Survivorship