March 2019

Below are key updates in Geriatric oncology from the last 5 weeks, curated by Dr. Lorenzo Dottorini.

1.Patient- and tumor-related predictors of chemotherapy intolerance in older patients with cancer: A systematic review. van Abbema DL, van den Akker M, Janssen-Heijnen ML

In this study, it is once again highlighted how the physical, psychic and social conditions of the patient, normally included in the multidimensional geriatric evaluation, as well as some specific types of chemotherapy, can influence tolerability of treatments in elderly patient.

Full link : Journal of Geriatric Oncology 2019 Jan;10(1):31-41. doi: 10.1016/j.jgo.2018.04.001.

2. A Practical Approach to Assessing and Mitigating Loneliness and Isolation in Older Adults. Perissinotto C, Holt-Lunstad J, Periyakoil VS, Covinsky K.

Loneliness and social isolation are strongly associated with several adverse health outcomes in older persons including death, functional impairments and quality of life.  This paper provides a practical approach on how to recognise loneliness and isolation, on the different ways of loneliness affecting older patients and guidance for future interventions.

Full link : Journal of the American Geriatrics Society doi: 10.1111/jgs.15746

3. Depressive Symptom Profiles and Survival in Older Patients with Cancer: Latent Class Analysis of the ELCAPA Cohort Study. Gouraud C, Paillaud E, Martinez-Tapia C, et al.

This paper is a subanalysis of the ELCAPA study. Five classes of depressive symptom were identified (“no depression/somatic only”, “no depression/pauci-symptomatic”, “mild depression”, “severe depression”, and “demoralization”) and were observed that poorer outcome were associated with higher depressive symptoms. Here is underlined how identification and management of depression should be considered a high priority in this population. Practice-changing paper?

Full link : The Oncologist doi: 10.1634/theoncologist.2018-0322.

4. “Surgical Decision Making for Older Adults” Jill Q. Dworsky, Marcia M. Russell,

Published on JAMA patient page a very interesting reflection on the objectives and goals to which an elderly patient should think before undergoing a delicate surgical procedure such as the importance of prolonging life, preserving independence, or maintaining quality of life.

Full link : JAMA. 2019;321(7):716. doi:10.1001/jama.2019.0283

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