Editorial: Supportive and palliative care of older adults with cancer.

Abstract

DOI:10.1097/SPC.0000000000000538 Given that cancer incidence rates are strongly related to age [1], it could be said that all health professionals who care for adults with cancer are geriatric oncology health professionals. However, the complexities and diverse needs of this population remain under-recognized. There has been significant growth in the field of geriatric oncology, however much work needs to be done to advance uptake of geriatric principles into routine oncology practice. In this edition, we highlight several important factors related to providing supportive and palliative care for older patients with cancer. The biologic changes that occur due to aging and how they affect pharmacokinetics and pharmacodynamics of systemic anticancer agents are described in the article by Crimmin et al (pp. 29– 38). They discuss these changes in detail, as well as the role of comorbidities and their impact on cancer treatments, and using a comprehensive geriatric assessment (CGA) to recognize the factors. By addressing how to best screen patients for frailty and provide CGA, Puts et al. (pp. 16–22) highlight several recent randomized controlled trials that provide evidence to the benefits of CGA in improving quality of life, and reducing toxicity, among others. In the paper by Dr Menjak et al., (pp. 3–10) an overview of screening tools to identify potential toxicity of various cancer treatments is provided, and it is clear that much of the research focus has been on predicting chemotherapy and surgery outcomes, but there remains a gap in evidence for radiation therapy. The usefulness of measuring quality of life routinely during cancer treatment as it relates to older adults and its role in planning cancer treatments is described in the paper by Fitch et al. (pp. 39–47) However, quality of life can be challenging to measure with current instruments that are often focused on functional status. Dr Fitch et al. describe that measuring quality of life routinely can identify older adults at risk due to symptom burden of functional status impairments, it can help to guide symptom management and inform the healthcare team where education and rehabilitation can be beneficial. Dr Lloyd-Williams et al. (pp. 11–15) reviewed the