It takes more than a village

In 2020, there were more than 19 million new cancer cases and almost 10 million cancer deaths worldwide.[i] The global increase in cancer prevalence highlights the urgent need for continued education for oncologists to arm them with the specialized knowledge they need to improve outcomes for people living with cancer.

On World Cancer Day, I participated in a panel discussion hosted by the Union for International Cancer Control (UICC) featuring experts at the intersection of geriatric care and oncology. Dr. Nicolo Battisti, a medical oncologist and President-Elect of the International Society of Geriatric Oncology (SIOG), explained during our discussion that “unfortunately there is a very big need in terms of improving the care of older patients with cancer at a global level because they need more complex and more multidisciplinary input from a number of professions. [...] There are few geriatric oncology clinics that are able to really provide comprehensive care to these patients.”

I echo Dr. Battisti’s concerns about the need for continued education for geriatric oncologists, particularly on the importance of considering both "functional age" (a person’s level of physical functioning in their daily lives) and "chronological age" (a person’s calendar age) when making treatment decisions.[ii] Chronological age alone is often a poor indicator of the physical wellness of adults and should not be the primary factor guiding treatment decisions in oncology.[iii] For example, some of us can experience more rapid declines in physical or mental health as we grow older, while others see less pronounced changes over time. We all wish to belong to the latter group.

In my past experience as a physician, I have seen firsthand the importance of weighing all relevant factors when determining the right approach for each person I treated. Tools like geriatric assessments can provide a fuller understanding of the functional and chronological age of an older person living with cancer by evaluating several criteria, including physical function, cognition, nutrition, co-morbidities, psychological status, and social support, to help physicians determine the best course of care.iii

By improving healthcare professional education about the impact of other factors on a person’s health and encouraging more personalized cancer plans – including geriatric assessments – we can better meet the needs of individuals and ensure better care.

The role of the collective cancer community is important. Global cancer organizations, patient advocacy groups, healthcare professionals and others in the broader cancer community elevate issues that are impacting the care of people living with cancer and work together to identify solutions that can address inequities in care. Another example is our When Cancer Grows Old? initiative aiming to help each person living with cancer have the chance to grow older despite the stage of the cancer, their age and other global healthcare disparities. One meaningful step we are taking is through our support of local organizations with our annual When Cancer Grows Old contributions initiative. This year, our initiative is providing funding for up to 20 local organizations that are working to address systemic challenges that improve care for vulnerable communities.

Yet, as individuals we each have weight to bear if we’re going to make progress. We can’t forget that alone we have voices that can advocate and strong experiences that allow us to educate others. For me, it’s sharing my experiences to advocate for those who are older and living with cancer. We all have a role in ensuring no one with cancer is left behind. How will you do your part?

# # #

[i] Sung H,?Ferlay?J, Siegel RL,?Laversanne?M, Seromata I, Jemal A, Bray F. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: a cancer journal for clinicians. 2021 May;71(3):209-49.?

[ii] Cancer.net What is a Geriatric Assessment? Last updated February, 2022. https://www.cancer.net/navigating-cancer-care/adults-65/what-geriatric-assessment

[iii] E Soto-Perez-de-Celis, D Li, Y Yuan et al. “Functional versus chronological age: geriatric assessments to guide decision making in older patients with cancer”, The Lancet Oncology, 2018. https://www.thelancet.com/article/S1470-2045(18)30348-6/fulltext