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Development of Oncogeriatry – A European Perspective from the French Experience

Published Online: June 3rd 2011 European Oncology, 2009;5(1):84-8 DOI: https://doi.org/10.17925/EOH.2009.05.1.84
Authors: Catherine Terret
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Oncogeriatry is the clinical discipline concerned with the management of elderly cancer patients. It is based on a global oncological and geriatric approach to the health status of patients. Oncogeriatry has been widely adopted throughout the world, but the approaches used and the organisational solutions provided are complex and varied. Based on the French experience of a centralised health system, the different aspects are discussed: clinical management, organisation, clinical research and information. At a European level, the best approach seems to be a partnership between the International Society of Geriatric Oncology and the Elderly Task Force of the European Organisation on Research and Treatment of Cancer. This co-operation ensures comprehensive information on oncogeriatric programmes, clinical research and teaching programmes, thus enhancing the effectiveness of the oncogeriatric approach.

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Cancer is mainly a disease of the elderly. As a result of increased life expectancy, over 60% of new cancer cases and over 70% of cancer deaths occur in people 65 years of age or older in Europe and in the US.1 Ageing is associated with progressive but extremely uneven decline of functional reserves and a reduction of adaptability. Geriatricians, who commonly handle the highly heterogeneous process of ageing, have devised a comprehensive multidisciplinary assessment tool called ‘comprehensive geriatric assessment’ (CGA), in which all aspects of older individuals are considered and all resources and abilities are listed. Based on this appraisal, geriatricians can elaborate and co-ordinate an effective care plan with interventions tailored to each individual’s problems.2

Health authorities and health professionals must face the expanding challenge of the management of elderly cancer patients. This challenge has not been anticipated and the ever-increasing number of elderly patients suffering from cancer will result in higher costs of medical and social care. However, the costeffectiveness of cancer management in the elderly remains to be evaluated both at country level, because health organisations are different across European countries,3 and at the European level. Cost-effective strategies for preventing and detecting cancer early should also be considered.4 Two important observations are that elderly patients have been critically undertreated in the past,5 but that their willingness to receive treatment is evident.6

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