Integrating Geriatric Care in Clinical Oncology Practice: Recommendations from an Interdisciplinary Professional Survey Study in a Single-Cancer Center in Switzerland.

Abstract

Cancer is a common health problem in the older population. In Switzerland, more than 40,000 patients are diagnosed with cancer every year, with the majority older than 65 years. Because older patients are often excluded from clinical trials, optimal treatment for this population needs to be considered to prevent over- or under-treatment. Several international guidelines provide recommendations for special care of older and frail patients, with a focus on addressing comorbidities in cancer care. In many countries, including the USA, Belgium, France and the Netherlands, special geriatric oncology units are established for this huge group of cancer patients. Currently, such units have not been routinely established in Switzerland, so we were interested in assessing viewpoints and opinions about such a future geriatric oncology unit at our institution. This article discusses the outcome of an online questionnaire within a midsize cancer center in Switzerland. The survey focused on preferences among members of the interdisciplinary cancer diagnostic and treatment team regarding screening for frailty, decision tools and instruments, while also accounting for each individuals level of healthcare experience. The response rate was 54% (22 out of 41 responses within 4 weeks). The majority (94%) voted for a clear benefit from a regular geriatric oncology multidisciplinary team meeting (MDT) and 54.5% voted to use the G8 form as the preferred screening tool for frailty. In order to optimize treatment, most participants stressed the importance of adjusting all factors according to co-morbidities and nutrition. This questionnaire, however, represents only a small group of healthcare professionals working in the cancer center who are in favor of implementing a geriatric oncology unit. PEER REVIEWED ARTICLE