Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2019

Survivorship Needs of an Elderly Population with Cancer - a Pilot Study of Care Coordination (#270)

Zee Wan Wong 1 2 3 , Sandra Maciver 1 , Anjali Khushu 1 , Linda Rabbidge 1 , Tracey Bucki 3 , Vinod Ganju 1 2 , Lisa Taylor 1 , Wei Wang 2 , Iain Edwards 1 , Srikanth Velandai 1 2
  1. Peninsula Health, Frankston, VIC, Australia
  2. Peninsula Clinical School, Monash University, Frankston, VIC, Australia
  3. Southern Melbourne Integrated Cancer Services, Melbourne, VIC, Australia

Background

Elderly patients have age-associated factors that may influence cancer treatment decisions, recovery and survivorship; such as frailty, cognitive decline, sensory deficits, co-morbidities, social isolation and depression. A 12-month pilot geriatric survivorship project is funded by the Victorian Government at Peninsula Health where one of the highest concentrations of over 65-year-olds in Australia reside.

Methods

Cancer patients aged 70 and older, with a life expectancy of at least 5 years and have non-metastatic disease who ceased cancer treatments within 6 months are recruited from September 2018 to January 2019. Eligible patients were contacted and once consented, were screened using validated questionnaires of a Comprehensive Geriatric Assessment (CGA) followed by geriatrician assessment. The recruitment target was 30 patients. Life expectancy beyond 12 months, low-volume metastatic disease and maintenance endocrine therapy or immunotherapy were subsequently allowed due to slow enrolment. Post intervention survey at six months will be conducted. Ethics approval was obtained.

Results

Twenty-six patients were enrolled from both the Chemotherapy Day Unit and Oncology Clinic. Median age was 76.5 (range 71 – 83). Three-quarters were females; 18 have localised whilst 8 have metastatic disease. Majority (46%) have breast cancer followed by lung, genitourinary, gastrointestinal, gynaecological cancers and melanoma. Fifteen received chemotherapy, 13 endocrine, 4 immunotherapy and 2 targeted therapy; 14 underwent radiation, 13 surgery and 2 on clinical trials. Six patients were referred to cancer rehabilitation program, 10 to cardiology, geriatrics, endocrinology and urology. 5 refused referrals. Individualised elderly specific survivorship care plans were integrated with community services and primary care. Data collection is ongoing.

Conclusions

Early recognition of issues specific to older cancer survivors and timely referrals to rehabilitation and other services may improve patients' recovery, functioning and quality of life. Plans are underway to incorporate upfront geriatric assessments at diagnosis into oncologic management plans for better patient outcomes.