More and more patients aged 70 and over are being diagnosed with cancer, and to respond to this challenge, La Fe has established a working group in which specialists from oncology, geriatrics, home hospitalization, urology and radiotherapy work together in a coordinated way to maximize success. The well-being of every elderly cancer patient. One hundred of them have already been treated with positive results.
The number of older people with cancer tends to rise because age is a risk factor for oncological diseases and because the survival rate is increasing thanks to advances in oncology. Specifically, there are more and more patients who overcome their tumors and age, or who age their tumor disease thanks to increasing therapeutic efficacy and targeted or new therapies such as immunotherapy, and they are the so-called long-term survivors.
Deputy Medical Director of the Hospital, Vicente Campos stressed that La Fe approaches “this challenge in a multidimensional way, seeking to address each case from all points of view.” “In other words, the patient’s degree of functioning is evaluated, if he suffers from other diseases, if he is taking multiple medications, his emotional and cognitive state and his social and family situation. In addition, their wishes and desires are integrated at all times.”
The pilot trial evaluating geriatric oncology in urology has begun and is being led by Chief of Medical Oncology, Regina Geronis, with geriatrician Dr. Sylvia Forcanoand medications Good Padilla, among other professionals.
The team, consisting of medical and nursing staff, goes to the patient’s home to complete his medical history with preliminary information about who he lives with, or the extent of his exposure to risks, such as falling or taking medication. “In this way, objective data on muscle atrophy (loss of muscle mass) and weakness or dependence are analyzed in the real context of the person in order to personalize his oncology treatment as much as possible,” explained Regina Geronis.
Geriatric evaluation of the first 100 patients prevented major prostate and bladder surgeries in 62% of patients, suppressed or modified 44% of proposed chemotherapy, reduced radiotherapy in 27%, and discouraged the prescription of hormonal therapy. Antiandrogens In 68% of cases.
In addition, in 75% of cases, physical and psychological preparation before oncology treatment was indicated to improve it and reduce possible side effects, to improve the results. Tumor specific Reducing toxicity. In the remaining 25%, palliative treatment needs were identified. “With these modifications, we sought to achieve a balance between cancer treatment and the person’s maximum well-being, or what is the same, treating their disease in a way that is effective, but does not aggravate their condition,” Geronis noted. Degree of dependency.
Description and examination of the prostate
In order to achieve this same goal, a geriatric evaluation was launched as a pilot trial in La Fe, which also provides pharmacological prescribing. As Dr. Padilla puts it, it’s about “reviewing and reducing the amount of medications an elderly patient is taking, especially those that may be inappropriate, unnecessary, or potentially harmful because of their side effects or interactions.”
These first results published by the La Fe Geriatric Evaluation Team were presented at the 7th National Days ofOncology treatmentwho was detained in the hospital.
In addition, controversies regarding, for example, prostate cancer screening starting at age 70 years were reviewed. In this sense, the doctor of the Department of Urology at La Fe, Manuel Martinez, emphasized the need for a personalized approach to avoid over-diagnosis and over-treatment in some patients.
To do this, La Fe has its own protocol that evaluates PSA ranges (pathology index) by age and the need to evaluate the life expectancy of the elderly through geriatrics in order to adapt therapeutic resources.
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