NEW YORKDespite considerable progress in the
management and treatment of cancer in the overall population, cancer-related
mortality among the elderly increased by 20% between 1970 and 1984. Cancer is
often undertreated in the elderly, which affects their prognosis, said Roberto
Bernabei, MD, of the Universita Cattolica del Sacro Cuore, Rome.
Dr. Bernabei, who spoke at the Fifth International Conference
on Geriatric Oncology, believes a new approach is needed to "deal with the
‘peculiarities’ of the elderly cancer patient." At his institution,
Dr. Bernabei and his colleagues have developed and use a comprehensive
geriatric assessment tool.
The new instrument, Minimum Data Set for Cancer (MDS-CA),
documents the patient’s oncologic screening and treatment data, and provides
a structured, multidimensional assessment of the patient’s general health,
including cognitive and functional parameters, emotional and behavioral
patterns, nutritional status, co-morbidities, lifestyle and preventive
measures, quality of life, pain status, activity and movement status,
continence status, informal support availability, and overall medications.
"Such a tool," Dr. Bernabei said, "will provide an assessment
that can help us build treatment decisions and monitor the treatment."
They have used this new instrument on 220 consecutive elderly
patients referred to the oncologic consultation team after a new diagnosis of
cancer. "We wanted to define the functional characteristics of these
patients and understand who was treated with chemotherapy/radiotherapy and
why," he said. Dr. Bernabei stressed that this approach already has shown
"considerable benefits in different settings and for conditions other than