“We serve a dynamic population that is aging and experiencing higher cancer rates than the national average. All of them deserve the very best, most personalized care we can offer,” said James Demetriades, CEO of Penn Medicine Princeton Health. “We see a significant and growing need for specialized cancer care for older adults. Today, 70 percent of our patients with cancer are 65 or older, and 18 percent are at least 80 years old. Every one of those individuals faces unique challenges, and we are committed to working with them to develop care plans that meet their unique needs.”
The Geriatric Oncology Program at Princeton Health is led by Ramy Sedhom, MD, a clinical assistant professor of hematology-oncology in the Perelman School of Medicine at University of Pennsylvania. Dr. Sedhom is co-leader of the Geriatric Oncology service line across the Penn Medicine system, a faculty member at the Penn Center for Cancer Care Innovation (PC3I), and a representative on the National Comprehensive Cancer Network (NCCN) Clinical Practice Guideline Committee for Older Adult Oncology.
“Our program is rooted in the proposition of caring for the whole patient, not only their disease,” said Dr. Sedhom, a member of the Medical Staff of Penn Medicine Princeton Health, who is board certified in medical oncology and hospice and palliative care. “There is a core tenant in geriatrics — you don’t know what you don’t know. Older adults are a distinct group with unique personal and caregiver needs. We are fortunate to receive support from the Bristol Myers Squibb Foundation (in the form of a $2.5 million grant) to transform the cancer care of older adults in our community.”
The grant supports the Geriatric Oncology Program’s efforts to build a research infrastructure to design and implement clinical trials to improve the care of older adults with cancer. It will also bolster an array of other crucial activities, such as:
Recruiting multidisciplinary teams of professionals with expertise in geriatrics, including clinicians, supportive care staff, and community health navigators.
Testing new treatments and care delivery models by bringing new research from Penn Medicine’s Abramson Cancer Center to patients in central New Jersey.
Expanding geriatric competencies of Princeton Health staff through education and increasing outreach to seniors through community health navigators.
In addition to corporate support, this invaluable program has also received considerable community support.
Geriatric Assessment
A cancer diagnosis can be traumatic no matter what your age, and when it comes to older patients age 65 and above, treatment can be more complex.
“Cancer does not operate in a vacuum,” says Dr. Sedhom. “There are other health considerations that come into play for patients, and for older adults those considerations can involve physical, emotional, and even social concerns. They can be quickly identified and then addressed through an action plan by performing a geriatric assessment.”
A geriatric assessment is designed to gain a comprehensive understanding of patient fitness and needs. Conducted by a multidisciplinary team, it evaluates a patient’s fitness; medical conditions; nutritional status; emotional and cognitive state; individual values; and social support network.
“All of these things can impact the patient’s outcomes,” says Dr. Sedhom. “And when we have the results of a geriatric assessment, we can develop a more thorough care plan. We know what support systems, if any, are in place and can provide additional social work help. We know if there are other areas where we need to focus attention when it comes to physical and occupational therapy. We can work with other physicians to minimize the impact cancer treatment may have on a patient with other health concerns.”
Geriatric assessments are a relatively recent step in the cancer treatment process.
“It is something we are doing at Princeton Medical Center regularly, but it is not something all hospitals do,” says Dr. Sedhom. “So if an older adult is diagnosed with cancer they should talk to their doctor about an assessment.” Guidelines suggest it be considered for anyone above the age of 65 considering the use of chemotherapy.
Benefits of a Geriatric Assessment
- Improves patient/physician communication regarding the patient and family’s treatment priorities and objectives
- Helps predict the functional effects of treatment
- Lessens the chance of under or overtreatment
- Helps establish a complete support network, including physical, emotional, and social needs
- Helps predict complications to reduce the risk of unplanned hospitalizations or treatment needs
Key Components of a Geriatric Assessment
- Evaluate other illnesses, diseases, vision and hearing loss, and regularly prescribed medications
- Assess balance, strength, and walking speed
- Evaluate memory, concentration levels, and psychological status, including depression and anxiety
- Assess ability to complete daily activities such as bathing and eating
- Analyze weight changes in recent months
- Assess social support network