Australia has a growing ageing population. It is known that the incidence of cancer increases with age; and with this a higher rate of concurrent co-morbidities and frailty 1,2. This has been shown to lead to deficiencies in the diagnosis of, and treatment of cancer in the elderly3. This lack of a complete geriatric assessment may lead to over or under treatment 3.
The Senior Medical Oncology Clinic was started in June 2015 to provide a multifaceted geriatric assessment. This clinic was established to form a multidisciplinary, patient centred approach, to improve outcomes for senior cancer patients. The aim of this audit was to assess the initial experience of the Senior clinic.
Data was collected prospectively from the senior clinic (case) patients, and retrospectively from the general oncology clinic (control) patients. Data collected included functional status, co morbidities, medication, cognition, nutrition, psychological state, social supports, as well as basic demographics.
The patients’ in both groups had similar demographics and malignancies, with the majority having later stage disease. None of the patient’s seen in the general oncology clinics had a complete geriatric assessment. Functional status was the best evaluated with 63% of control patients assessed. Less than 50% of general oncology patients’ had an assessment of their home living situation. Patients’ seen in the senior clinic had a 100% rate of geriatric assessment as part of their evaluation.
Rate of referral to allied health increased in the senior clinic patients (1% vs. 41%); however rate of referral to sub-specialties was approximately the same between both groups. Treatment with chemotherapy was reduced in the senior clinic patients; 48% compared to 65% of the general oncology patients.
The senior clinic improved the assessment of geriatric patients. In future a further audit is planned to assess long term outcomes of these patients.