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This book summarizes evidence on frailty and ageing, how this may impact patient outcomes and how frailty can be assessed, managed and incorporated in the decision-making process for older patients with cancer. The book aims to: empower clinical teams to assess and support older cancer patients with frailty, ideally within a multidisciplinary setting; and to improve the selection of older cancer patients to the most appropriate management/treatment strategies in order to improve the outcomes of this group of patients often underrepresented in research.
The reader will learn the methods available for assessing frailty, such as screening tools, but also how to perform different geriatric assessments covering the different key components (physical, nutritional, social, psychological, etc.). The book also provides information on how to manage and intervene on frailty with the role of pre-habilitation and re-habilitation, how to set-up specialised teams and pathways within one's hospital and community for these older cancer patients with frailty. Finally, the management of this challenging group of patients according to the cancer type is discussed in detail, alongside with mapping the unmet research needs and future directions in this field.
Dr Fabio Gomes (MD, MRes) is a consultant medical oncologist at The Christie Hospital in Manchester (United Kingdom). He completed his training and MD in Lisbon (Portugal) and due to his interest in geriatric oncology he enrolled the Academic Visitor & Scholars Program at the Moffitt Cancer Center, Florida (United State of America) in 2015 under the mentorship of Dr Martine Extermann and Dr Lodovico Balducci. Since then he has been actively involved in the International Society of Geriatric Oncology (SIOG) participating in multiple projects and he is currently the elected vice-chair of the YSIOG group.
In 2016, Dr Gomes moved to the United Kingdom and he has been working in Manchester where his clinical work focuses primarily in the management of patients with lung cancer. Here he achieved a further research degree (MRes) in experimental cancer medicine with the University of Manchester and he works in the Christie Patient-Centred Research team. Since then, he has led onresearch and quality improvement projects to improve the care and outcomes of older adults with cancer, in particular those with frailty. More recently, in 2021 he was appointed the new Director of Clinical Outcomes for cancer patients in the region.
Introduction to frailty in older adults with cancer.- Global action and policies in older adults with cancer and frailty.- Frailty screening and comprehensive geriatric assessment.- Cognitive impairment in older adults with cancer and frailty.- Psychosocial dimension in older adults with cancer and frailty.- Comorbidity and polypharmacy in older adults with cancer and frailty.- Malnutrition, cachexia and sarcopenia in older adults with cancer and frailty.- Physical performance and functional status in older adults with cancer and frailty.- Prehabilitation and rehabilitation in older adults with cancer and frailty.- Holistic needs assessment and advance care planning in older adults with cancer and frailty.- Multidisciplinary onco-geriatric care models.- Decision-making process in older adults with cancer and frailty.- Perioperative care in older adults with cancer and frailty.- Radiotherapy and systemic anti-cancer treatment in older adults with cancer and frailty.- Palliative carein older adults with cancer and frailty.- Frailty research: the present and the future.- Breast cancer in older adults with frailty.- Non-small cell lung cancer in older adults with frailty.- Colorectal cancer in older adults with frailty.- Prostate cancer in older adults with frailty.- Renal cell carcinoma in older adults with frailty.- Cutaneous melanoma in older adults with frailty.- Gastroesophageal cancer in older adults with frailty.- Hepatopancreaticobiliary cancer in older adults with frailty.- Gynaecological cancer in older adults with frailty.- Head and neck cancer in older adults with frailty.- Hematological cancer in older adults with frailty.
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