Deep Dive : WHY You Need a Geriatrician If You are Diagnosed with Cancer in Later Life
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Jun 27, 2025
Some older adults feel that they only need to see a geriatrician if they are "too old", "too weak" , " about to lose it ", or "already lost it". This is an incorrect perception. Many times, the role of a geriatrician or geriatric care provider is to assess your health as a whole person, to explore your goals and wishes, and assess how the proposed cancer treatment may or may not fit into your wishes. Moreover, the assessment also sheds light on what challenges you may be facing, so a proactive plan, rather than a reactive plan, is advised.
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okay let's dive in welcome everyone to a
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new deep dive glad to be here so picture
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this scenario you're an older adult
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maybe retired maybe still working but
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you feel good you know active
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independent sharp pretty much running
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your own life exactly and then bam a
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serious diagnosis hits you something
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like cancer it's overwhelming naturally
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you're gearing up to fight it looking at
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treatments maybe getting second opinions
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all that right and then your doctor says
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"I recommend you see a geriatrician."
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And that's the moment right for a lot of
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people it just feels off jarring you
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think "Wait hold on geriatrician I'm not
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frail my mind's working fine i handle my
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own stuff i walk a mile every day." Or
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you know whatever it is that makes you
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feel capable it can feel like like
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they're suddenly seeing you differently
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like maybe they think you can't handle
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this it really can like maybe it's a
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step towards being I don't know
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sidelined
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underestimated but that's what we're
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unpacking today we've got this source
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material that really challenges that
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initial reaction we want to dig into why
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this recommendation gets made and
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actually uncover the um the really
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crucial value in it yeah what we found
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is it's not about limiting you at all
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it's actually the opposite it's about
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enabling you helping you get the best
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possible treatment but safely okay so
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the source material tackles that first
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feeling that why me i'm fine feeling it
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does right up front it really emphasizes
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that look a geriatric assessment it
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isn't just for someone who's visibly
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struggling or having like significant
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memory issues it serves a much wider
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purpose especially when you're facing
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something as demanding as cancer
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treatment got it so it's absolutely not
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about saying "Oh you're too old for
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this," or "You're too weak." Definitely
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not the source actually uses this great
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analogy think of your oncologist your
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cancer doctor as the driver of the car
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they're steering the main treatment plan
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okay the driver makes sense and the
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geliatric assessment that's like
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installing a really sophisticated airbag
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system in that car i like that so it's
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not driving it's not choosing the route
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or the speed nope its job is to do a
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really thorough check of the whole
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vehicle that's your overall health
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beyond just the cancer specifically
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looking for potential um bumps in the
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road that might pop up during that
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really intense treatment journey okay
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and then critically it helps build in
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the cushion the safety measures to
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protect you to preserve your strength
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your quality of life so that you can
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actually complete the journey so it's
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like proactive safety planning tailored
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just for you exactly customuilt and to
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make this really clear the source gives
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us this fantastic real world example a
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patient they call Eleanor right eleanor
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let's talk about her yeah Elanar's case
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is perfect because she really fits that
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profile of someone who'd likely you know
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question the need for this she was 79 a
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retired research chemist so sharp lady
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very sharp and high functioning by any
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standard active walked a mile daily
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lived independently with her husband
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handled all her own finances medical
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stuff just seemed incredibly capable and
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the source mentioned she had that
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analytical mind probably made her even
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more likely to push back on things that
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seemed well unnecessary to her
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absolutely so she gets diagnosed with
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esophageal cancer and her reaction when
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she's sent to the geriatrician the
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source quotes her directly with this uh
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sharp analytical look she says "Doctor I
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appreciate the thoroughess but I need
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you to know I'm not losing it why am I
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here?" Wow that perfectly nails that
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feeling we were talking about it really
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does so okay she seems so capable why
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did you need this assessment what was
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the benefit for her well this is key the
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source points out that even when someone
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seems really high functioning on the
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surface the cancer itself can be quietly
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taking a toll ah even before treatment
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yes in Elellanar's case her esophageal
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cancer was already causing her
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significant trouble swallowing she had a
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cough some nausea and all this was
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leading to this underlying fatigue she
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might not have even fully realized it
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was the cancer causing it yet okay so
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her baseline her reserves might have
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been a bit lower than they looked
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exactly and then you add cancer
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treatment which by design is intense
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it's powerful and it can interact with
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these uh sort of hidden vulnerabilities
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things that might not come up in a
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standard oncology visit that's really
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focused on the tumor and the treatment
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drugs right the oncologist has a
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specific focus the geriatric assessment
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takes that wider view that systems level
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look at the whole person okay let's
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really get into the weeds then what are
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the key parts of this assessment using
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Eleanor's case like the source does what
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bumps were they looking for and how did
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they build that airbag for her what's
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first first up is what they call
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competing illnesses basically other
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significant health conditions someone
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has alongside the cancer okay for
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Elellanar it wasn't just being 79 with
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this cancer she had a pretty significant
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history of heart disease major bypass
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surgery years ago and her latest EKG
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showed a minor electrical irregularity
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and why is her heart history so critical
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specifically when planning cancer
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treatment well because as the source
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explains a lot of standard chemo drugs
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and even some of the newer
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amunotherapies can be well tough on the
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heart right they can add stress some can
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even be directly toxic so if the
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oncologist is thinking about using one
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of these drugs which might be the most
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effective option for the cancer you have
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to know can her heart handle that extra
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load safely makes sense ignoring it
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would be like planning a massive road
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trip without checking the engine oil
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exactly it's a perfect analogy so the
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assessment flagged this risk it
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triggered a consult with a heart
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specialist before treatment started and
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again it wasn't about saying "Oh she
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can't have the treatment." It was about
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making sure her heart was ready for it
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making it safe to receive it optimizing
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her whole system for the treatment okay
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that clicks what's another area they
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looked at nutrition super important now
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Eleanor's weight was stable but remember
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she was already having trouble
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swallowing because of the tumor itself
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and the source points out that treatment
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for esophageal cancer whether it's
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surgery radiation chemo or some combo is
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almost certainly going to make that
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swallowing issue worse at least for a
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while so they don't wait until she's
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already losing weight and getting weight
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no that's the key the proactive approach
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the source really highlights this get a
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nutritionist involved from day one have
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an honest talk about strategies maybe
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even discussing the possibility of a
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temporary feeding tube which some people
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might see as like a sign of failure or
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giving up but that's not how it's framed
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here at all the source emphasizes it's
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presented as a smart temporary bridge a
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tool to preserve muscle mass and
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strength to make sure her body has the
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fuel it needs to actually get through
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the demanding treatment without getting
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dangerously depleted okay proactive
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nutrition planning makes sense so other
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health issues nutrition what about all
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the other medications someone might be
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taking ah yes polyfarm pharmacy or
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really just careful medication review in
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Elellanar's case she was taking dasipm a
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long acting sedative for sleep hm okay
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seems kind of minor compared to cancer
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and chemo maybe does changing a sleep
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aid really move the needle that much
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you'd be surprised the source points out
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that this specific type of long-acting
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seditive can cause a lingering hangover
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effect which was likely contributing to
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Eleanor's daytime fatigue even before
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treatment fatigue kicked in imagine
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trying to navigate tough chemo side
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effects when you're already feeling
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unnecessarily groggy from your sleep med
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yeah that would be rough stacking
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difficulties right so the assessment
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caught this and recommendation was
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pretty simple switch to a much shorter
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acting medication taken only if she
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really needed it it seems like a small
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tweak right
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but it could significantly boost her
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energy levels her alertness and
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ultimately her ability to tolerate the
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cancer treatment and maintain a better
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quality of life during it it's about
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removing even those small hurdles that
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really shows how detailed and holistic
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this is looking at everything any other
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major areas yep one more big one they
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highlight is looking at pre-existing
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conditions and how this specific planned
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cancer treatment might affect them
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eleanor already had some peripheral
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neuropathy that tingling or numbness
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usually hands and feet exactly and this
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was crucial for her because the source
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notes a very common very effective chemo
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drug for her type of cancer pletexel is
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uh notorious for making neuropathy worse
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oh wow so if she already had tingling
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that drug could really ramp it up
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precisely so knowing about her
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pre-existing neuropathy before starting
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treatment that's vital information it
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allows for a truly personalized approach
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how so what could they do well the
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oncology team and the geriatric team can
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talk maybe they opt for a different
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chemo drug that's less likely to cause
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neuropathy if that's a good option for
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her cancer or if pletyl is really the
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best choice they have a clear plan ready
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from day one to monitor her closely and
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manage that side effect aggressively if
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it starts to appear so it's not
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necessarily about avoiding the best drug
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no it's about figuring out the safest
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way for her to get that drug to complete
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the whole planned course without a
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debilitating side effect like severe
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neuropathy forcing her to stop treatment
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early okay this is really bringing it
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together let's circle back to that key
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point eleanor's initial "Why am I here
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i'm not losing it." This whole
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assessment it wasn't about judging if
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she was too old or too frail for the
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treatment itself no it was the absolute
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opposite the source is so clear on this
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the entire goal was to gather all this
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comprehensive info heart nutrition meds
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neuropathy but also her cognitive
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strengths her family support and use it
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to make it possible for her to get the
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best most effective cancer treatment for
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her and to get through it safely they
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weren't deciding if she could be treated
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they were figuring out how she could be
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treated successfully yeah building that
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airbag like you said that's exactly it
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the assessment identified those
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potential vulnerabilities the heart risk
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the swallowing issue the sedative the
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neuropathy risk and then importantly it
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turned that knowledge into a concrete
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actionable plan for her oncologist like
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okay here's what we need to do get the
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heart consult make sure the nutrition
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plan is ready watch for neuropathy
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precisely and just as important it also
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highlighted her strengths her sharp mind
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her supportive family those were seen as
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assets things that would help her
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tolerate and complete the treatment did
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Elanor come around to seeing it that way
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the source says she did she understood
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it wasn't a judgment about her age or
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her abilities it was actually a very
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sophisticated approach to honor her
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entire health story all the pieces to
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give her the best shot at a good outcome
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which connects right back to you the
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listener if you're ever in this
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situation or loved one is understanding
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why this detailed assessment is
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suggested is so important that the
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source calls it the ultimate form of
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personalized medicine and it really is
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it's seeing you as a whole person your
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unique history your strengths your
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potential weak spots not just the
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disease label and using all of that
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information specifically to help keep
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you safe strong and living as well as
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possible while you go through something
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as tough as cancer treatment it's about
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stacking the odds in your favor so
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boiling it down what's the core takeaway
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from the source material here if you or
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someone you care about gets recommended
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for a geriatric assessment especially
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around cancer care please try to see it
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as a really positive sign it means your
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medical team is being incredibly
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thorough proactive they're looking at
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everything because they see you as a
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candidate for effective treatment and
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they want to make absolutely sure you
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have every support every safety net in
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place to tolerate it and get the full
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benefit yeah the advice from the source
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is really clear don't shy away from it
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ask for it if it isn't offered maybe and
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if it is offered embrace it it's
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designed to empower you exactly to
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optimize your chances of getting through
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treatment successfully and hopefully
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thriving afterwards and maybe just one
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final thought building on all this for
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you to ponder this whole approach this
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comprehensive proactive planning that
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looks at the entire person their health
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their life not just the diagnosis how
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could that model apply more broadly
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beyond cancer yeah what assumptions do
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we tend to make about aging and about
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healthcare that this kind of deep dive
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fundamentally challenges something to
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think about
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#Aging & Geriatrics
#Cancer
#Health Conditions