0:05
okay let's jump straight in the world is
0:08
well it's getting older and
0:09
unfortunately that means more people are
0:11
facing cancer in their later years but
0:13
here's the critical twist older adult
0:17
isn't really a single category is it not
0:19
at all someone in their 70s might be
0:21
running marathons while you know another
0:23
person in their 60s could be managing
0:25
multiple serious health issues how they
0:28
handle cancer treatment their symptoms
0:30
their whole experience it's incredibly
0:32
varied exactly and this is where um
0:36
traditional ways of thinking in oncology
0:38
really start to fall short how so well
0:40
just looking at a patient's
0:41
chronological age or using simple scales
0:45
like ECOG or Carnovski which mainly
0:48
score how well someone moves around they
0:50
just don't capture that individual
0:52
complexity in fact those simple scores
0:54
can sometimes penalize older adults
0:56
making them seem less capable than they
0:58
really are in their sort of daily lives
1:00
they miss so much of the real person
1:01
right like um can they cook for
1:03
themselves do they have family nearby to
1:05
help how many medications are they
1:06
juggling that's the stuff that truly
1:08
impacts how someone navigates something
1:10
as tough as cancer treatment and that's
1:13
exactly what we're digging into today
1:14
we're doing a deep dive into this
1:16
important article from CA a cancer
1:19
journal for clinicians which is uh
1:22
essentially a guide for clinicians on
1:23
geriatric assessment in cancer care yeah
1:26
and our mission with this deep dive is
1:27
really to give you a clear quick
1:29
understanding of this vital tool we'll
1:31
explore why this comprehensive approach
1:33
is now essential what exactly goes into
1:36
it and maybe most importantly how it's
1:39
actually being put into practice to make
1:40
a real difference a difference for older
1:42
adults with cancer and also for the
1:44
people who care for them which is key
1:46
absolutely for the caregivers too so
1:48
let's get to the heart of it what is
1:50
geriatric assessment or GA as it's
1:52
commonly called okay so think of GA as a
1:56
like a 360°ree look at an older person's
1:59
health status it goes way beyond just
2:02
the cancer diagnosis it's a structured
2:04
way to evaluate several key dimensions
2:06
of their life and health and what are
2:07
those dimensions what kind of things are
2:09
they looking at specifically well the
2:11
paper highlights some critical areas
2:13
there's physical performance you know
2:15
how they move functional status which is
2:18
often split into activities of daily
2:20
living or ADLs the basics yeah the
2:22
basics like bathing or getting dressed
2:25
and then instrumental activities of
2:27
daily living IADLs that's the more
2:30
complex stuff like managing finances
2:32
shopping using the phone okay it also
2:34
assesses other medical conditions uh
2:36
known as coorbidity and importantly how
2:39
many medications someone is taking
2:41
that's polyfarm pharmacy which can get
2:42
complicated really quickly for older
2:44
adults absolutely plus it covers
2:46
nutrition how sharp their cognitive
2:48
function is their social support system
2:50
you know who's there for them and their
2:52
psychological state like mood and
2:54
anxiety levels okay so compared to just
2:56
saying your ECOG score is two which you
2:59
know might mean you're mostly up but
3:01
can't do strenuous activity GA tells you
3:04
if that person can still live
3:05
independently manage their bills and has
3:07
someone checking in on them that's a
3:09
completely different level of detail it
3:12
is and the article points out that while
3:14
traditional performance scores like ECOG
3:16
or Carnovski they're pretty good at
3:18
flagging physical limitations uhhuh they
3:21
don't correlate nearly as well with
3:22
those other critical domains GA captures
3:24
like cognitive function or social
3:26
support ga gives you the actual picture
3:29
of someone's life and well their
3:32
resilience this detailed picture sounds
3:34
incredibly useful but why does it make
3:36
such a difference specifically in cancer
3:39
treatment what can GA actually predict
3:42
about a patient's journey this is really
3:44
where the rubber meets the road ga
3:46
information is a much much stronger
3:48
predictor than age alone of how well an
3:51
older person will tolerate cancer
3:52
treatment particularly intensive
3:54
therapies like chemotherapy so it can
3:56
actually predict who might have severe
3:57
side effects like really bad ones
3:59
exactly researchers have used GA data to
4:01
build validated predictive models these
4:04
are specifically designed to estimate
4:06
the risk of serious chemotherapy
4:07
toxicity we're talking those
4:09
clinicianrated grade 3 to five adverse
4:12
events the paper mentions models like
4:14
CARG for solid tumors and crash which is
4:17
used for solid tumors and also lymphas
4:19
and hematlogic malignancies so these
4:22
aren't just like educated guesses
4:23
they're validated tools based on data
4:27
right they take specific variables
4:29
directly from the GA things like a
4:31
history of falls how active someone is
4:33
socially or even their hearing ability
4:36
for the card model interesting iadl's
4:39
cognition and nutrition for the ciderish
4:41
model and they use them to stratify a
4:43
patient's risk level for severe toxicity
4:46
and do certain things pop up again and
4:47
again well yeah while the exact
4:49
variables might differ a bit between the
4:51
models domains like fall history and
4:53
overall physical function consistently
4:55
show up as strong predictors across the
4:57
board and is this something that adds
4:59
hours to a clinic visit because you know
5:02
time is always a factor that's a great
5:03
point and a common concern the article
5:06
notes that the CARG model can take less
5:08
than 5 minutes to complete 5 minutes
5:10
that's it yeah the cy model is a bit
5:12
more comprehensive takes about 20 to 30
5:14
minutes so it's designed to be feasible
5:16
within a busy clinical setting you
5:17
mentioned lymphas and hematic
5:19
malignancies with CRS does GA play a
5:22
role in predicting outcomes in blood
5:25
cancer specifically beyond just
5:27
chemotoxicity absolutely ga variables
5:30
are powerful predictors of crucial
5:31
outcomes in blood cancers like acute
5:34
myoid leukemia AML myoidis plastic
5:36
syndromes MDS multiple myyoma and
5:39
lymphoma things like overall survival
5:41
and how long someone can actually stay
5:43
on their treatment are there specific
5:44
tools for those blood cancers yes there
5:47
are disease specific risk scores that
5:48
incorporate GA like factors for example
5:51
um there's the elderly prognostic index
5:53
for a type of lymphoma called DLBCL it
5:56
includes age coorbidities and functional
5:59
status alongside disease features okay
6:01
an MDS specific frailty index uses
6:03
things like fatigue and interestingly
6:06
ability to prepare meals and for
6:07
multiple myyoma there's an international
6:09
myoma working group frailty score using
6:12
age coorbidities and function so the
6:14
message is the key takeaway here is that
6:16
if you routinely collect ADLs IDLs and
6:18
coorbidity information using GA you're
6:20
already getting the data needed to apply
6:22
these specific validated risk scores for
6:24
blood cancers okay so GA helps predict
6:27
risks which is vital for anticipating
6:29
problems maybe preventing them but does
6:32
it actually change how treatment is
6:34
given does it guide clinical decisions
6:36
it fundamentally does yes the paper
6:38
highlights a systematic review showing
6:40
that incorporating GA results changed
6:42
the plan treatment course in a
6:44
significant number of patients 31% wow
6:47
nearly a third yeah and often this led
6:50
to doctors opting for a less intensive
6:52
treatment approach less intensive
6:54
meaning potentially easier to tolerate
6:56
but still effective against the cancer
6:58
is that the idea precisely the goal is
7:00
to tailor the treatment to the person
7:02
not just the disease label or the age
7:04
makes sense the article gives examples
7:06
from trials in a lung cancer study ESOA
7:09
using GA to guide treatment decisions
7:11
led to fewer toxicities and actually
7:13
increased treatment failure-free
7:16
survival patients stayed on treatment
7:18
longer without major issues that's a
7:20
massive benefit reducing toxicity while
7:23
maintaining or even improving treatment
7:24
duration that's huge it is an analyoma
7:27
trial anziner 3 using a less intensive
7:31
chemotherapy regimen guided by a GA like
7:33
assessment was just as effective as the
7:36
standard regimen in fitter older
7:38
patients okay and even better for very
7:40
old patients with lower risk disease
7:42
mainly because it was better tolerated
7:44
so this isn't just about predicting
7:45
problems it's really about making
7:47
smarter safer choices for the individual
7:49
patient based on their overall health
7:51
exactly and that brings us neatly to the
7:54
crucial second step geriatric assessment
7:56
management or GAM okay so GA is the
7:59
assessment getting that detailed picture
8:01
jam is taking that picture and actually
8:03
doing something about what you see
8:05
that's the perfect way to think about it
8:07
gam takes the specific impairments
8:09
identified during the GA maybe it's poor
8:11
balance difficulty managing medications
8:14
maybe nutritional issues and it triggers
8:17
tailored interventions to address those
8:18
specific problems it turns assessment
8:20
into action and this aligns so well with
8:23
what older adults themselves often
8:25
prioritize doesn't it you hear things
8:27
like maintaining their independence
8:29
staying active keeping their mind sharp
8:31
absolutely gam directly targets those
8:34
quality of life outcomes that matter so
8:36
much if the GA shows someone is at high
8:39
risk for falls right gm means getting
8:41
them to physical therapy maybe doing a
8:43
home safety check if they have polyfarm
8:45
pharmacy issues it triggers a medication
8:47
review perhaps by a pharmacist
8:49
nutritional problems mean a referral to
8:51
a dietitian so these interventions
8:53
aren't necessarily just about fighting
8:54
the cancer directly they're about
8:56
supporting the whole person's health
8:58
building them up that's key the paper
9:00
mentions that recommendations for
9:02
non-oncologic interventions things like
9:04
improving social support nutrition
9:06
managing medications these come up in
9:08
over 70% of patients who get a GA it's
9:11
about building a foundation of overall
9:12
health to better withstand the cancer
9:15
treatment itself okay so is there
9:16
concrete evidence that doing JAM taking
9:19
these actions actually improves things
9:21
for patients does it work yes there's
9:23
strong evidence now from numerous
9:25
clinical trials and large analyses meta
9:27
analyses gam has been shown to improve
9:30
really important outcomes like what
9:31
patients are more likely to complete
9:33
their plan treatment they report better
9:35
quality of life communication with their
9:37
care team improves and important
9:39
conversations like advanced care
9:40
planning are more likely to happen and
9:42
what about reducing those negative
9:43
outcomes we talked about earlier like
9:45
toxicity precisely it lowers the risk of
9:48
treatment related toxicity it reduces
9:50
falls and it helps manage polyarm
9:52
pharmacy a meta analysis specifically
9:55
found a significantly lower risk of
9:57
treatment toxicity when GAM was
9:59
implemented compared to usual care
10:01
reducing severe toxicity I mean that's a
10:04
massive impact on someone's well-being
10:05
during a tough treatment it really is
10:08
the article highlights several key
10:09
trials demonstrating these benefits the
10:11
Gaines study which involved a geriatric
10:14
multiddisciplinary team saw over a 10%
10:17
absolute reduction in severe
10:18
chemotherapy toxicity wow and increased
10:21
completion of advanced directives the
10:23
Jericho study focused on frail colarctal
10:26
cancer patients and found higher rates
10:28
of completing plan treatment and
10:29
improvements in quality of life and
10:31
mobility real tangible improvements in
10:33
how people feel and function dayto-day
10:36
exactly another trial integrate showed
10:39
patients who received an integrated
10:41
geriatrician consultation maintain their
10:43
social function better and had fewer
10:45
unplanned hospitalizations and perhaps
10:48
one of the most compelling go on the
10:49
GAP7 plus study this used an algorithm
10:53
to provide GA based recommendations
10:55
directly to oncology teams in community
10:57
practices not just academic centers and
11:00
what did GAP7 plus show in that
11:03
community setting it showed a marked
11:04
reduction in clinician rated toxicities
11:07
dropping from 70% in the control group
11:09
down to 50% in the group receiving the
11:11
JAM recommendations that's huge patients
11:14
also reported less toxicity themselves
11:16
they saw fewer falls improvements in
11:18
polyfarm pharmacy management and
11:19
interestingly increased initial dose
11:21
reductions based on the GA results which
11:24
might make some people nervous right but
11:26
crucially without harming overall
11:28
survival outcomes the code trial had a
11:30
similar design and showed improved
11:32
communication about aging related issues
11:34
and higher satisfaction for both
11:35
patients and their caregivers okay so
11:38
the evidence base seems really solid
11:40
taking action on GA results leads to
11:42
better outcomes across the board even if
11:45
you know a few smaller trials maybe
11:46
haven't shown clear benefits possibly
11:49
due to their specific design or maybe
11:50
outside factors like the pandemic
11:52
messing things up yeah the overall
11:54
utility is well established now and it's
11:57
why major cancer organizations like ASCO
11:59
and SCIOG now recommend incorporating GA
12:02
and GAM into routine care for older
12:05
adults okay so with all this compelling
12:07
evidence the guidelines now recommending
12:09
it you'd think GA and GAM would be
12:11
standard practice everywhere by now but
12:13
the article points out that's just not
12:15
the case right still lagging that's the
12:17
big challenge yeah despite the known
12:19
benefits routine implementation the
12:21
actual uptake in everyday oncology
12:23
practices is still quite low a survey
12:25
cited the paper found only maybe 22% of
12:28
oncology providers are regularly using
12:30
GA only 22% that's a tiny fraction why
12:33
such a big gap between knowing something
12:35
works and actually doing it consistently
12:38
well the article delves into the
12:39
barriers providers report the most
12:41
common ones are things like lack of
12:42
dedicated support staff lack of time
12:45
during busy clinic visits feeling like
12:47
they don't have enough knowledge or
12:48
training on how to perform GA or what to
12:50
do with the results uncertainty yeah
12:52
uncertainty about which tools to use
12:54
competing priorities within the clinic
12:56
or the institution and just difficulty
12:59
linking patients to the right supportive
13:00
care services or specialists after the
13:02
assessment is done so referral pathways
13:05
exactly and it seems concerns about
13:07
resources and time are pretty universal
13:09
but providers who are less familiar with
13:11
the guidelines also feel less confident
13:13
in their own knowledge about it okay so
13:15
if those are the barriers time staff
13:19
knowledge pathways how do we overcome
13:22
them how do we make GA practical in the
13:24
real world day in day out so the paper
13:27
discusses strategies framed around this
13:28
idea of increasing capability
13:30
opportunity and motivation for
13:32
clinicians the COM model a key
13:35
development to directly address the time
13:36
and resource issue is the creation of
13:38
simpler more practical GA tools like
13:41
what give me an example like the
13:43
practical geriatric assessment or PGA
13:45
this is developed by ASCO and curric
13:48
it's designed specifically for routine
13:50
clinical practice it's mostly patient
13:52
reported which saves staff time oh it
13:54
takes only about 10 to 25 minutes covers
13:57
the core GA domains gives you clear
13:59
score cut offs and even includes an
14:01
action chart that quickly translates the
14:02
results into recommendations things like
14:05
specific referrals or suggesting dose
14:07
adjustments that sounds much more
14:09
userfriendly for a busy clinic
14:10
environment less daunting exactly but
14:13
tools aren't enough right engaging the
14:15
whole oncology team is crucial how do
14:17
you do that well it means providing
14:19
education to build knowledge and
14:21
importantly bust some myths about how
14:23
long GA really takes and providing
14:26
training to build comfort and skill in
14:28
administering and interpreting the
14:29
assessments it also often requires
14:31
rethinking how things actually flow in
14:33
the clinic day-to-day how can workflow
14:35
help changing the process yeah you need
14:38
to integrate GA into the existing
14:40
process not make it feel like some extra
14:42
thing tacked on the article gives
14:44
examples having patients complete parts
14:46
of the assessment online before the
14:47
visit right using portal technology or
14:50
having a medical assistant or nurse
14:52
complete other parts during the rooming
14:54
process using the electronic health
14:56
record the EHR to automatically score it
14:59
and maybe even pop up suggested
15:00
recommendations for the doctor or nurse
15:02
practitioner to review embedding GA into
15:05
the workflow provides the opportunity
15:08
and makes it less of a separate burden
15:09
and who drives that kind of change who
15:11
makes it happen it really requires
15:13
clinical champions within the practice
15:15
you need people who are enthusiastic and
15:17
can lead the implementation effort so
15:19
doctors nurses yeah often physicians
15:22
nurses or PAs they can form teams to
15:24
manage the whole process from exploring
15:26
options preparing the staff implementing
15:28
the changes and crucially sustaining it
15:31
long term that includes checking if it's
15:33
actually working providing feedback and
15:35
there are resources out there from
15:37
organizations like CARIG CO ACCCC to
15:40
help practices do this you mentioned
15:42
using electronic health records how else
15:44
can technology help with getting GA and
15:46
JM implemented more widely technology is
15:49
becoming a huge enabler here collecting
15:52
GA data digitally whether it's through
15:54
patient portals or web-based tools is
15:57
increasingly feasible even for older
15:59
adults there's that talk of the digital
16:01
divide well the paper notes that while
16:03
that's been a concern the gap is closing
16:06
rapidly we've seen significantly
16:08
increased smartphone and internet use
16:10
among older adults in recent years so
16:13
tech adoption is rising and EHR
16:15
integration is key for making the
16:17
assessment and the resulting
16:18
recommendations just part of the routine
16:21
clinical flow not a separate spreadsheet
16:22
somewhere and tele medicine that
16:24
exploded recently does that fit in oh
16:26
absolutely tele medicine is a natural
16:28
fit for delivering GA and JAM especially
16:30
the consultative parts it allows for
16:32
virtual assessments remote communication
16:34
of action plans to patients and their
16:36
caregivers right and easier access to
16:38
those supportive care specialists like
16:40
physical therapists or social workers
16:42
this is particularly valuable for
16:43
patients in rural areas or maybe those
16:45
with mobility issues who find travel
16:47
difficult hybrid models using both
16:50
virtual and in-person elements are also
16:52
being explored what about things like
16:54
you know smartwatches or fitness
16:56
trackers wearables yeah mobile health
16:59
technology like wearables can provide
17:01
real-time data on things like activity
17:03
levels gate patterns maybe even vital
17:05
signs or sleep this data could
17:07
potentially alert the care team to
17:09
changes in a patients status between
17:11
visits or help tailor recommendations
17:13
like exercise plans more dynamically
17:16
okay so now we're talking about
17:17
generating a huge amount of data from
17:19
lots of different places the GA the EHR
17:22
wearables what about advanced analytics
17:24
AI yeah that's definitely the frontier
17:27
machine learning and AI have the
17:29
potential to combine all this diverse
17:30
data the GA results the EHR data claims
17:34
data maybe wearable sensor data to
17:36
create even more powerful predictive
17:38
models than we have now like what well
17:40
imagine as a sort of digital twin for a
17:42
patient using all this information to
17:44
simulate how they might respond to
17:45
different treatment options before you
17:47
even start wow that sounds really
17:49
exciting almost science fiction what are
17:51
the hurdles to getting there it can't be
17:52
simple no there are significant
17:54
challenges lack of infrastructure to
17:56
actually combine these massive data sets
17:58
from different sources is a major one
18:01
data sharing is complex technically and
18:03
legally and ethically absolutely there
18:06
are important ethical concerns ensuring
18:09
patient privacy and data security is
18:11
paramount addressing potential bias in
18:14
algorithms we don't want them
18:16
disadvantaging certain groups ensuring
18:18
equitable access to these advanced
18:20
technologies and making sure the AI's
18:22
recommendations are transparent and
18:24
understandable not just a black box okay
18:27
so while the promise is huge
18:28
implementing advanced tech for GA needs
18:30
really careful consideration of the
18:32
practical and the ethical implications
18:34
that makes sense now as the older
18:36
population itself diversifies how does
18:38
GA fit into ensuring equitable care for
18:41
everyone not just the majority
18:43
population this is a critical area the
18:45
article really highlights the older
18:46
adult population is becoming
18:48
increasingly diverse racially and
18:49
ethnically and we know that structural
18:51
inequities things like systemic racism
18:54
contribute significantly to health
18:55
disparities so how can GA help well GA
18:58
has the potential to reveal important
19:00
social determinants of health that
19:02
impact care especially if you use tools
19:05
that maybe assess community level needs
19:07
or social vulnerability alongside the
19:10
individual assessment so it can help us
19:12
see that bigger picture beyond just the
19:14
medical conditions the social context
19:16
yes exactly yeah but a challenge is that
19:19
most of the research on GA and JAM so
19:21
far has involved patient populations
19:23
that aren't very diverse often majority
19:26
white participants there's a real need
19:28
to figure out how to effectively
19:30
implement practical GA approaches in
19:32
underserved communities and rural areas
19:34
where diversity is often greatest and
19:36
language barriers must complicate things
19:38
even further right they absolutely do a
19:41
significant portion of the population
19:42
speaks English less than fluently and a
19:45
large percentage of those are older
19:46
adults language barriers severely impact
19:48
communication the quality of care people
19:50
receive their adherence to treatment
19:52
safety it contributes to mistrust and
19:55
potential discrimination we saw this
19:57
amplified during the pandemic actually
19:59
with lower tele medicine use among some
20:01
non-English-speaking patient groups so
20:03
how can GA help bridge that specific gap
20:06
well GA interventions that focus on
20:08
improving communication like those
20:10
tested in the COC trial could certainly
20:12
help but fundamentally delivering truly
20:14
patient centered care for people with
20:16
limited English proficiency means really
20:19
understanding their preferences within
20:20
their specific social and cultural
20:22
context it's not just about translation
20:25
no the article emphasizes the need for
20:27
research to actively include diverse
20:29
populations and focus on solutions to
20:31
these complex issues ensuring equitable
20:34
jam requires health systems to actively
20:36
address these social factors through
20:38
awareness adjusting care plans
20:40
accordingly providing assistance like
20:42
interpretation or referrals to community
20:44
resources and even advocating for
20:46
broader system changes it's clear that
20:48
reaching diverse populations equitably
20:50
is a major focus for the future of GA
20:52
the article also shines light on another
20:54
group who are absolutely essential but
20:56
let's be honest often overlooked
20:58
caregivers how does GA relate to their
21:00
needs right caregivers they're often
21:03
older female family members maybe a
21:05
spouse or daughter and they play a vital
21:07
role but frequently experience
21:10
significant burden burden meaning
21:12
meaning negative impacts on their own
21:15
emotional social financial and physical
21:17
well-being and this burden is often
21:19
directly linked to the patients level of
21:22
impairment particularly in those
21:24
activities of daily living and
21:25
instrumental activities of daily living
21:27
that GA measures so well so the patients
21:30
functional limitations directly create
21:33
challenges and stress for the person
21:35
caring for them it's interconnected
21:37
precisely and these caregivers often
21:38
have their own health issues to deal
21:40
with they tend to be in their 60s on
21:42
average with their own medical
21:43
conditions studies consistently show
21:45
caregivers of older adults with cancer
21:47
report higher rates of emotional
21:48
distress physical health problems and
21:51
they're less likely to get preventive
21:52
care for themselves because they're so
21:54
focused on the patient and that burden
21:56
isn't just hard on the caregiver
21:57
personally it can affect the patient's
21:59
care too yeah it can actually impact
22:01
their ability to provide that care
22:03
effectively high caregiver burden has
22:05
been linked to things like more
22:07
hospitalizations for the patient or
22:09
maybe less appropriate end of life care
22:12
because the caregiver is just
22:13
overwhelmed are we getting any better at
22:15
assessing caregiver needs just like
22:17
we're trying to do systematically for
22:19
patients with GA well validated tools
22:22
exist to screen for caregiver distress
22:24
things like the cancer support source
22:26
caregiver tool and studies have shown
22:28
it's feasible to use GA like approaches
22:31
to assess caregivers own health and
22:33
their supportive care needs however
22:35
implementing these tools in routine
22:37
oncology practice is still very limited
22:39
it's not standard yet it sounds like
22:42
similar to the patient side with GA
22:44
moving to GAM we need to move from just
22:46
knowing about caregiver burden to
22:48
actually doing something systematic
22:49
about it exactly while there's been
22:51
research on supportive interventions for
22:53
caregivers things like problem solving
22:56
psychoeducation these studies have often
22:58
been small lack diversity in their
23:00
participants and the findings can be
23:02
hard to translate into everyday clinical
23:04
practice so what do caregivers
23:06
themselves say they need caregivers
23:08
themselves have identified what they
23:10
need most a workshop highlighted five
23:12
key areas better information and
23:14
training on how to provide care being
23:16
more integrated into the patients care
23:18
team getting help navigating the complex
23:20
health care system more focus and
23:22
support for their own health and broader
23:25
policy changes to support caregiving so
23:28
the future really needs to integrate
23:29
caregiver assessment and support
23:31
directly into the patients geriatric
23:33
assessment management plan recognizing
23:35
they function as a unit a diad and you
23:38
can't effectively care for the patient
23:40
without considering and supporting the
23:42
caregiver too that's absolutely the
23:43
clear direction the field is and needs
23:45
to be moving treating the patient
23:48
caregiver diet okay let's try and bring
23:49
this deep dive together then we've
23:51
explored how geriatric assessment is
23:53
really transforming cancer care for
23:54
older adults it provides this rich
23:57
comprehensive picture that goes way
23:59
beyond simple age or those basic
24:01
physical scores right it's a powerful
24:03
tool for predicting how patients will
24:05
tolerate treatment much better than age
24:07
alone and for guiding smarter more
24:09
personalized therapy decisions and then
24:11
geriatric assessment management GAM
24:14
takes those insights and turns them into
24:16
concrete action implementing tailored
24:18
interventions that we've seen
24:19
significantly improve key outcomes for
24:21
patients reducing toxicity improving
24:24
quality of life enhancing communication
24:27
big impacts yeah and while those
24:28
practical implementation challenges
24:30
definitely exist time resources training
24:33
the field is actively addressing these
24:35
through simplified tools like the PGA
24:37
rethinking clinic workflows training
24:40
teams and importantly leveraging
24:42
technology like tele medicine and mobile
24:44
health and critically the focus is
24:46
expanding needing to expand more to
24:48
ensure this comprehensive approach is
24:50
available equitably to the increasingly
24:52
diverse older adult populations we see
24:54
and also to finally recognize and
24:56
support the vital needs of the
24:57
caregivers who are truly partners in
24:59
this journey yeah this article makes it
25:01
really clear that the future of cancer
25:03
care for older adults has to be holistic
25:05
it has to be personalized and it has to
25:07
recognize the unique strengths and
25:09
challenges of each individual and their
25:11
support system so as you our listener
25:14
reflect on all of this maybe consider
25:16
this given the really clear evidence
25:18
that geriatric assessment and management
25:20
significantly improves outcomes for
25:22
older adults with cancer and the fact
25:24
that implementation is still challenging
25:27
what do you think is the single most
25:28
important step needed right now to
25:30
ensure this comprehensive care reaches
25:32
everyone who could benefit regardless of
25:34
who they are where they live something