Arti Hurria: Identifying risks in older cancer patients

July 21, 2013 | by Denise Heady

Arti Hurria, M.D., director of the Cancer and Aging Research Program at City of Hope, feels strongly that too little attention has been paid to the needs of older people with cancer. She's working to change that.

Arti Hurria Health care workers must identify and assess the unique risks faced by older cancer patients, says City of Hope's Arti Hurria.

She recently presented an overview of her work – and the context for it – at the annual meeting of the American Society of Clinical Oncology (ASCO), where she was honored as the 2013 recipient of the B.J. Kennedy Award for her contributions to the research, diagnosis and treatment of cancer in the elderly. Here, we offer the fourth in a five-part series on the most important aspects of her work – and what doctors and others need to know about treatment of the elderly.

Part 4: Identifying at-risk patients

Because cancer is a disease associated with old age, it may be no surprise that older adults are at higher risk for toxicity to cancer therapy. But researchers such as Hurria are now working on a more thorough way to identify the factors contributing to this risk.

These geriatric assessments for oncologists represent the integration of geriatrics into the oncology field. Hurria’s model takes into account both the factors that increase the risk for chemotherapy-related toxicity, as well as factors other than chronological age that predict the risk of morbidity and mortality. Included in her model are assessments of functional ability, other medical conditions, nutritional status, cognitive function, mental health, social support and medications that could interfere with cancer treatment.

Further, targeted assessments can help guide practical interventions, she has found. Physicians can currently use these specialized tools to warn of possible toxicity to cancer treatment, predict survival of older cancer patients and to uncover problems that might not be detected in a routine history and physical. 

Incorporating a geriatric assessment and other tools in oncology practice is not only feasible, but vital to identifying at-risk older adults, Hurria said.

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