As the global population experiences a demographic shift, understanding the complexities of ageing becomes crucial for both individuals and professionals. Geroncology brings together the sciences of gerontology and oncology, and is the multidisciplinary study of ageing and the issues related to ageing. It covers, among others, the fields of nursing, medicine, psychology, sociology, social work and public health, and focuses on understanding the physical, psychological and social aspects of ageing and finding ways to enhance the quality of life for older individuals.
There are currently 3 million people living with cancer in the UK, estimated to reach 5.3 million by 2040 (Macmillan, 2022). On average, in the UK, a person is diagnosed with cancer every 90 seconds. Advanced cancer predominantly affects older adults and the challenge of how to best treat this patient group has led to the emergence of geriatric oncology (Hamaker and Rostoft, 2021).
The ageing of the global population, along with lifestyle factors, advances in health care and improved survival rates, contributes to the rise in the number of those who will require cancer care in future. This emphasises the importance of developing and enhancing healthcare strategies and infrastructure to meet the unique needs of this growing demographic, with care provided on the basis of need and not age.
The ability of nurses to take a holistic approach, act as patient advocate, co-ordinate services, expertly manage symptoms, offer patients psychosocial support and contribute to research and education puts them at the centre of service development. Nurses are well placed to ensure that cancer care is comprehensive, patient-focused and aligned with the developing needs of an ageing population.
The changing landscape of cancer care for the older population reflects a commitment to address the unique needs of this demographic through specialist approaches, improved screening, interdisciplinary collaboration, technological integration, research approaches and a focus on holistic and supportive care. The priority is to ensure that older individuals diagnosed with cancer receive the best possible care tailored to their specific circumstances.
However, adults aged 70 years and older with ageing-related conditions are under-represented in clinical trials to determine standard of care for treating advanced cancer, despite the fact that they comprise a significant proportion of the population.
Older adults with advanced cancer are at a high risk of toxic effects related to treatment modalities (Mohile et al, 2021). A central component of high-quality care is a comprehensive assessment that evaluates age-related issues (eg, comorbidity, polypharmacy, falls), which is then used to guide management. Such a geriatricfocused assessment has the potential to reduce serious toxic effects in those receiving high-risk treatment such as chemotherapy.
Mohile et al (2021) recommended that geriatric assessment and geriatric assessment-guided management be considered the standard of care for older patients with advanced cancer and ageing-related conditions when they commence a new treatment regimen that carries a high risk of toxicity. Assessment strategies must reflect the multidimensional contribution of the older person's health status considered from physical, functional and psychosocial domains, as well as acknowledging the heterogeneity in the older population – assessment of frailty only is insufficient and culpable.
Gerontology permeates every facet of our lives, offering a holistic perspective to ageing that must extend to the provision of oncology care. This discipline is set to take on a growing role in health care, requiring nurses and other health and care professionals to develop their current practice further in response to the needs of this older patient group.