Objectives
  • To be able to perform/interpret geriatric screening and/or assessment of older patients with cancer

  • To be able to counsel on an optimal treatment strategy for each individual

Awareness
  • Appreciation of the importance of the evaluation of the general health status by geriatric assessment in older patients with cancer: detection of unidentified non-cancer health problems, prediction of adverse outcome and better estimation of residual life expectancy in relation to lethality of the malignancy

  • Appreciation of the different domains of geriatric assessment: social status/support, functional status, fatigue, comorbidity, cognition, mental health status, nutrition and geriatric syndromes such as falls, incontinence and delirium

  • Appreciation of the need of polypharmacy evaluation and drug compliance in this population

  • Recognition that older patients may die from their cancer but also from other causes as well as from adverse effects of cancer treatment

  • Appreciation that tumour biology can be different in older versus younger patients with cancer

  • Appreciation that pharmacology of anticancer agents can be different in senior adults

  • Awareness that the toxicity of anticancer agents can be different in senior adults and can be affected by comorbidities, eg, susceptibility to cardiotoxic agents

Knowledge
  • Understanding that geriatric evaluation can have an impact on treatment decisions

  • Understanding that, if geriatric assessment reveals problems, it needs to be followed by targeted geriatric interventions

  • Familiarity with international guidelines, for example, from the International Society of Geriatric Oncology (SIOG) concerning specific treatment approaches for different tumour types

  • Familiarity with the epidemiology of cancer in relation to age

  • Familiarity with SIOG guidelines on other ageing-related issues such as geriatric evaluation and pharmacology

  • Familiarity with (geriatric assessment-based) predictors of survival

  • Knowledge that geriatric assessment-related factors correlate with chemotherapy-induced toxicity, and that predictive models exist

  • Knowledge of how to evaluate possible drug–drug interactions in older patients with cancer

  • Knowledge that chemotherapy pharmacology can differ for some chemotherapeutic agents in older patients, and where to find information for each specific chemotherapeutic agent

Skills
  • Ability to perform a geriatric assessment or geriatric screening

  • Ability to interpret the results of a geriatric assessment or geriatric screening

  • Ability to collaborate with geriatricians or specialised healthcare workers to improve care for each older patient with cancer

  • Ability to integrate a geriatric assessment into oncology decision-making

  • Ability to address issues related to social situation, access to care and the needs of the caregiver

  • Ability to take treatment decisions in the palliative versus curative setting regarding appropriate drug dosing and supportive care modalities like growth factors or antiemetics

  • Ability to assess therapy-induced toxicity, ie, standard toxicity criteria, and to deal with these toxicities; functional assessment and detection of functional impairment