Older Person with Cancer Program 

As part of the Older Person with Cancer Program, NEMICS has provided funds to Austin, Eastern and Northern Health to pilot models of care that support older people with cancer to make treatment decisions and have their supportive care needs met. 

Across NEMICS health services, people aged 70 plus years account for 50% of cancer-related admissions (VAED 2018/19).  As the Victorian population ages, the number of older people being diagnosed with cancer will continue to increase (Victorian Cancer Plan, 2020-2024).  Providing evidence-based care to this growing population is a priority given their unique aged related needs. 

Older people: 

  • experience a poorer response to treatment contributing to poorer outcomes 
  • require management that is complicated by comorbidities and functional status 
  • have complex polypharmacy issues due to multiple medications being taken for comorbid conditions 
  • make up less than 10% of clinical trial participants, resulting in a lack of evidence-based information to guide their treatment 
  • are at risk of over and under treatment due to this lack of evidence 
  • can experience worsening of pre-existing vulnerabilities due to their cancer diagnosis and treatment; this can lead to protracted/permanent deterioration in their functional status 
  • often live alone and may be socially isolated. 

Position statements developed by peak cancer bodies across the world (e.g. ASCO, NCCN, COSA) support targeted screening and assessment to aid treatment decision making and supportive care interventions for the older person with cancer. 

The Victorian Cancer Plan 2020-2024 identified a comprehensive, inclusive and equitable approach to providing cancer care, stating ‘cancer treatment in older patients can be complicated by concurrent illnesses.  These illnesses may require active management and affect health outcomes.  Importantly, geriatric assessment informs the right treatment and care based on each patient’s health and fitness rather than their age’ (page 7). The cancer plan includes a focus on up skilling the workforce focusing on care for the underserved. 

In 2019, the Victorian Integrated Cancer Service (VICS) conducted a scoping project to gain a comprehensive understanding of the current geriatric oncology services, models of care, guidelines, and other resources available for use with older persons with cancer to inform future geriatric oncology initiatives in Victoria.  Recommendations included: 

  • the use of standardised geriatric oncology screening tools across Victoria 
  • provision of multi-disciplinary approaches in the delivery of services for older people with cancer, and 
  • opportunities for more educational programs for clinicians and older patients with cancer. 

In 2020, NEMICS investigated issues with the coordination of care for older cancer patients across our region. Findings identified several gaps in the way care is coordinated and clinician knowledge of available services (health service, community and non-government organisation). There are no specific services in place across all NEMICS health services to support the older person with cancer to make treatment decisions and/or to provide support while undergoing treatment. 

With growing evidence of the unique needs of the older person and support by national and international cancer peak bodies, the Older Person with Cancer Program will pilot evidence based models of care that will support patient and clinician and the health service to achieve optimal cancer care outcomes.  Projects will run throughout 2021 over a nine-month period. 

If you would like further information regarding this initiative, contact the NEMICS older person with cancer Project Manager, Melissa Shand on 9496 3322 or Melissa.shand@austin.org.au

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