Oncogeriatric development through time: the challenge of cancer - - PowerPoint PPT Presentation
Oncogeriatric development through time: the challenge of cancer care transformation " Matti Aapro, M.D. (Switzerland) Percentage of total population aged 60 years or older 2002 " Percentage'aged' 60'years'or'older''
Oncogeriatric development through time: the challenge of cancer care transformation "
Matti Aapro, M.D. (Switzerland)
Percentage of total population aged 60 years or older 2002"
United'Na*ons.'Popula*on'Division.'Department'of'Economic'' and'Social'Affairs.'Popula*on'Ageing.'2002'
0–9' 10–19' 20–24' No'data' Percentage'aged' 60'years'or'older'' in'2002:'
World Health Organization
Department of Chronic Diseases and Health Promotion
World Health Organization
Mean age of global population is increasing
Figure taken from United Nations World Population Prospects at http://esa.un.org/unpp/index.asp?panel=2
55 50 45 40 35 30 25 20 15 Year United States South Korea Japan China India Mexico Pakistan 1950 1960 1970 1980 1990 2000 2010 2020 2030 2040 2050 Median age (years)
United'Na*ons.'Popula*on'Division.'Department'of'Economic'' and'Social'Affairs.'Popula*on'Ageing.'2050'
Percentage of total population aged 60 years or older 2050"
0–9' 10–19' 20–24' No'data' Percentage'aged' 60'years'or'older'' in'2050:'
received from R. Audisio
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18 1 4.3 5.8 7.9 10.8 14.2 2.3 3.2 4.7 6.7 12.4 9.3 1.5 2.2 3.3 6.7 4.9
5 10 15 20 25
70 years 75 years 80 years 85 years 90 years 95 years Life expectancy, years Top 25th percentile (FIT seniors) Lowest 25th percentile (FRAIL seniors) 50th percentile (MEDIAN life expectancy)
Walter LC et al. JAMA 2001, 285, 2750-2756 Domains Cognition Comorbidity Emotional conditions Function Geriatric syndromes Nutrition Pharmacy Socioeconomic conditions
Health status groups
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Short history of cancer treatment in older patients1
1983 1988 1990 1998 2000 2002 2003
National Cancer Institute and National Institute
a symposium Perspectives
and treatment
the elderly
The Venice statement2 Cancer in the elderly: why so badly treated ?
First edition of Comprehensive Geriatric Oncology released International Society
Oncology (SIOG) formed First onco- geriatric guidelines published
growth factors in elderly patients receiving cytotoxic chemotherapy3 World Health Organization 58th General Assembly resolution on Strengthening Active and Healthy Ageing Comprehensive Geriatric Assessment guidelines by the SIOG4 Dr BJ Kennedy encouraged the study of ageing and cancer during the Presidential Address at ASCO 1988
2005
US Geriatric Oncology Consortium founded to initiate trials and raise awareness
patients
2006
National Comprehensive Cancer Network (NCCN) guidelines published practice guidelines for senior adult
2010 JOURNAL
ONCOLOGY ESMO HANDBOOK
World Health Organization
Department of Chronic Diseases and Health Promotion
Following the adoption of these resolutions WHO is intensifying:
persons.
CANCER IS ON THE POLITICAL AGENDA
! The United Nations General Assembly adopted by
consensus the resolution titled "Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases" (document A/66/L.1). – High-Level Meeting on NCDs, 19-20 September 2011
UN Political Declaration
! We, Heads of State and Government and
representatives of States and Governments, assembled at the United Nations on 19 and 20 September 2011,…..
! 21. Recognize that the conditions in which people live
and their lifestyles influence their health and quality of life and that poverty, uneven distribution of wealth, lack of education, rapid urbanization, population ageing and the economic social, gender, political, behavioural and environmental determinants of health are among the contributing factors to the rising incidence and prevalence of noncommunicable diseases;
UN Political Declaration
! Chapter 45 ! (e) Pursue and promote gender-based approaches for
the prevention and control of non-communicable diseases founded on data disaggregated by sex and age in an effort to address the critical differences in the risks of morbidity and mortality from non- communicable diseases for women and men;
Growing interest has led to the formation
member of UICC
President: R. Audisio (UK) President-elect: A. Hurria (USA ) Past President: M. Extermann (USA) Treasurer: C. Steer ( AUS)
FNCLCC GEPOG GeriONNE GIOGer
EUGMS
EORTC
www.siog.org
exercitationesque virtutum
age are culture and the active exercise of the virtues Cicero, De Senectute www.siog.org
You may be sure, my dear Scipio and Laelius, that the arms best adapted to old age are culture and the active exercise of the
every period -if one has lived much as well as long- the harvest they produce is wonderful, not only because they never fail us even in our last days (though that in itself is supremely important), but also because the consciousness of a well-spent life and the recollection of many virtuous actions are exceedingly delightful.
WHY CICERO
Cicero, De Senectute
We cannot simply apply principles of clinical studies validated in younger patients
EORTC workshop on clinical trial methodology in older individuals with a diagnosis of solid tumors
A.G. Pallis, A. Ring, C. Fortpied, B. Penninckx, M.C. Van Nes, U. Wedding, G. von Minckwitz, C.D. Johnson,
On behalf of the EORTC Elderly Task Force Annals Oncology, 2011
The SIOG guidelines
! Management of elderly patients with breast cancer:
updated recommendations of the International Society
Breast Cancer Specialists (EUSOMA).
Biganzoli L, Wildiers H, Oakman C, Marotti L, Loibl S, Kunkler I, Reed M, Ciatto S, Voogd AC, Brain E, Cutuli B, Terret C, Gosney M, Aapro M, Audisio R. Lancet Oncol 2012 Apr; 13:e148-60
! Anthracycline cardiotoxicity in the elderly
cancer patient: a SIOG expert position paper.
Aapro M, Bernard-Marty C, Brain EG, Batist G, Erdkamp F, Krzemieniecki K, Lenoard R, Lluch A, Monfardini S, Ryberg M, Soubeyran P, Wedding U. Ann
UICC World Cancer Declaration
Martine Extermann, MD Moffitt Cancer Center Tampa, FL, USA
www.siog.org
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