COMPREHENSIVE GERIATRIC ASSESSMENT (CGA): IS IT NECESSARY FOR TREATMENT OF CANCER PATIENTS? INTERDISCIPLINARY EFFORTS AND IMPORTANCE OF ITS IMPLEMENTATION IN A CANCER CENTER PROGRAM IN LATIN AMERICA

CGA is gaining importance in treatment of elderly cancer patients, since ageing is a global phenomenon. That shift in demographics has huge impact in healthcare. However, the more reliable validated way to apply CGA in Geriatric Oncology is an open research field so far. The efforts to find the best interdisciplinary approach for conducting CGA in daily clinical practice demand a worldwide multi-institutional collaboration. This presentation will review some topics in Geriatric Oncology, highlighting strategies and difficulties of implementing such a unit. Daily routine of a interdisciplinary Geriatric Oncologic team work will be discussed, to put into the context of a high volume cancer hospital, the daily needs of caring for elderly oncology patients. Attending public will discuss, among other topics: a) epidemiology of aging and cancer around the world; b) efforts to better care in geriatric oncology; c) CGA in cancer patients; d) important points in geriatric oncology in different settings (public or private; acute or intensive care unit, ambulatory, nursery, hospice, home care); e) administrative and financial support for geriatric oncology. In A. C. Camargo Cancer Center, in Sao Paulo, Brazil, we are starting a project hoping for government grant, aiming to: □ Detect predictive factors of complications in oncological treatment □ Propose treatment protocols adapted to functional capacity, to avoid over and under treatment. □ Offer ways to rehabilitation of reversible vulnerability and frailty, with combined interprofessional work. □ Prevent additional common complications in elderly: falls, polypharmacy, undernutrition, depression, sarcopenia, for example. □ Detect early signs of psychological or cognitive alterations that may contribute to additional deficits. □ Offer home, ambulatory and hospital support to all patients, specially for the ones that cannot receive specific cancer treatment. □ Combine assistance to comorbidities with the oncology team. Topics above will be illustrated by our experience, initiated in 2010, in the implementation of a Geriatric Oncology Unit in A. C. Camargo Cancer Center – one of the largest oncology hospitals in Latin America – specially how to apply a time-consuming elderly evaluation in a high volume cancer center for multidisciplinary treatment. In our initial retrospective cohort, the incorporation of CGA in daily practice was feasible and useful to predict needs and complications of systemic cancer treatment, like dose adjustment, ability to complete proposed treatment, and hospitalisation. Next step should be to look for correlations with markers of efficacy, such as survival and quality of life. We believe that the comparison of different approaches in Geriatric Oncology may help to improve their applications in many settings and services, with good ideas being applied with local contextualisation. Those efforts will directly benefit elderly cancer patients. Disclosure of interest: None declared