Terret Catherine, Zulian Gilbert B, Naiem Arash, Albrand Gilles
Lyon's Geriatric Oncology Program Centre Léon Bérard, Lyon, France.
J Clin Oncol. 2007 May 10;25(14):1876-81. doi: 10.1200/JCO.2006.10.3291.
Given the dramatic demographic shift observed in developed countries, the medical community, especially oncologists, geriatricians, and primary care providers, are confronted with the expanding challenge of the management of elderly people with cancer. Ageing is associated with the accumulation of multiple and various medical and social problems. With a prevalence comparable to that of other chronic conditions in this age group, such as diabetes or dementia, cancer holds a prominent place among diseases of the elderly. The care of elderly cancer patients is fundamentally interdisciplinary. Communication and collaboration between geriatricians/primary care providers and oncologists represent key features of effective care in geriatric oncology. The combination of the disease-oriented approach of oncologists and the patient-oriented approach of geriatricians is the most powerful way to better serve this specific population. The medical approach of elderly cancer patients should ideally be under the lead of geriatricians or primary care providers sensitive to geriatric issues. Oncologists should manage the biologic consequences of the interplay between cancer and ageing. Close collaboration between clinicians will help promote active dedicated clinical research and the development of guidelines on the management of elderly people with cancer.
鉴于在发达国家观察到的显著人口结构变化，医学界，尤其是肿瘤学家、老年病学家和初级保健提供者，面临着管理老年癌症患者这一不断扩大的挑战。衰老与多种不同的医学和社会问题的积累相关。癌症在老年疾病中占据突出地位，其患病率与该年龄组的其他慢性疾病（如糖尿病或痴呆症）相当。老年癌症患者的护理从根本上说是跨学科的。老年病学家/初级保健提供者与肿瘤学家之间的沟通与协作是老年肿瘤学有效护理的关键特征。肿瘤学家以疾病为导向的方法与老年病学家以患者为导向的方法相结合，是更好地服务于这一特定人群的最有效方式。老年癌症患者的医疗方法理想情况下应由对老年问题敏感的老年病学家或初级保健提供者主导。肿瘤学家应处理癌症与衰老相互作用的生物学后果。临床医生之间的密切合作将有助于推动积极的专门临床研究以及制定老年癌症患者管理指南。
