PLYMOUTH MEETING, PA — The National Comprehensive Cancer Network has released new patient guidelines for adults 65 and older, emphasizing health, cognition, and physical function rather than chronological age alone when assessing cancer treatment options.
The NCCN Guidelines for Patients: Older Adults With Cancer are based on the organization’s clinical guidelines used by health care professionals and are intended to help patients and caregivers understand how individual health factors can affect treatment decisions.
The guidance covers assessment tools clinicians can use to evaluate physical ability, cognitive function, other medical conditions, medications and the risk of treatment complications. It also addresses support for patients with cognitive impairment or an elevated risk of falls.
“We need to carefully assess any patient over 65, because there can be a huge range in areas such as memory function, physical ability, or treatment interactions with other medications and conditions,” stated Dr. Efrat Dotan of Penn Medicine Lancaster General Health’s Ann B. Barshinger Cancer Institute, who chairs the NCCN Guidelines Panel for Older Adult Oncology.
The guidelines are designed for anyone diagnosed with cancer after age 65 but may also be relevant to younger patients who have additional medical concerns.
NCCN cautions against treating age alone as a proxy for a patient’s ability to undergo cancer treatment. Although side effects and comorbidities become more likely with age, mental and physical fitness can vary substantially among people in their 80s, 90s and beyond.
“We all age differently,” stated Dr. Louise C. Walter, chief of geriatrics at the University of California, San Francisco and vice chair of the NCCN panel. “People should really be talking with their doctor about what makes sense for them as an individual, with their specific health situations, and come up with the best plan that’s not based on chronologic age, but on what’s most important to them.”
The resource also addresses challenges facing caregivers. Patient advocate Glenn Sykes, whose mother was diagnosed with cancer at 95, pointed to issues such as explaining treatment to a person with dementia as an example of circumstances that can complicate care for older patients.
NCCN publishes more than 75 patient resources covering cancer types as well as prevention, screening, survivorship, fatigue, distress management and other areas. The guides use plain-language explanations, illustrations, glossaries and suggested questions for patients to discuss with clinicians.
The patient guidelines are updated annually in English and Spanish. The new older-adult cancer guide is available free at NCCN.org/patientguidelines and through the NCCN Patient Guides for Cancer App. Printed copies are available for a fee through Amazon.
The National Comprehensive Cancer Network Foundation provides funding for the patient-guideline series. More information about the foundation is available at NCCNFoundation.org.
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