Annu RajpurohitNational Institute of Medical Science, India
Title: Geriatric oncology in India: An unmet need
Being the most populated country in the world and with better life expectancy, India is facing the challenges of increased cancer incidence in geriatric population. The exact reason for this higher incidence is not clearly established; however, it is expected to be multifactorial with some of the factors being defective DNA repair, immunological ageing, oncogene activation due to piling up of random somatic/genetic mutations, prolonged carcinogenic exposure, and changes in hormonal milieu. Geriatric oncology patients are prone to develop severe toxicities in view of multiple comorbidities and polypharmacy. Furthermore, the majority of the clinical trials exclude geriatric patients. This, in turn, leads to availability of little data for geriatric patients, and thus the management of geriatric patients requires significant expertise and attention to cater to individual patients. The American Society of Clinical Oncology (ASCO) recommends that all geriatric oncology patients should undergo an assessment of various geriatric domains, including social support, physical function/falls, cognition, nutrition, medications, comorbid medical disorders, and depression. Despite these special needs, geriatric oncology as a subspecialty of oncology is still in primitive stages of development in India. The lack of awareness of geriatric oncology tools has been found to be widely prevalent among Indian oncologists. In addition, comprehensive geriatric assessment (CGA) as a means to understand and document the vulnerabilities of geriatric patients has been limited due to complexities and time requirement to assess the multiple CGA domains. Surveys should include question about age cutoff used by the oncologists around the country.
In summary, there is an unmet need to cater to geriatric patients in oncology, and the treating oncologists should make an effort to incorporate some of the important tools in daily practice while dealing with geriatric patients. There are certain systemic ways by which above challenges can be addressed.
Annu Rajpurohit is one of the young and dynamic medical oncologists of India, she pursued her DM in medical oncology from India's most reputed cancer institute ,Tata Memorial hospital, Mumbai. She also excelled in field of clinical research and participated actively in prestigious international & national oncology conferences. She has many publications in eminent international Journals.Her expertise is in both blood and solid cancers with extra devotion to women cancers.