Geriatric Oncology: A Field Coming of Age

A saying within oncology is: If you’re not a pediatric oncolo-gist, you’re a geriatric oncologist. Maybe while not literally true, this phrase is recognition that all of the subspecialties of oncology are rapidly becoming a field that will be primarily concerned with the care of older patients. While there is not one precise definition of the age of geriatric patients, it is clear that the aging of our society has necessitated a focus on this segment of the population. It has long been recognized that the most significant risk factor for the development of cancer is increasing age. This, together with epide-miologic shifts, has resulted in a marked increase in the number of older patients with cancer, which will markedly increase the cancer burden to the world.1,2 It may also compromise the life expectancy, as well as the active life expectancy, of older individuals. Cancer and cancer treatment may appear as several of the prime causes, not only of mortality, but also of disability, in older individuals. The traditional ways in which cancer is studied—by clinical trials focusing on younger, healthier patients—has left us devoid of useful data with which to treat older patients in an evidenced-based fashion. Not only have these earlier trials failed to establish the relative efficacy of cancer treatment in the elderly, but they also were unable to provide information related to the short- and long-term complications of treatment including decline in function.3 Among the first to recognize this issue was Dr Rosemary Yancik, who in 1983 organized a symposium sponsored by the National Cance