Delivering Palliative and Supportive Care for Older Adults with Cancer: Interactions between Palliative Medicine and Geriatrics

SIMPLE SUMMARY: Advanced cancer represents the most common reason for needing palliative care among older adults worldwide. Unfortunately, older adults face several barriers when trying to obtain high-quality palliative care partly due to a lack of data regarding the best way to treat them and to limited geriatric expertise among clinicians. Providing palliative care for older patients with cancer requires considering the physiological and functional changes related with aging to tailor therapy and provide individualized care. Furthermore, since geriatrics and palliative care share many common goals, there is a need to create models of care that successfully integrate both disciplines. In this review, we summarize the current evidence regarding the provision of palliative care and symptom control for older adults, as well as guidance regarding the use of geriatrics for decision-making in older patients with incurable diseases. ABSTRACT: The world’s population is aging rapidly, with projections indicating that by 2050 one in six people will be aged ≥65 years. As a result, the number of cancer cases in older people is expected to increase significantly. Palliative care is an essential component of cancer care with a direct impact on quality of life. However, older adults with cancer often suffer from multiple comorbidities, cognitive impairment, and frailty, posing unique challenges in the delivery of palliative care. The complex healthcare needs of older patients with cancer therefore require a comprehensive assessment, including a geriatric evaluation. Collaboration between geriatrics and palliative care can offer a solution to the challenges faced by older people with cancer, since this is a population with overlapping concerns for both disciplines. This review highlights the importance of palliative care for older adults with cancer and the benefits of a multidisciplinary approach. It also addresses the coordination of palliative care and geriatrics for specific symptom management and decision making.