The provision of appropriate care to older adults with cancer is a major challenge for all clinicians. As the median age of patients with lung cancer in Australia is 72 years (AIHW) all providers of health care to adults with cancer will require the skills to manage older adults. The central tenet of this care provision is that "Adequate assessment yields appropriate care". Geriatric assessment has been shown to improve communication about age-related concerns. This includes establishing what matters most to the patient and the provision of age friendly care.
Ageism is a major barrier to the appropriate care of older adults. Ageism takes a number of forms and includes institutional, interpersonal and internalised ageism (ie the phenomenon where older adults marginalize and discriminate against other older people).
The solutions to combatting ageism in cancer care are multifactorial and involve education, regulation and improvement in resources to facilitate geriatric assessment. Improving access to clinical trials for older adults can also be a driver for positive change.
Evidence suggests that the provision of information via a geriatric assessment to clinicians at the time of treatment decision making enables informed decisions and reduces treatment toxicity. A geriatric assessment estimates frailty and helps estimate a patient's life expectancy without the cancer, ensuring that decisions are not made on the basis of age alone.
The creation of age friendly health systems will reduce agesim and improve the care of all older adults with cancer. Practical examples from around the world will be discussed.