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Table of Contents
LETTER TO EDITOR
Year : 2020  |  Volume : 3  |  Issue : 3  |  Page : 658

Paving the way for a bright future for geriatric oncology in India


1 Division of Medical Oncology, National Cancer Centre, Singapore
2 Department of Internal Medicine, Sengkang Hospital, Singapore, Singapore

Date of Submission29-Jun-2020
Date of Decision03-Jul-2020
Date of Acceptance04-Jul-2020
Date of Web Publication19-Sep-2020

Correspondence Address:
Ravindran Kanesvaran
National Cancer Centre Singapore, 11, Hospital Crescent, Singapore 169610
Singapore
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/CRST.CRST_224_20

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How to cite this article:
Kanesvaran R, Chowdhury AR. Paving the way for a bright future for geriatric oncology in India. Cancer Res Stat Treat 2020;3:658

How to cite this URL:
Kanesvaran R, Chowdhury AR. Paving the way for a bright future for geriatric oncology in India. Cancer Res Stat Treat [serial online] 2020 [cited 2020 Oct 22];3:658. Available from: https://www.crstonline.com/text.asp?2020/3/3/658/295552



India, just like many other Asian countries, is currently on the cusp of experiencing the silver tsunami. This second-most populous country in the world is not only seeing a rapid rise in its aging population but is also witnessing a rising population of older adults with cancer.[1] Hence, it is timely that Noronha et al. at the Tata Memorial Hospital had the foresight to start the first geriatric oncology (GO) clinic in India in June 2018.[2]

GO is a new oncologic specialty born in the west over 20 years ago. However, it gained recognition in Asia only over the past decade.[3] Although it was viewed with some skepticism when it was first conceived, it has now become a key component of the care of an older adult with cancer. Some of the challenges faced by oncologists in instituting the GO principles into practice have been outlined by the authors in their article and the accompanying editorial in the same issue.[2],[4] Geriatric assessment (GA) is time-consuming,[5] as is shown by the median time of 50 min it took the team at Tata Memorial Hospital to perform it. In this study, 98% of the patients were found to have at least one deficit among the various GA domains tested. This meant that screening tests will likely be futile as nearly everyone will likely be screen positive. One solution would be to send some of the GA questions to the selected patients either via snail mail or E-mail. Although there will be some challenges related to Internet access and literacy, these will certainly be overcome with greater internet penetration and improved literacy projected in the future.

Some of the other challenges faced by the authors with regard to the poor literacy levels and cultural differences compared to the Western populations made it hard for them to use some of the tools commonly used as part of the GA.[6] However, the authors were resourceful and used the Hindi version of the Mini-Mental State Examination for a third of the study population that was illiterate. This highlights some of the unique challenges faced by oncologists in developing countries when trying to apply GO tools that were developed in the Western world. This may also present a wonderful opportunity for the GO clinic at the Tata Memorial Hospital to develop new tools that would not only apply to India but also other developing countries in the region.[7]

It was also interesting to note that none of the patients assessed in the study had poor social support. This highlights some of the benefits of living in households with an extended family, which is in line with the traditional beliefs in Asia that value filial piety. This strength can be harnessed in getting the families of these older patients to actively participate in the GA. Finally, we would like to applaud this wonderful effort by Noronha et al. and hope that this will be an important first step in encouraging the use of GO in oncology practices all over India.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Rajpurohit A. Geriatric oncology in India: An unmet need. Cancer Res Stat Treat 2020;3:150-1.  Back to cited text no. 1
  [Full text]  
2.
Noronha V, Ramaswamy A, Dhekle R, Talreja V, Gota V, Gawit K, et al. Initial experiences of a geriatric oncology clinic in a tertiary cancer centre in India. Cancer Res Stat Treat 2020;3:208-17.  Back to cited text no. 2
  [Full text]  
3.
Kanesvaran R, Li H, Koo KN, Poon D. Analysis of prognostic factors of comprehensive geriatric assessment and development of a clinical scoring system in elderly Asian patients with cancer. J Clin Oncol 2011;29:3620-7.  Back to cited text no. 3
    
4.
Parikh PM, Chaitanya K, Boppana M, Kumar M S, Shankar K. Geriatric oncology landscape in India – Current scenario and future projections. Cancer Res Stat Treat 2020;3:296-9.  Back to cited text no. 4
  [Full text]  
5.
Pandey A, Singh A. Treating the older patients with 'younger' evidence-based therapy: Time to tailor to suit the fragility. Cancer Res Stat Treat 2019;2:226-7.  Back to cited text no. 5
  [Full text]  
6.
Noronha V, Talreja V, Joshi A, Patil V, Prabhash K. Survey for geriatric assessment in practicing oncologists in India. Cancer Res Stat Treat 2019;2:232-6.  Back to cited text no. 6
  [Full text]  
7.
Vora AD. The real issue with geriatric oncology. Cancer Res Stat Treat 2020;3:149-50.  Back to cited text no. 7
  [Full text]  




 

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