“The biggest risk for cancer development is age,” said Maria Carney, MD, chief of geriatric and palliative care for the North Shore-LIJ Health System and codirector of the Cancer Institute’s Supportive Oncology Center. “And as we age, we are also apt to have more health issues that need to be managed.”
The multidisciplinary Cancer and Aging Program addresses the complex needs of mature cancer patients. Its first task: evaluate the quality of life in breast cancer patients 65 and older. A collaboration between the North Shore-LIJ Cancer Institute and the health system’s Division of Geriatric and Palliative Medicine, the program is the first of its kind in the Northeast.
Ruby Sharma, MD, a medical oncologist at the Monter Cancer Center, is the clinical lead and principal research investigator of the Cancer and Aging Program.
The number of mature cancer patients — and mature cancer survivors — is growing. In fact, 60 percent of all cancers occur in people older than 65 years of age. The American Society of Clinical Oncology projects that this group of cancer patients will grow 67 percent by 2030.
“It gets complex for an oncologist to manage aging patients alone,” said Dr. Carney. “We hope that by offering to comanage care, we can better help patients and really promote longevity, independence and improved quality of life.”
“What makes this new program unique is that it is centered around clinical research questions, and we’re truly collaborative, with the whole team seeing patients together under one roof at the Monter Cancer Center [in Lake Success],” said Myra Barginear, MD, initiator of the study. “Patients can see the interdisciplinary team, in the setting of this clinical trial, in one visit, which enhances complete, comprehensive care. We believe our older patients with breast cancer may benefit because their functionality, comorbidities, social support, medications and other health issues are very different compared to younger patients.”
Dr. Sharma also collaborates with Gisele Wolf-Klein, MD, director of geriatric education at LIJ Medical Center, on each patient enrolled in the clinical trial. Initial patient visits usually take 60 to 90 minutes, and follow-up visits 20 to 30 minutes. Renee Pekmezaris, PhD, an investigator at The Feinstein Institute for Medical Research and vice president of community health and health services research for North Shore-LIJ, collaborated for more than a year with Drs. Barginear and Wolf-Klein to establish the initiative.
Clinical trials provide the evidence-based research that leads to new and improved standards of patient care. This research is vital, because older patients are under-represented in national cancer clinical trials.
“In many earlier studies, age was often an exclusion criterion. If you were 70 years old, you may have been excluded,” said Dr. Sharma. Yet a 70-year-old woman is often very different from a 50-year-old for many reasons, she said, adding, “We are already seeing that our patients are eager and happy to be a part of this study. This is only the start of our long-term efforts to transform the approach to cancer prevention and treatment in mature women with breast cancer.”
Clinical Trial for Older Adults with Breast Cancer
The Cancer and Aging Program’s first clinical trial focuses on older adults with breast cancer, and began in January with the generous support of the Manhasset Women’s Coalition Against Breast Cancer and the Fan Fox and Leslie R. Samuels Foundation, Inc.
The trial focuses on:
- quality of life;
- emergency department visits; and
- the value of having a formal geriatric assessment.
Participants are evaluated at the time of their first diagnosis and again three to four months later. The study will last 18 months to two years; research coordinators hope to enroll 240 patients. As with other clinical research, the investigators will evaluate the data and discuss the results at national medical conferences and in internationally recognized medical journals.
Learn more by calling Dr. Sharma at 516-734-8964.
Read the next article, Meeting the Demand: Community-Based Care