Cecilia Margareta Lund

Purpose: To provide an up-to-date overview of geriatricians’ involvement in oncological and onco-surgical care for older adults across Europe. Methods: An anonymous 35-item online survey was distributed via (inter)national societies between 10 April and 23 May 2025. The responses were summarized, and associations between comprehensive geriatric assessment (CGA) outputs, participation in oncological multidisciplinary team (MDT) meetings, and involvement in treatment decision-making were explored. Results: A total of 2160 responses were received from 37 countries. Further analysis included 395 geriatrician/internal medicine respondents with > 25% survey completion from 34 countries. Of them, 19% reported no formal geriatric oncology model; the most common approaches were referral based on clinical judgment (43%) and a two-step pathway (42%). Frailty screening-guided referral occurred in 63%, with the G8 (50%) and Clinical Frailty Scale (32%) being the most commonly used. Among respondents, 30% reported routine MDT attendance, and 20% reported involvement in treatment decisions. In exploratory analyses, routine MDT participation was associated with active treatment decision-making (aOR 6.01, 95% CI 3.08–11.7), CGA-based recommendations addressing both geriatric domains and oncological treatment (aOR 5.81, 95% CI 3.16–10.7), and positive feedback from oncology/surgery teams (aOR 3.75, 95% CI 1.96–7.14; all p < 0.001). Only 39% of respondents were involved in inpatient surgical oncology care, with liaison models predominating (37%). Conclusion: Geriatric oncology and geriatric surgical oncology remain unevenly implemented across Europe. Standardized pathways, training, and MDT integration may improve equity of care for older adults with cancer.

Background: Many admitted geriatric patients are malnourished with insufficient intake of trace elements. Zinc status is crucial to maintaining normal immune function and is assessed using plasma zinc concentration.

Supportive care, encompassing the prevention and management of cancer-related adverse events, including nutritional interventions, aims to enhance Quality of Life (QoL) and optimize the effectiveness of cancer treatment [1].

Background: To prevent severe toxicity and hospital admissions, adequate management and recall of information about side effects are crucial and health literacy plays an important role. If age-related factors impact recall of given information and handling of side effects, revised ways to give information are required. Patients and Methods: We undertook a questionnaire-based survey among 188 newly diagnosed patients with pancreatic cancer or colorectal cancer and chemo-naive patients with prostate cancer treated with adjuvant or first-line palliative chemotherapy comprising satisfaction with given information, recall of potential side effects, and handling of hypothetical side effect scenarios. We evaluated the association between baseline characteristics, ie, age, frailty (G8 score), comorbidity (Charlson Comorbidity Index), cognitive function (Mini-Cog), satisfaction, recall of information, and handling of side effects. Results: Reduced ability to recall information about several side effects (eg, chest pain) was associated with older age (odds ratio adjusted for cancer [aOR] 0.94 [95% CI, 0.88-0.98]) and poor cognitive screening (aOR 0.56 [95% CI, 0.33-0.91]). Insufficient or dangerous handling of side effects was associated with older age (aOR 0.96 (95% CI, 0.92-0.99)) and cognitive impairment (aOR 0.70 [95% CI, 0.50-0.95]). Conclusion: Older age and poor cognitive screening may impact patients’ ability to understand and adequately handle chemotherapy-related side effects. Cognitive screening and focus on individual ways to give information including assessment of recall and handling are needed.

The association between pre- and perioperative inflammatory biomarkers, major complications, and survival rates after resection of colorectal cancer (CRC) in older patients is largely unknown. The aim was to investigate age-dependent differences in these associations. Serum CRP, IL-6, and YKL-40 were measured preoperatively and on the first and second day after resection of CRC (stages I–III) in 210 older (≥70 years) and 191 younger patients (<70 years). The results from the complications was presented as an odds ratio (OR, with a 95% confidence interval (CI)) with logistic regression. Results from the mortality rates were presented as a hazard ratio (HR, with a 95% CI) using Cox proportional hazards regression. The preoperative inflammatory biomarkers were higher in the older vs. the younger patients. The risk of complications was increased in older patients with a high preoperative CRP (OR = 1.25, 95% CI 1.03–1.53), IL-6 (OR = 1.57, 95% CI 1.18–2.08), and YKL-40 (OR = 1.66, 95% CI 1.20–2.28), but not in younger patients. Mortality was higher in younger patients with high preoperative YKL-40 (HR = 1.66, 95% CI 1.06–2.60). This was not found in older patients. Elevated preoperative inflammatory biomarkers among older patients were associated with an increased risk of complications, but not mortality. Preoperative inflammatory biomarkers may be useful in assessing the risk of a complicated surgical course in older patients with CRC.

Background: Sparse evidence exists regarding the feasibility and patients’ experiences of exercise programs among older cancer populations. Objective: The aim of this study was to explore the experiences of older patients with advanced cancer who participated in a 12-week supervised and multimodal exercise program in a hospital setting. Methods: Individual interviews were conducted with 18 participants (≥65 years) with advanced cancer who completed the intervention program regardless of compliance rate. In addition, written evaluation questionnaires were collected. Data were analyzed using thematic analysis. Results: Three main themes were identified: (1) Motivated to strengthen body and mind, with the subthemes “Doing what only I can do” and “Reaching goals with support from healthcare professionals and peers”; (2) Exercise as an integrated part of the treatment course; and (3) Overcoming undeniable physical limitations. Conclusions: The participants experienced several benefits from participation, including physical improvements, increased energy, reduction of symptoms, and improved social engagement. Goal setting, being positively pushed and cheered on, and integration of fun games increased motivation. In contrast, being pushed beyond physical limitations and experiencing severe symptoms were experienced as barriers toward exercising. Adherence to the exercise program was facilitated by coordinating a tailored program with medical appointments and receiving comprehensive support and guidance. Implications for Practice: Multimodal exercise programs seem to be beneficial for older patients with advanced cancer and should be coordinated with oncological treatment in combination with targeted support and advice on symptom management.