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A B S T R A C T S
S9
the developed world today. In this context, it is clear that
population aging of the kind that raises serious economic
and social issues in the more developed countries is not
such a distant in developing countries, the analysis of the
situation reveals many problems that make it more difficult
to care for an emerging aging population in which illiteracy,
poverty, and poor social and family support prevail and lead
to a poor self-care capacity. It is necessary to recognize that
the care for elderly cancer patients often requires more
time in scheduling, comprehensive management, strategies
and organization of the multidisciplinary team resources:
available resources must be organized according to the reality
of the center in which multidisciplinary geriatric oncology
approach is implemented.
Latin America countries need to assess the needs of the
older people, in particular their very basic needs—food,
health, housing, etc. In this perspective, they should define
long-term strategies to partially reorient public investment
efforts as well as training programs. Session will review those
topics, describing administrative and financial aspects in
geriatric oncology implementation in Latin America.
Disclosure of interest:
None declared
S26
PERSPECTIVES FROM ASIA—END-OF-LIFE ISSUES:
RESPECTING THE PATIENT’S DIGNITY AROUND THE WORLD
Lalit Krishna
Deputy Program Director, Duke-NUS Practice Course Year 2
(Professionalism and Ethics), Assistant Professor, Duke-NUS
Graduate Medical School Singapore, Assistant UG Curriculum
Director (Clinical), Centre of Biomedical Ethics at NUS, Palliative
Medicine, Singapore, Singapore
Grounded in new data from the geriatric oncology scene
in South East Asia, this 13-minute session will look at the
concepts of personhood in the elderly oncology patient and
the impact of psychosocial considerations upon respect for
dignity.
This session hopes to offer a wider understanding of
dignity from the perspective of the elderly oncology patient
in South East Asia and forward a number of considerations
that must be made in determining goals of care and end of
life care plans.
Disclosure of interest:
None declared
S27
ISSUES ON PAIN MANAGEMENT IN ELDERLY
Lalit Krishna
Deputy Program Director, Duke-NUS Practice Course Year 2
(Professionalism and Ethics), Assistant Professor, Duke-NUS
Graduate Medical School Singapore, Assistant UG Curriculum
Director (Clinical), Centre of Biomedical Ethics at NUS, Palliative
Medicine, Singapore, Singapore
This session moves beyond simply a discourse on means
of pain assessment and use of the WHO analgesic ladder to
the meaning of pain in the elderly. Drawing upon local South
East Asian data and experiences, this 12-minute discussion
will look upon the psychosocial aspects of pain management
in the elderly.
This session seeks to orientate participants to the wider
impact of assessing and treating pain in the elderly
Disclosure of interest:
None declared
S28
MULTIPLE MYELOMA
Alessandra Larocca
A. O. Città della Salute e della Scienza di Torino, P.O. Molinette,
Divisione Universitaria Ematologia 1, Torino, Italy
Multiple myeloma (MM) is a neoplastic disease of older
adults, with a higher incidence in elderly patients. The
annual prevalence of MM is approximately 31 cases per
100,000 people in patients aged 65–74 years, and it increases
to 46 cases per 100,000 people in patients aged
75 years.
Furthermore, the prevalence of myeloma is likely to increase
due to the extended survival and the growing life expectancy
of the general population.
Much progress has been made in the past few years
thanks to the introduction of new drugs. However, increases
in survival were much less pronounced in patients aged 60
to 69 years, and no improvement was seen in older patients.
Furthermore, the currently approved treatment regimens
were tested in clinical trials with stringent inclusion criteria.
Aging is associated with a high prevalence of frailty, that
is, a state of increased vulnerability to stressors due to a
critical decline in physiologic reserves. Elderly people may
be categorized as fit or frail according to clinical, functional
and cognitive criteria. The presence of frailty may complicate
the management and outcome of myeloma patients. To date,
the choice of treatment of myeloma patients has focused
primarily on chronological age and performance status as
markers of frailty. However, the elderly population is highly
heterogeneous, and improved assessment strategies are
needed to define the frailty profile of patients and provide
them with the most adequate treatment, thus avoiding the
overtreatment of frail patients and the undertreatment of
fit patients. The geriatric assessment (GA) is a fundamental
tool for the evaluation of cognitive and functional status.
Because a full comprehensive geriatric assessment is a time-
consuming procedure that is difficult to use in every day
clinical practice, a simplified GA that includes Activities of
daily living (ADL) scale, Instrumental ADL (IADL) scale, and
the Charlson Comorbidity Index (CCI), should be adopted for
elderly patients.ADL is used to screen for disability in self-care
tasks and IADL to explore tasks of household management.
Many prognostic indices for the elderly that incorporate age
and/or comorbidity are available. The Charlson co-morbidity
index is one of the most frequently used in cancer patients.