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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




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


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



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



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.