Skip to main content

 

 On November 19, 2021, UNC Lineberger Cancer Network will be hosting this year’s Geriatric Oncology Research Symposium online! We are excited to hear research updates and a variety of topics on the oncology care of the geriatric community. The symposium will include over 20 speakers and allow for interactive audience participation. Leading and moderating the symposium are Drs. Jan Busby-Whitehead, MD, Hy Muss, MD, and Kirsten Nyrop, PhD.  

To prepare for the event, we asked them a series of questions to gain some insight into the symposium and their work. 

 Dr. Nyrop, tell us about this symposium?  

We hold this symposium annually. It is open to the public as well as people within UNC or UNC Healthcare. We really enjoy the in-person conferences, but the “Zoom” format has also worked very well. 

 What are some of the important points or overall themes you would like highlighted during the symposium?  

One exciting theme is the “biomarker of aging” p16INKA4a which was first identified by Dr. Ned Sharpless, current director of the national cancer institute and former director of the UNC Lineberger comprehensive cancer center. Dr. Muss has continued this line of research in women with breast cancer and has brought other investigators into this area of research. Another thing we hope to highlight is the range of investigators, from current medical students to internal medicine residents, fellows, and faculty. It is exciting to see a new generation of researchers interested in “geriatric oncology”. 

 When it comes to cancer treatment for geriatric patients, is it the one-size-fits-all approach? 

 This is an important area of research because older people are generally under-represented in clinical trials. We now know that chronological age is less informative than “functional” age, as assessed through geriatric assessment. Many older people are very “robust” and able to benefit from state-of-the-art treatment, while others under age 65 are actually “frail” or “pre-frail”. This is why it is important for the clinician to go beyond age in determining the best course of treatment for the individual patient. 

 How has conducting comprehensive geriatric assessments helped older oncology patients? 

The pioneering work of Dr. Arti Hurria and others has shown again and again that older patient “fitness” for standard of care treatment can best be determined through a brief geriatric assessment. Her research opened the door for older patients to be considered for and benefit from a wider range of treatment options. 

 With the senior population increasing, will the number of older adults receiving a cancer diagnosis increase? If yes, why?  

Cancer is a disease of aging, with a median age at diagnosis of 66 (55% of newly diagnosed are age 65 or older). As the proportion of persons age 65+ (currently 16% in the u.s. and even higher in states such as Maine 21%, Florida 21%, West Virginia 20.5%, Vermont 20%) (expected to rise to 22% by 2050) increases in the U.S. population, there will be an ever-increasing proportion of older persons among people newly diagnosed with cancer. 

 What are some unique obstacles older oncology patients encounter that younger oncology patients may not?  

They often have multiple comorbidities, which may limit treatment options to the extent they are not well-managed. Many elderly persons are also dependent on others for transportation to the clinic or hospital where they receive chemotherapy or radiation treatment. And, many live alone and are socially isolated, which can impair their ability to take medications as directed or maintain a healthy diet. 

 How important are the considerations for preserving function and quality of life in the decision-making process of oncology care?  

Thanks to the “patient-reported outcomes” research of Dr. Ethan Basch and others, the FDA now includes “function” as an important outcome — along with safety and efficacy — in clinical trials. The same is true for patient care — the function and quality of life during treatment and after is important to the overall quality of care and patient satisfaction. 

 And finally, I wanted to ask a couple of personal questions to each of you. What initially led you to choose this patient population to study and serve? 

Dr. Busby-Whitehead: 

I have a strong family history for cancer.  My mother had breast cancer at the age of 30.  She underwent the standard surgical treatment at that time and fortunately survived to age 76 when she developed pancreatic cancer. Her experiences were influential in directing my interest in cancer diagnosis and treatment. 

Dr. Nyrop: 

My father developed prostate cancer when he was age 73 and his experience with a cancer diagnosis and treatment influenced my interest in this area of health services research. I had the very great fortune of meeting Dr. Muss shortly after I completed my “late-life PhD” and the rest is history. 

Dr. Muss: 

I got interested in this due to one of my great mentors, William Hazzard MD, who was one of the country’s pioneering geriatricians and who was my chief of medicine when I was at Wake Forest. He got me interested in a project in breast cancer in older women, and after that, I realized how much I enjoyed caring for older patients, and as important, how little we knew about treating them. That’s the goal of our program. 

 What are some of the most rewarding aspects of working with this population? 

 Dr. Busby-Whitehead: 

 Interacting with older patients is truly rewarding, as they share their amazing life stories and experiences. As a geriatrician, I feel privileged to work with them and share their care with our wonderful UNC oncology teams.   

 Dr. Nyrop: 

 Working with Dr. Muss and other oncology clinicians at UNC, getting to interact with the wonderful patients who agree to participate in our studies and collaborating with colleagues across many disciplines in writing manuscripts and grant applications as been very rewarding. 

 Is there anything else you’d like to share that I haven’t asked you? 

 Dr. Busby-Whitehead: 

 Dr. Muss has done a great job of building the Geriatric Oncology program, and I appreciate the opportunity to work with him and Dr. Nyrop. 

 We want to thank each of you for participating in this interview and for the work you are doing for the geriatric community! 

 Please join us at the Symposium:   Register for free 

Schedule and topics:    Agenda