Structured care pathways in geriatric oncology

Cindy Kenis is a clinical nurse specialist in geriatric oncology at the University Hospitals of Leuven and served as co-chair of the Scientific Committee of the annual conference of the SIOG held in Ghent. She summarised the plenary session that focused on structured care pathways in geriatric oncology and highlighted the increasingly central role of nurses in the care of older adults with cancer.

A key message emerging from the plenary session was the recognition of nurses as leaders in the management of older patients with cancer. Population aging has led to a steady increase in cancer diagnoses among older adults, many of whom present with multimorbidity, polypharmacy, and varying degrees of vulnerability or frailty. These characteristics are often dynamic, requiring frequent reassessment, timely interventions, and close coordination of care. Nurses are uniquely positioned to address these needs. Advanced practice nurses and clinical nurse specialists are now leading geriatric screening, comprehensive assessment, and management processes, thereby contributing directly to treatment decision-making for older patients with cancer. The systematic use of geriatric screening tools and assessment instruments in nursing practice improves the identification of health-related problems, functional limitations, and supportive care needs. Because nurses accompany patients throughout the entire cancer trajectory—from diagnosis and active treatment to survivorship or end-of-life care—they are well placed to detect subtle clinical changes that may have significant consequences for outcomes and quality of life.

The plenary session presented several international examples of innovative, nurse-led geriatric oncology care models. These structured care pathways address the multidimensional needs of older adults with cancer and have demonstrated measurable benefits. Reported outcomes include earlier identification of geriatric syndromes, increased implementation of geriatric interventions, improved alignment of cancer treatments with patient goals and preferences, enhanced communication between healthcare professionals and patients, and greater opportunities for shared decision-making. Additionally, these models have been associated with reductions in emergency department visits, shorter hospital stays, lower treatment-related toxicity, and improved support for informal caregivers.

Despite these positive outcomes, several challenges related to implementation were identified. The translation of theoretical principles into daily clinical practice remains complex and cannot be achieved in isolation. Successful implementation requires collaboration among motivated and like-minded colleagues, ongoing awareness-raising among patients and healthcare professionals regarding the value of geriatric screening and management, and strong institutional support. Hospital leadership engagement and the availability of well-designed electronic patient tracking systems were identified as critical facilitators for effective communication and care coordination.

Although the evidence supporting nurse-led geriatric oncology models is robust, consistent and thoughtful implementation remains necessary. Continued investment in specialised education and training for oncology nurses, formal recognition and support of advanced nursing roles, and greater involvement of nurses in research and clinical trials are essential steps forward.