Saint-Luc geriatric oncology care pathway

Dr Frank Cornelis, medical oncologist at Saint-Luc University Hospital with a clinical focus on geriatric oncology presented a structured geriatric oncology care pathway that has been implemented for older adults with cancer at his institution.

Within this pathway, all patients aged 70 years or older with a cancer diagnosis undergo, in parallel, a standard oncological workup and a geriatric evaluation. The oncological trajectory includes diagnostic procedures, disease staging, discussion at a multidisciplinary oncological tumor board, and formulation of a proposed cancer treatment plan. In parallel, the geriatric assessment follows a two-step approach. Initial screening is performed using the G8 tool by either the oncological care coordinator or the treating oncologist. Patients with an abnormal G8 score subsequently undergo a comprehensive geriatric assessment conducted by trained geriatric nurses.

The results of both evaluations are discussed in a weekly multidisciplinary geriatric oncology meeting attended by medical oncologists, geriatricians, geriatric nurses, and other healthcare professionals as needed. The objective of this meeting is to develop a personalised oncogeriatric care plan, which is documented in a formal report. This report is communicated to the patient’s general practitioner and cancer specialist and is made accessible within the electronic medical record.

The care plan comprises two components: recommendations regarding potential adaptation of the proposed oncological treatment and a set of tailored geriatric interventions formulated in collaboration with geriatric specialists. Based on institutional experience, approximately 20% of patients undergo modification of their oncological treatment following this multidisciplinary discussion. Implementation of the oncogeriatric care plan is actively coordinated by geriatric nurses, who liaise with involved healthcare providers, including general practitioners, and ensure structured follow-up.

On average, four geriatric interventions are recommended per patient, with approximately 3.5 interventions effectively implemented. Overall, this structured oncogeriatric pathway fosters close interdisciplinary collaboration and enables a high level of both recommendation and execution of geriatric interventions in older patients with cancer.