Recently, health authorities and politicians have begun to recognize the healthcare impact of an ageing population, with its profound consequences for health and for the quality, cost and outcome of healthcare services. It has now become an urgent matter to address the needs of older cancer patients in Europe. In cancer medicine, the situation was anticipated over 25 years ago. Yancik and colleagues1 showed how ageing and cancer incidence were linked, because time is required to allow cancer to develop. They broadly predicted today's situation in Europe. However, limited attention was paid to the subject of cancer and ageing. Cancer specialists continued to concentrate more specifically on developing local and systemic therapies, whereas geriatricians emphasized the global care and functional capacity of the older patient. To remedy this situation, individuals and organizations in Europe and internationally have set out to bring the different specialities together, to establish programmes of research, and to disseminate their findings and educate healthcare professionals of all disciplines, as well as healthcare services managers and political leaders.
In this chapter, we summarize the work of three organizations that are having a positive impact, and describe the notable efforts of one country as an example.
The International Society of Geriatric Oncology (SIOG)
At the beginning of the 1990s, after a conference held in Italy, a group of medical oncologists gathered in Paris to plan regular meetings on the subject of cancers occurring in older people. For strategic reasons linked to the development of the US Senior Adult Cancer Program, the first scientific meeting on geriatric oncology was organized in the USA.2 Other meetings have followed every year on alternate sides of the Atlantic and have emphasized the need to properly assess not only the cancer but also the broad clinical, functions and holistic impact of the disease on the patient. Multidimensional geriatric assessment, evaluating the function and functional reserves of an individual, became the cornerstone of geriatric oncology.
In 2000, the International Society of Geriatric Oncology (SIOG) was founded under Swiss law (www.siog.org). Since then, every effort has been made to bring together people and specialities that focus on caring for an ageing population and are concerned about cancer incidence, diagnosis and management, and all aspects of cancer care. Health professionals attending SIOG annual meetings can thus teach and learn about all aspects of the problems and challenges encountered by older patients confronted with cancer, including physical, psychological, social and spiritual domains. As a scientific body, SIOG's current strategy includes supporting research, but without a direct sponsorship role, promoting education, promoting career development and expanding internationally. This is embodied in the SIOG 10 priorities initiative.3
Besides its annual meeting, SIOG has produced numerous clinical guidelines on the most pertinent subjects of cancer care in older people, which have been published in peer-reviewed journals including its own official publication, ...