The Oncogeriatrics program at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James) is setting new standards in cancer care for older adults and helping physicians understand how age-related factors impact quality of life and treatment outcomes. Patients benefit from multidisciplinary care at the Cancer and Aging Resiliency (CARE) clinic, which offers coordinated care with a team of specialists.
“When patients are diagnosed with cancer, physicians traditionally focus on the cancer itself, including the staging, indicated treatments and potential toxicities,” says Ashley Rosko, MD, CARE Clinic co-director and medical director of the Oncogeriatrics program at the OSUCCC – James. “But for older adults, there are many physical, cognitive and support issues that are often overlooked due to time limitations, even though they’re an equally important part of overall health.”
Established in 2016, the OSUCCC – James’ CARE Clinic provides a convenient, “one-stop” experience for older adults living with cancer. During a single visit, patients see a pharmacist, physical therapist, nutritionist, audiologist, nurse case manager, a nurse specializing in cognitive assessment and a hematologist/oncologist or geriatrician/palliative care physician.
“We want to simplify the process for our patients,” Dr. Rosko says. “They remain in the same room, and care providers are the ones who rotate from room to room, asking questions specific to our own specialty so that patients don’t have to retell the same health facts over and over. At the conclusion of each visit, the entire team meets to compare findings and refine an all-inclusive treatment and follow-up plan.”
Clinicians in the CARE Clinic evaluate patients with geriatric assessment tools that score their overall fitness for tolerating intense or lengthy treatments. Factors include:
- Function and fall risk
- Geriatric syndromes: fatigue, frailty and insomnia
- Sensory loss
- Memory impairment
- Social support
- Psychologic state
The CARE clinic is available to any OSUCCC – James patient, but it’s also accessible with a physician referral from other cancer centers or even for virtual consultation, which is offered once a month.
“Our goal is to optimize each patient’s quality of life and to work in tandem with primary oncologists,” Dr. Rosko explains. “We want to identify and address potential health risks proactively. We also coordinate everything to simplify the process for both the patient and the referring physician. If medical equipment is recommended, we’ll handle its acquisition. If we suggest physical therapy, we’ll find a therapist in the patient’s own local community. We even have a sound booth on-site to support testing with audiologists, and a case manager can help with transportation, home safety, food insecurity, financial concerns or any other issues that might impact treatment access.”
A similar clinic specific to patients with breast cancer is available through the OSUCCC – James’ Stefanie Spielman Comprehensive Breast Center.
Another important aspect of the OSUCCC – James’ Oncogeriatrics program is cancer and aging research.
“We believe both our basic science and health outcome research are key to improving survival rates and treatment options—which, for cancer, are generally quite aggressive and difficult for older adults to tolerate,” Dr. Rosko explains. “Importantly, in both our CARE Clinic and in our research, we focus on biologic age, instead of chronological age, because it is a better predictor of a patient’s resilience and provides a more appropriate basis for planning treatment.”
To support physician education related to older adult care, Ohio State Wexner Medical Center also offers a Grand Rounds geriatric series. And, developed in cooperation with the Office of Geriatrics and Interprofessional Aging Studies, an online platform provides learning modules that address many facets of aging, including oncogeriatrics, falls and frailty, caring for the aging LBGTQ population, alternative therapies, sexuality and more.
To initiate a referral for the CARE Clinic or schedule a telehealth option, please call 614-685-0050 to make an appointment. For breast cancer patients, the Breast CARE Clinic can be reached at 614-293-0066.