Princes Alexandra Hospital model of comprehensive geriatric assessment of cancer patients: Methodological and practical aspects

There is increasing momentum in oncology to implement a two stage assessment process that accurately determines the ability of older patients to cope with, and benefit from, chemotherapy for cancer. The two-step approach aims to ensure that patients clearly fit for chemotherapy can be accurately identified and referred for treatment without undergoing a time and resource intensive Comprehensive Geriatric Assessment. Ideally, a two-step process removes the uncertainty of how to classify and then appropriately treat the older cancer patient. After trialing a two-stage screen and Comprehensive Geriatric Assessment process in the Division of Cancer Services at Princess Alexandra Hospital in 2011-12, a model of oncogeriatric care was implemented based on the findings. In this paper, the methodological and practical aspects of implementing the Princess Alexandra Hospital model are explored and further work needed to refine the process is outlined.