Bringing Two Worlds Together: Oncology and Geriatrics

SIOGKwok Leung Cheung is a Clinical Associate Professor at the University of Nottingham and Honorary Consultant Breast Surgeon at Derby Hospitals. In this blog, he discusses his ongoing work in geriatric oncology.

The 14th Conference of the International Society of Geriatric Oncology (SIOG) was held in October 2014 in Lisbon, celebrating SIOG’s mission by bringing together multidisciplinary experts in cancer and ageing via its annual conference theme, ‘Bringing Two Worlds Together: Oncology and Geriatrics’.  For more than a decade, geriatric oncology has been emerging across the globe as a discipline aiming to improve the care for older adults with cancer.  The majority of cancers occur in the older population which is also rapidly expanding.  Attention should now be paid not just to cancer biology and treatments, but also the holistic needs of the older population, which have been well known to you all in the field of geriatrics.  Unfortunately, involvement of geriatricians in the care of cancer patients remains patchy in the world.  In the UK, oncology practice remains predominantly tumour site based with little focussed interest in geriatric oncology.  The use of geriatric assessments and involvement of geriatricians in the multidisciplinary team management of cancer patients are almost unheard of.

As the UK National Representative of SIOG, I would like to work with you as the UK specialty association in geriatrics to enhance the link between these two ‘worlds’ in the UK.  Furthermore, it would be extremely helpful if SIOG has a stronger membership from the discipline of geriatrics so please consider joining the society, which will allow you to exchange ideas and further the mission with an international effort.  Please visit www.siog.org for details.

Alongside the above mission, I have a personal vision to optimise the care of older women with primary breast cancer, given my subspecialty interest as a breast surgeon.  To that end, I am hosting, on behalf of the University of Nottingham, under the auspices of SIOG, the Third Symposium on Primary Breast Cancer in Older Women on 6th March 2015 at East Midlands Conference Centre.  Dr Etienne Brain, SIOG’s President, will be part of the faculty.  For abstract submission, registration and further details, please visit www.nottingham.ac.uk/medicine/breastmeetings

I look forward to working with you!  If you have any queries or ideas that you would like to discuss, please contact me via kl.cheung@nottingham.ac.uk

November issue of Age and Ageing journal out now

The November 2014 issue of Age and Ageing, the journal of the British Geriatrics Society is out now.

A full table of contents is available here, with editorials, research papers, reviews, short reports, case reports book reviews and more. Hot topics this issue include:

  • Guidelines for management of frailty
  • Systematic review on sarcopaenia
  • Inappropriate drug use in older people
  • Co-morbidities in dementia
  • Cost-effectiveness of telecare

The Editor’s View can be read here.

This issue’s free access papers are:

Dysphagia Awareness Campaign

Olivia Hallam, Rosa Holden and Joanne White are third year Speech and Language Therapy students from De Montfort University. Here they explain their participation in a campaign to increase awareness of dysphagia.

 

We will be spending five days following a sponsored ‘modified diet’ to raise awareness of swallowing difficulties (dysphagia). This means that we will only be eating ‘soft consistency’ foods (mainly purée, with added examples of a fork-mashable diet) and drinking thickened fluids (to Stage 1, Syrup consistency). . This is because, as speech and language therapists, we often work with people with dysphagia and have realised that both the level awareness and availability of resources are low.

 

See our short promotional video here where we explain more:

https://www.youtube.com/watch?v=x0dQo9kUXbg Continue reading

Curiouser and curiouser: the changing numbers in dementia diagnosis

ZPrS_Z4mTom Dening is Professor of Dementia Research at the Institute of Mental Health at the University of Nottingham. He tweets at @TomDening

Dementia is getting more common as the population of the UK and, for that matter, the world gets older. But just how common? How many people are out there? It’s a really important question for us all.

There have been some interesting developments over the last year. Until then, the official figure was 800,000 in the UK. This was based on projections from the MRC Cognitive Functioning and Ageing Study (CFAS), data that were collected during the 1990s, and updated based on the demographic profile of the elderly population since then. So this figure was based on numbers around 20 years old.

Therefore it was important to replicate the study and eventually CFAS II was funded and carried out. The team reported their findings in the Lancet last year. Continue reading

The NHS England Five Year Forward View: A crucial document for our speciality, for the care of older people and for Health and Care Services in England.

David Oliver is President of the BGS, Visiting Fellow at the King’s Fund and Consultant Geriatrician at the Royal Berkshire Hospital, Reading. In part 1 of a 2-part blog, he discusses how the NHS “Five Year Forward View” is important for people involved in the care of older people.

October 23rd 2014 is memorable to me, as it’s my 23rd wedding anniversary. It’s also now of significance to the rest of us, as the date that NHS England’s “Five Year Forward View” plan was published. I realise not many of you will have had the time or necessarily inclination to read it, though at only 39 pages it’s an easy canter.

I also know it hasn’t attracted much Twitter activity from fellow BGS members. But it’s a document which I suspect will have far reaching influence and implications for the services we all work in. These implications seem largely positive. Let me explain why.

Continue reading

 Will volunteer success deliver the elusive Holy Grail of PPI?

Liz Charalambous is a qualified nurse on a female, acute medical HCOP (Health Care for Older People) ward at Queen’s Medical Centre, Nottingham University Hospital Trust.

Having nursed in different areas for over 30 years, she currently balances her time between clinical work, research into the prevention of delirium and studying for a MSc. in Advanced Nursing at the University of Nottingham.

Here she discusses whether PPI (Patient and Public Involvement) can contribute to person-centred care. Liz tweets from @lizcharalambou

Recent media coverage highlights loneliness in the elderly population and how some organisations are taking steps to combat this, such as the ‘Be a friend’ campaign launched recently by Friends of the Elderly http://www.beafriendtoday.org.uk/ . Patients and relatives must breathe a sigh of relief that when their loved one is admitted into hospital, at least they will be surrounded by others and therefore not at risk of loneliness.

Unfortunately, this is not always the case. Despite NICE guidelines for Delirium (2010) https://www.nice.org.uk/guidance/cg103 and Dementia (2006) http://www.nice.org.uk/guidance/cg042 calling for the involvement of families, as well as the much-vaunted Holy Grail of PPI (Patient and Public Involvement) post Francis, many older people remain at risk of confusion and developing delirium purely by virtue of the fact they are over 65 years of age and clinically unwell. Staff are very often tied up with the clinical side, and rightly so. A blocked airway, arrhythmias, acute kidney injury and clinical deterioration remain a priority over holding someone’s hand. Continue reading

Writing, music and geriatric medicine

The Secret Life of a Geriatrician

 This new BGS blog series shows how passion for a career and extra-curricular activities can share fascinating qualities.

Desmond (Des) O’Neill is a geriatrician and cultural gerontologist in Dublin. He is also the local lead for the IAGG-ER Congress in 2015

 

Last week was even more fun than usual. In addition to my current day job in the Acute Medical Unit, I was involved with a concert of works by our composer-in-residence; my first time speaking at a book festival; a talk to emergency physicians on traffic medicine at IAEM 2014; sitting in on a cracking competition in geriatric medicine between Irish medical schools, the Jack Flanagan Prize; and attending a study day on architecture, design and medicine.

 

Working as a geriatrician is fun in general: it remains one of life’s mysteries to me that this seems counter-intuitive not only to the general public but also to some (albeit increasingly fewer) of our medical colleagues, especially since entry to training in geriatric medicine has become so highly competitive in Ireland.

Continue reading

Seeing The Whole Picture

The Secret Life of a Geriatrician

This new BGS blog series shows how passion for a career and hobby can share fascinating qualities.

Philip Braude is an ST6 in Geriatric Medicine, specialising in perioperative medicine

There is a flash of knowing and relief as I click the shutter capturing a distinctive moment of the natural world. I take a moment to flick on the camera’s display screen to reassure me that everything has gone to plan, or not, and I make corrections for the next picture. Creating a cohesive image from the complex order and behaviour of wildlife takes planning, patience and perseverance.

My passion for nature photography grew from a need to relax away from long general medical on-calls. Many twilight evenings I would use my camera as an excuse to roam London’s outer green spaces. However, my understanding of this art form has developed alongside my medical career.

Continue reading

Many older adults still homebound after 2011 Great East Japan Earthquake

A new study, published online in the journal Age and Ageing today, shows that the homebound status of adults over the age of 65 in the aftermath of the 2011 Great East Japan Earthquake is still a serious public health concern. Of 2,327 older adults surveyed, approximately 20% were found to be homebound.

A team of researchers led by Naoki Kondo of the University of Tokyo’s School of Public Health studied data from the city of Rikuzentakata, an area that was seriously damaged by the disaster. Of its total population of 23,302 before the events of 2011, 1,773 people died or are still missing. Of 7,730 houses, 3,368 (43.6%) were affected with 3,159 “completely destroyed”. Much of the population had been concentrated in flat coastal areas, and since the community infrastructure was totally shattered, many people who lost their houses insisted on moving to areas in the mountains. Continue reading

What I do is who I am – the importance of activity in care homes

Lorraine Bridges is the Senior Communications Manager at the College of Occupational Therapists. She tweets at @L_BridgesLivingWellThroughAcitivityinCareHomesToolkit

Occupational therapists help people to carry out essential occupations – the activities that make up our daily lives – from washing and dressing, the weekly shop, visiting friends and all the things we enjoy in life.  For older people occupations are vital for health, social inclusion, and mental wellbeing, but become more difficult due to increasing frailty. Geriatricians will be all too familiar with the serious risks of immobility.

The College of Occupational Therapists, like the British Geriatrics Society, firmly believes in equal access to health and social care and developed the Living Well Through Activity in Care Homes Toolkit to ensure that people living in care homes have the same access to occupational therapy as those living in their own home.  The resource is part of the College’s wider aim to champion dignity, choice, respect and control for older people, recognising occupational therapists’ unique skills in enabling occupation and understanding how dementia, co-morbidities, and other factors such as poor vision, impact on activity participation. Continue reading