Addressing cancer survivorship needs in geriatric survivors: Feasibility of a primary care–based survivorship clinic.

person Maya Kavita Ramachandran Stanford Health Care, Palo Alto, CA info_outline Maya Kavita Ramachandran, Natasha Steele, Jennifer Kim, Lidia Schapira, Ilana Yurkiewicz

Authors person Maya Kavita Ramachandran Stanford Health Care, Palo Alto, CA info_outline Maya Kavita Ramachandran, Natasha Steele, Jennifer Kim, Lidia Schapira, Ilana Yurkiewicz Organizations Stanford Health Care, Palo Alto, CA, Stanford Comprehensive Cancer Institute, Palo Alto, CA Abstract Disclosures Research Funding No funding sources reported Background: The largest segment of the growing population of cancer survivors is at least 65 years of age, a population that is likely to have comorbidities and requires co-management between primary care and specialist physicians. The goal of this study was to characterize care for this patient population in a specialized primary care for cancer survivorship clinic that manages survivorship issues and ongoing primary care in one place. Methods: This study collected demographic and clinical data via electronic chart review of patients aged 65 and over who established care in the Primary Care for Cancer Survivorship clinic at an academic center from November 1, 2021 through November 30, 2023. Results: Out of 228 total patients who established primary care in the clinic, 63 patients were over the age of 65. The mean age of the group was 73, with the range 65 to 90. Seventy-three percent of patients were female, and 27% were male. The most common cancers were breast (38%), lung (10%), leukemia (13%), lymphoma (8%), prostate (8%), and multiple myeloma (6%). Twenty-five patients (40%) had active disease, 37 patients (58%) were post-treatment, and 1 patient was a “previvor” with Li-Fraumeni syndrome. Cancer surveillance was discussed with 81% of patients, and 2 patients (5% of post-treatment patients) were diagnosed with recurrent cancer. Secondary cancer screening was performed in 86% of patients, with no secondary cancers diagnosed. The most common referral sources were medical oncology from the same institution (40%), self-referrals (25%), and hematology (13%). The average number of visits per year was 2.8 with 61% in person and 29% via video. Cardiovascular risk was addressed in 98% of patients; 32% had at least one cardiovascular medication started and 17% were referred to a cardiologist for management. Long term and late effects were addressed in 84% of patients, including mental health (70%), bone health (65%), cognitive function (21%), cancer-related fatigue (13%), and sexual health (11%). Ten percent had end-of-life issues or goals of care addressed. Conclusions: This study demonstrates the feasibility of a primary care-based cancer survivorship clinic to address the ongoing needs of geriatric cancer survivors. Quality review of these patient encounters can identify gaps in care delivery and inform new models of comprehensive care for the growing geriatric cancer survivor population. Geriatric survivor patient characteristics. Total Patients N=63 (%) Female 46 (73%) Cancer surveillance addressed 51 (81%) Secondary cancer screening 54 (86%) Cardiovascular risk addressed 62 (98%) Mental health addressed 44 (70%) Bone health addressed 41 (65%) Cognitive function addressed 13 (21%) Cancer-related fatigue addressed 8 (13%) Advanced care planning addressed 6 (10%)