Older Adult Hematologic Malignancy (OHM) Program

Taking part in the Older Adult Hematologic Malignancy (OHM) Program is voluntary. If you are a patient aged 70 or older who comes to Dana-Farber Brigham Cancer Center for treatment of your blood cancer, you will be approached to take part in the program, beginning with a 10-20-minute assessment by our research assistant.

In addition, as a patient in the OHM Program:

• Depending on your assessment, you may be directly offered a follow-up appointment with a geriatrician.
• You may also be sent to one of our geriatricians by your oncologist.
• At a later date, you may be asked for an extra blood or bone marrow sample for us to send to our laboratory scientists, who study older patients with blood cancers.
• Importantly, you may decline participation in any aspect of the program at any time, and the decision not to participate will not affect your cancer care in any way.

Why might older patients need specialized services?

Patients age 70 and older are at higher risk for treatment complications — partly because they are likely to have other age-related illnesses, such as diabetes or high blood pressure. Including the expertise of a geriatrician in the treatment plan helps guide therapy decisions, minimizing side effects and enhancing the patient's overall quality of life. If you are an older adult, here are some reasons to consider this special type of care for your cancer:

• Cancer may behave differently in an older body than a younger one. Cancer cells tend to have more genetic damage in older patients, which can affect how they respond to treatment.
• Cancer may accompany other health issues that come with age, such as heart disease, high blood pressure or arthritis, so the risk of complications is greater.
• Your decisions about cancer treatment may be different at this stage of life than they would have been when you were younger.
• Your "functional age" may differ from your calendar age; you may have the activity level of a younger person or an older person, and your treatment should be tailored accordingly.
• You may need a treatment plan that includes physical therapy, home visits, or non-cancer medication management.

What are the treatment options for patients 70 or older?

These options include various types of chemotherapy, and enrollment in clinical trials. Another choice appropriate for some blood cancers is to monitor patients, and treat them when necessary with care directed at symptoms alone. In some cases, patients may choose to have supportive care only.

What benefits does the specialized OHM approach provide older patients and families?

We can offer more intensive treatments than older patients would be likely to receive in the community, based on their preferences and functional age, rather than their calendar age. With the help of Drs. Driver and Hshieh, we can also eliminate unnecessary or potentially harmful medications, and help organize exercise and physical therapy, home visits by caregivers, and medication management.