Medicine Matters in the Older Cancer Patient: Drug Interactions and Toxicities (#28)
Aging is an important risk factor for the development of cancer. In fact, it was reported that more than 60 % of new cancer cases and over 70 % of cancer deaths occur in patients aged 65 and older in developed countries. It is recognized that changes in pharmacokinetics and pharmacodynamics of anticancer therapy as a result of aging, together with polypharmacy, may lead to significant toxicities in the elderly. This is because anticancer drugs are inherently toxic, possess complex pharmacological profiles, and narrow therapeutic indices. Even minor changes in the pharmacokinetics or pharmacodynamics of a chemotherapy drug could substantially alter its efficacy or toxic effects. Moreover, many patients might also take self-prescribed over-the-counter drugs or complementary and alternative medicines. In this talk, we will discuss a common challenge that clinicians face when they manage elderly patients with cancer: management of drug-drug interactions and associated toxicities. In addition, at National Cancer Center Singapore, which is currently the largest cancer center in Singapore, a pharmacist-run medication therapy management (MTM) service was established since 2009. We will learn how the MTM service operates and how its introduction has improved pharmaceutical care in elderly cancer patients by resolving drug-related problems.