It’s easy to tell which oncology topics are hot and which are not here at the Multidisciplinary Cancer Congress in Stockholm. Metastatic breast cancer? Thousands of people pushing their way into the cavernous meeting hall.  Advanced non-small cell lung cancer? I practically had to bribe the doorman to let me in.  Geriatric oncology? (crickets chirping)  It was kind of lonely in the geriatric oncology meeting room, one that was a tiny fraction of the size of the main hall.

Yes, it’s difficult to study cancer therapies in elderly patients.  They may have  comorbidities and poor performance status.  They may have impaired cognition or be unsuitable candidates for surgery. They may be frail. Then again, they may be none of those things. In fact, they may be in better health than younger patients. As one oncologic surgeon put it, “chronologic age should not be a primary factor in the decision-making process” for cancer treatment in elderly patients.

What is clear is that we’re going to need lots of interest and research in geriatric oncology, now that the baby boomers are approaching old age. So far we have no good tools for separating the elderly patients who can handle more aggressive treatment from those who can’t.  We have little data on the effects of cancer treatments on elderly patients because they are typically excluded from trials. We don’t even have a clear definition of “elderly.”

The fact that we’re ill prepared to care for the growing population of elderly cancer patients  is the elephant in the room. Sadly, it’s a small room that’s pretty empty.