What question did this study set out to answer?

Evaluate the feasibility and clinical utility of comprehensive geriatric assessment in older men undergoing androgen deprivation therapy for prostate cancer.

July 13, 2026Open Access

Feasibility a retrospective service evaluation

KBK BalachandranSt Bartholomew's Hospital SLS LightbodyGuy's and St Thomas' NHS Foundation Trust MBM BrennanGuy's and St Thomas' NHS Foundation Trust

Key Points

Evaluate the feasibility and clinical utility of comprehensive geriatric assessment in older men undergoing androgen deprivation therapy for prostate cancer.
Retrospective service evaluation of consecutive new patients aged 65+ starting ADT in a uro-oncology clinic over 6 months.
Assessment of referral patterns to a geriatric oncology clinic and interventions provided to referred patients.
Data collected on patient characteristics, CGA feasibility, effectiveness, and clinical utility.
45% of patients referred for CGA, with 100% of those receiving the assessment.
76.3% of referred patients had 4 or more long-term conditions, compared to 34.8% not referred.
Over 80% of referred patients underwent ADT toxicity screening and 55.3% had DEXA scanning; 188 additional interventions were implemented.

Abstract

Androgen Deprivation Therapy (ADT) is often a component of treatment for localised and advanced prostate cancer but carries multiple potential side-effects. We evaluated the feasibility of a clinical pathway delivering comprehensive geriatric assessment (CGA) for older men receiving ADT for prostate cancer, and its utility in targeting patients with multiple other long-term conditions. This retrospective service evaluation included consecutive new patients aged 65 + with prostate cancer of any stage, commencing ADT in a dedicated uro-oncology clinic in a 6-month period in 2021. The clinical referral pathway to a specialist geriatric oncology clinic for CGA was available for any of these patients who the nurses delivering the ADT initiation clinic considered would benefit. Patient characteristics were compared and for those referred to the pathway, outcome measures included feasibility, effectiveness in targeting medically complex patients, and clinical utility including ADT-specific assessments and other CGA interventions. Overall, 84 patients were seen in the ADT clinic during the evaluation period with a mean age of 73.4 years (SD 6.6). 45% were referred for CGA and of these, 100% received CGA. There were a greater number of patients with 4 + long-term conditions in the group referred for CGA (76.3%) vs. those who were not (34.8%). ADT toxicity screening (non-radiological) was performed in over 80% of the 38 patients referred for CGA, and DEXA scanning was completed in 55.3%. For the 38 patients who received CGA, 188 interventions unrelated to ADT were also implemented. Interventions were varied and tailored to a range of long-term conditions, which may not have been identified outside CGA. This service evaluation confirms the feasibility and utility of CGA performed in a specialist geriatric oncology clinic for older men commencing ADT for prostate cancer. To fully explore the impact of CGA on clinical outcomes (cancer-related and otherwise) for older men starting ADT, prospective studies are needed.

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