Feasibility of a Geriatric Oncology Longitudinal End to End (GOLDEN) Program in a Tertiary Cancer Center in Singapore

Sep 24, 2026

Upload by Eliana

In the National University Cancer Institute, Singapore (NCIS), two pilot services—surgical prehabilitation before cancer surgery and geriatric oncology support for older adults receiving chemotherapy and/or radiotherapy—were merged in 2019 to form the Geriatric Oncology Longitudinal End to eNd (GOLDEN) program. Patients aged ≥65 underwent geriatric assessment and were evaluated for changes to treatment plans and effects on patient outcomes. Over 2 years, 777 patients were enrolled and program-based recommendations led to plan changes, with most participants reporting improvement or benefit.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

Abstract

Introduction

Methods and Materials

Results

Conclusion

Implications for Practice

Received and Accepted

Introduction

Background and Rationale

Feasibility of a Geriatric Oncology Longitudinal End to End (GOLDEN) Program in a Tertiary Cancer Center in Singapore Francis Ho1, Alfred Kow2, Wan Chin Lim2, Matthew Zhixuan Chen3, Nydia Camelia Mohd Rais4, Natalie Mun Wai Ling3, Melissa Ooi5, Jing Yu Ng6, Yean Shin Ng5, Meiling Chun6,Yao Yao7, Noorhanah Mohd Said8, Wan Nghee Eng8, Wen Meei Chen9, Vivian Luah10, Yijun Loy11, Jiexin Ong11, Wei Yee Wong12, Beatriz Korc-Grodzicki13, Stuart M. Lichtman14, Angela Pang5,*, 1Department of Radiation Oncology, National University Cancer Institute, Singapore 2Department of Surgery, National University Hospital, Singapore 3Division of Geriatric Medicine, Department of Medicine, National University Hospital, Singapore 4Division of Geriatric Medicine, Department of Medicine, Ng Teng Fong General Hospital, Singapore 5Department of Haematology-Oncology, National University Cancer Institute, Singapore 6Department of Surgery, Ng Teng Fong General Hospital, Singapore 7Department of Pharmacy, National University Hospital, Singapore 8Department of Oncology Nursing, National University Cancer Institute, Singapore 9Department of Nursing, Ng Teng Fong General Hospital, Singapore 10Department of Medical Social Work, National University Hospital, Singapore 11Department of Rehabilitation, National University Hospital, Singapore 12Department of Dietetics, National University Hospital, Singapore 13Department of Geriatrics, Memorial Sloan Kettering Cancer Center, New York, NY, USA 14Memorial Sloan Kettering Cancer Center, Commack, NY, USA * Corresponding author: Angela Pang, MBBS, MRCP, Mmed, Department of Haematology-Oncology, National University Cancer Institute, Singapore (NCIS), Tower Block Level 7, 1E Kent Ridge Road, Singapore 119228. Email: [angelapang81@gmail.com](angelapang81@gmail.com); Abstract Introduction: In the National University Cancer Institute, Singapore (NCIS), 2 pilot programs providing (i) surgical prehabilitation before cancer surgery and (ii) geriatric oncology support for older adults planned for chemotherapy and/or radiotherapy were merged to form the Geriatric Oncology Longitudinal End to eNd (GOLDEN) program in 2019 to support patients from the time of their cancer diagnosis, through their treatment process, to cancer survivorship. Methods and Materials: Older adults aged ≥65 years were enrolled in either surgical prehabilitation, the geriatric medical oncology (GO) arm, or both. All patients undergo a geriatric assessment. We assessed if patients had a change in treatment plans based on GOLDEN recommendations, and the impact on patient related outcomes. Results: There were 777 patients enrolled in the GOLDEN program over 2 years; 569 (73%) were enrolled in surgical prehabilitation, 308 (40%) were enrolled in the GO arm, with 100 (12 .8%) enrolled in both. 56.9% were females. Median age was 73. Lower gastrointestinal (51.2%) and hepatobiliary cancers (24 . 1%) were the most common cancer types. 43.4% were pre-frail and 11.7% were frail. Of the 308 patients in the GO arm, 86.0% had geriatric syndromes, while 60.7% had a change in their treatment plans based on GOLDEN recommendations. 31.5% reported an improved global health status, while 38.3% maintained their global health status. 226 (73%) responded that they had benefited from the GOLDEN. Conclusion: More than half of the population was either pre-frail or frail. Amongst those in the GO arm, the majority had geriatric syndromesand had a change in their treatment plans based on GOLDEN recommendations. Majority reported either improvement or maintenance in global health status, with most feeling they have benefited from the program. Further evaluation of the longitudinal geriatric hematology-oncology program for cancer-related outcomes and sustainability should be carried out. Key words: Geriatric Oncology Longitudinal Program; older adults with cancer. Implications for Practice This article reports the evolution of the GOLDEN geriatric hematology o

FAQs

What is the GOLDEN program and why was it created?

The GOLDEN program was created by merging surgical prehabilitation and geriatric oncology support to help older adults from diagnosis through treatment to survivorship, addressing complex oncologic and geriatric care needs.

How were patients included and what assessments were performed?

Older adults aged ≥65 were enrolled in surgical prehabilitation, the geriatric medical oncology (GO) arm, or both, and all patients underwent a geriatric assessment.

What were the key findings on treatment plan changes and patient outcomes?

Many patients had geriatric syndromes and a substantial proportion reported changes in treatment plans based on GOLDEN recommendations, with most reporting improvement, maintenance of global health status, and perceived benefit from the program.

Sep 24, 2026

Upload by Eliana