Loneliness in Older Adults with Cancer: A Silent Clinical Challenge

As populations age, oncology is increasingly confronted with the complex needs of older patients. Beyond the biological and therapeutic challenges of cancer, psychosocial factors—particularly loneliness—are emerging as critical determinants of health outcomes. Yet loneliness remains insufficiently recognised and rarely addressed systematically in geriatric oncology.

A recent international consensus from the Multinational Association of Supportive Care in Cancer (MASCC) Geriatrics Study Group aims to close this gap by providing a framework for defining, assessing, and managing loneliness in older adults with cancer.

Recognising loneliness as a multidimensional clinical issue, the expert panel recommends integrating its assessment into routine cancer care. Screening should ideally begin at the time of cancer diagnosis, when patients often face major emotional and social disruptions. Importantly, the responsibility for detecting loneliness should not fall on a single professional group: oncologists, nurses, psychologists, social workers, and palliative care specialists all have a role in identifying and addressing psychosocial distress.

When it comes to interventions, the consensus strongly favors human-centered and community-based strategies. Support groups, psychological counselling, home visits, and programs that promote social engagement or physical activity were identified as particularly promising. In contrast, purely technology-driven approaches—while potentially useful—should be implemented cautiously, as they may not fully address the relational nature of loneliness, especially among older adults.

Another important dimension is health equity. Experts identified older adults living in poverty or in rural and remote areas as particularly vulnerable to loneliness. Structural barriers such as limited access to healthcare, transportation difficulties, and reduced community resources can exacerbate isolation and complicate cancer care.

Ultimately, the consensus highlights the need to embed social connection into the fabric of oncology care. As cancer increasingly becomes a chronic condition managed over years, addressing the emotional and relational needs of older adults will be essential to delivering truly patient-centered care.