{"title":"Support roles, carer burden, and decision-making preferences of carers of older adults with cancer","authors":"Wing Sze Lindsay Chan , Vasi Naganathan , Abby Fyfe , Alina Mahmood , Arnav Nanda , Anne Warby , Duong Pham , Natalie Southi , Sarah Sutherland , Erin Moth","doi":"10.1016/j.jgo.2024.102079","DOIUrl":"10.1016/j.jgo.2024.102079","url":null,"abstract":"<div><h3>Introduction</h3><div>Older adults with cancer value the perspectives of significant others and their carers regarding decision-making about treatment. Understanding the support provided by carers, and their perspectives on involvement in treatment decision-making, can help us improve our communication with patients and their supports. We aimed to describe the roles, burden, and decision-making preferences of carers of older adults with cancer.</div></div><div><h3>Materials and Methods</h3><div>We performed a cross-sectional survey of carers of older adults (≥65y) with cancer at three centres in Sydney, Australia. Type, frequency, and perspectives on providing care were evaluated using Likert scales. Preferred and perceived role in treatment decision-making by modified Control Preferences Scale, and carer burden by Zarit Burden Index (ZBI-12), were evaluated. Preferred role in decision-making and carer burden were compared between groups (culturally and linguistically diverse backgrounds [CALD], sex, and carer age ≥ 65) by chi-squared or <em>t</em>-tests.</div></div><div><h3>Results</h3><div>One-hundred and fourteen returned surveys were included (23 partially completed). Carer characteristics: median age 55y (range 24–90), female (74 %), child (49 %) and spouse (35 %) of the care-recipient. Care-recipient characteristics: median age 75y (range 65–96), receiving anti-cancer treatment (85 %), and CALD background (44 %). Carers were frequently involved in communication and information gathering (45 % -80 %) and supported instrumental activities of daily living (IADLs) (43 % - 81 %) more frequently than basic activities of daily living (ADLs) (2–13 %). Most (91 %) preferred to be present when treatment options were discussed. Their preferred role in treatment decision-making was passive in 66 %, collaborative in 30 %, and active in 4 %, with most (72 %) playing their preferred role. The preferred role was associated with carer age (<em>p</em> = 0.01) and CALD background (<em>p</em> = 0.04), with younger (<65y) carers and those caring for CALD older adults preferring a more passive role. Carer burden was ‘low’ in 29 %, ‘moderate’ in 31 %, and ‘high’ in 39 %, and providing psychological support was rated most challenging.</div></div><div><h3>Discussion</h3><div>Carers of older adults with cancer play varied support roles, particularly in communication and information gathering. Carers prefer to be present for discussions about treatment options, though favour a passive role in treatment decision-making, upholding patient autonomy. Understanding the communication preferences of carers is an important consideration when supporting the patient in deciding treatment options and direction of care.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"15 8","pages":"Article 102079"},"PeriodicalIF":3.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sebastian Kang , Sally Allen , Amy Brown , Dinuka Ariyarathna , Sabe Sabesan , Corinne Ryan , Suresh Varma , Zulfiquer Otty , Abhishek Joshi , Shivanshan Pathmanathan
{"title":"Providing early access to geriatric oncology services in a regional cancer centre – A two-year experience in the establishment of a Geriatric Oncology Nurse Navigator Model","authors":"Sebastian Kang , Sally Allen , Amy Brown , Dinuka Ariyarathna , Sabe Sabesan , Corinne Ryan , Suresh Varma , Zulfiquer Otty , Abhishek Joshi , Shivanshan Pathmanathan","doi":"10.1016/j.jgo.2024.102145","DOIUrl":"10.1016/j.jgo.2024.102145","url":null,"abstract":"<div><h3>Introduction</h3><div>Older patients with cancer often face increased risks of adverse reactions and complications when undergoing systemic therapy. In 2020, the Townsville Cancer Centre in North Queensland established a nurse navigator led geriatric oncology service for patients aged 75 years and above referred for systemic therapy for solid organ malignancy. This study sought to evaluate the safety outcomes and trends in the administration of systemic therapy in older patients following the introduction of this service.</div></div><div><h3>Materials and Methods</h3><div>A retrospective study was conducted at a single centre, focusing on patients aged 75 years and above referred for chemotherapy or immunotherapy for solid organ malignancies. Patients referred after the implementation of the service were classified as the geriatric assessment cohort, while those referred before were categorized as the historical cohort. Outcome measures included unplanned hospital admissions, duration of hospital stays, rates of systemic therapy de-escalation, and frailty identified during geriatric assessments.</div></div><div><h3>Results</h3><div>The study included 129 patients, with 60 in the geriatric assessment cohort and 69 in the historical cohort. The geriatric assessment cohort exhibited a significant decrease in both the average number of hospital admissions per patient compared to the historical cohort (0.59 vs. 1.13, <em>p</em> = 0.01) and the average length of hospital stay (4.3 days vs. 6.7 days, <em>p</em> = 0.04). Rates of systemic therapy de-escalation were comparable between the two cohorts (47 % vs. 59 %, <em>p</em> = 0.16). Frailty was frequently identified during geriatric assessments, requiring intervention both before and during treatment.</div></div><div><h3>Discussion</h3><div>Our two-year observation of the nurse navigator-led geriatric oncology model suggests that it contributed to improved safety outcomes, leading to reductions in unplanned hospitalizations and lengths of hospital stays, without significant changes in the rates of de-escalated systemic therapy.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 1","pages":"Article 102145"},"PeriodicalIF":3.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brendan L. McNeish , Andrea L. Rosso , Grace Campbell , Jennifer Fedor , Krina C. Durica , Christianna Bartel , Gregory Marchetti , Carissa A. Low
{"title":"An association of cognitive function with mobile metrics of community walking in older cancer survivors: A pilot study","authors":"Brendan L. McNeish , Andrea L. Rosso , Grace Campbell , Jennifer Fedor , Krina C. Durica , Christianna Bartel , Gregory Marchetti , Carissa A. Low","doi":"10.1016/j.jgo.2024.102146","DOIUrl":"10.1016/j.jgo.2024.102146","url":null,"abstract":"<div><h3>Introduction</h3><div>Older cancer survivors have an elevated risk for mobility dysfunction compared to their cancer-free peers. Despite the established link between cognitive function and community walking in older cancer-free adults, little is known about this relationship in older cancer survivors. This pilot study aimed to evaluate the association of performance-based and self-reported cognitive function with mobile metrics of community walking collected by a wearable Fitbit device.</div></div><div><h3>Materials and Methods</h3><div>This study enrolled older cancer survivors (mean age 73 years old, range 65–83; 98 % White; 50 % female) within five years of completing primary treatment. Cognitive function, specifically executive function and processing speed was collected with the digit symbol substitution test (DSST) and self-reported cognition was evaluated by the Patient Reported Outcomes Measurement Information System- Cognitive (PROMIS-Cog). Continuous walking data from Fitbit wearable devices were collected passively over four weeks. To examine associations between DSST and PROMIS-Cog with mobile measures of walking, we conducted bivariate correlation and multivariable linear regression analyses adjusting for age, education, and number of comorbidities.</div></div><div><h3>Results</h3><div>In bivariate analyses, higher DSST scores were correlated with higher step count and peak cadence and lower fragmentation of walking in daily life (<em>r</em> = 0.48–0.51, <em>p</em> < 0.01). Higher PROMIS-Cog scores were correlated with higher peak cadence (<em>r</em> = 0.32, <em>p</em> < 0.05), trended towards correlation with step count (<em>r</em> = 0.30, <em>p</em> = 0.06), and were not correlated with fragmentation of walking (<em>r</em> = −0.24, <em>p</em> = 0.13). In multivariable models adjusting for age, presence of graduate level education, and number of comorbidities, higher DSST scores were independently associated with higher peak cadence, step count, and demonstrated a trend towards lower fragmentation of walking in daily life, but PROMIS-Cog was not independently associated with any mobility metrics. Similar results for association of DSST with walking when models included adjustment for PROMIS-depression scale, receipt of chemotherapy treatment, or when education was defined by presence of a bachelor's degree.</div></div><div><h3>Discussion</h3><div>This study suggests an association between cognitive functions of executive function and processing speed with mobile metrics of community walking in older cancer survivors. Understanding how cognitive function affects walking may help identify new rehabilitation targets for older cancer survivors.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 1","pages":"Article 102146"},"PeriodicalIF":3.0,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Perioperative intervention of dysphagia rehabilitation team in older adults with gastric cancer: An inverse probability weighting analysis","authors":"Atsushi Yasuda , Yutaka Kimura , Tsutomu Saito , Yoko Hiraki , Takaomi Hagi , Hiroaki Kato , Osamu Shiraishi , Masayuki Shinkai , Motohiro Imano , Takushi Yasuda","doi":"10.1016/j.jgo.2024.102134","DOIUrl":"10.1016/j.jgo.2024.102134","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aimed to evaluate the efficacy of perioperative dysphagia rehabilitation in older adult patients diagnosed with gastric cancer who underwent gastrectomy.</div></div><div><h3>Materials and Methods</h3><div>This retrospective study included 149 patients over 80 years who underwent gastrectomies between January 2000 and December 2020. The patients were divided into two groups based on the intervention of the dysphagia rehabilitation team (DRT group: <em>n</em> = 101) and the non-intervention control group (C group: <em>n</em> = 48). Inverse probability weighting (IPW) analysis was used to reduce bias caused by potential confounding.</div></div><div><h3>Results</h3><div>The incidence of overall complications was significantly lower in the DRT group (odds ratio [OR]; 0.27[0.08–0.93]), among which the incidence of postoperative pneumonia (OR; 0.07[0.01–0.43]) and aspiration pneumonia (OR; 0.05[0.01–0.44] was significantly reduced. Ten patients developed postoperative pneumonia; seven were in the C group, and three were in DRT group. Sixty percent of these patients had preoperative comorbidities related to the respiratory system. Regarding the time of onset of aspiration pneumonia, two patterns were observed: onset within a short period after surgery and onset after the start of eating. In contrast, five patients underwent preoperative dysphagia rehabilitation in the DRT group. Among them, postoperative aspiration pneumonia was prevented in four patients, and the others were prevented from severe pneumonitis by the intervention of the dysphagia rehabilitation team.</div></div><div><h3>Discussion</h3><div>Perioperative intervention in dysphagia rehabilitation is not only associated with reduced postoperative pneumonia but also creates awareness in the medical staff and promotes careful observation of swallowing in patients, thereby controlling the incidence of postoperative pneumonia. The perioperative intervention of the dysphagia rehabilitation team is useful for older adult patients with gastric cancer.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 1","pages":"Article 102134"},"PeriodicalIF":3.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Minh-Thao Tu , Thi-Ngoc Tran , Hoejun Kwon , Yoon-Jung Choi , Youngjoo Lee , Hyunsoon Cho
{"title":"Prognostic value of electronic health records-based frailty measures for all-cause mortality in older patients with non-small cell lung cancer","authors":"Minh-Thao Tu , Thi-Ngoc Tran , Hoejun Kwon , Yoon-Jung Choi , Youngjoo Lee , Hyunsoon Cho","doi":"10.1016/j.jgo.2024.102130","DOIUrl":"10.1016/j.jgo.2024.102130","url":null,"abstract":"<div><h3>Introduction</h3><div>Frailty screening is important to guide treatment decisions for older patients with non-small cell lung cancer (NSCLC). However, the performance of frailty measures (FMs) remains unclear. This study aimed to evaluate the prognostic value of FMs based on electronic health records (EHR) data in clinical settings for all-cause mortality in older patients with NSCLC.</div></div><div><h3>Materials and Methods</h3><div>We retrospectively analyzed 4253 patients aged ≥65 years, newly diagnosed with NSCLC (2007–2018) using EHR data from the National Cancer Center, Korea. Frailty was measured by either laboratory tests (frailty index based on routine laboratory tests [FI-Lab]), comorbidities and performance status (electronic Frailty index [eFI]), or both (combined frailty index [FI-combined]). Patients were categorized as frail or non-frail. Cox proportional hazards models and C-index were used to estimate the predictive ability of FMs for all-cause mortality in 1 year, 3 years, and 5 years post-diagnosis, adjusting for age, sex, and SEER stage.</div></div><div><h3>Results</h3><div>EHR-based FMs could enhance the prognostic ability to predict the survival of older patients with NSCLC. In the total population, FI-Lab showed the largest predictive value, especially for 1-year mortality with an adjusted hazard ratio for frail vs. non-frail groups of 2.25 (95 % CI 2.02–2.51) and C-index of 0.74 compared to 0.72 in the base model (<em>p</em>-value<0.001). FI-Lab could improve the prognostic ability for 1-year mortality in patients with regional and distant SEER stages and those receiving systemic therapy, whereas FI-combined could improve the prediction of 3-year and 5-year mortality in patients with localized disease and receiving surgery.</div></div><div><h3>Discussion</h3><div>Easy-to-use FMs derived from EHR data can enhance the prediction of all-cause mortality in older patients with NSCLC. Oncologists can utilize comprehensive FMs comprising comorbidities, functional status, and subclinical tests or FI-Lab, depending on the patient's medical condition, to facilitate shared cancer care planning.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 1","pages":"Article 102130"},"PeriodicalIF":3.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pei-An Lee, Clark DuMontier, Nicholas Groblewski, Wanting Yu, Junhong Zhou, Tammy Hshieh, Dae Kim, Tom Travison, Jane Driver, On-Yee Lo, Brad Manor, Gregory Abel
{"title":"Smartphone application for longitudinal home gait speed measurement in older adults with blood cancers: A feasibility and acceptability study.","authors":"Pei-An Lee, Clark DuMontier, Nicholas Groblewski, Wanting Yu, Junhong Zhou, Tammy Hshieh, Dae Kim, Tom Travison, Jane Driver, On-Yee Lo, Brad Manor, Gregory Abel","doi":"10.1016/j.jgo.2024.102132","DOIUrl":"10.1016/j.jgo.2024.102132","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":" ","pages":"102132"},"PeriodicalIF":3.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Disparities in electronic health record patient portal activation and use among people with hematological malignancies.","authors":"Angela M Trammel, Bryan A Sisk, Mark A Fiala","doi":"10.1016/j.jgo.2024.102135","DOIUrl":"https://doi.org/10.1016/j.jgo.2024.102135","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":" ","pages":"102135"},"PeriodicalIF":3.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142501983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rupert Bartsch, Daniel Aletaha, Thorsten Fuereder, Matti Aapro, Francois R Jornayvaz, Pierre-Olivier Lang, Denis Migliorini, Chantal Csajka, Marie-Bernadette Aretin, Vérène Dougoud-Chauvin
{"title":"Corticosteroid therapy in older adults with cancer: Expert recommendations from a task force of the International Society of Geriatric Oncology.","authors":"Rupert Bartsch, Daniel Aletaha, Thorsten Fuereder, Matti Aapro, Francois R Jornayvaz, Pierre-Olivier Lang, Denis Migliorini, Chantal Csajka, Marie-Bernadette Aretin, Vérène Dougoud-Chauvin","doi":"10.1016/j.jgo.2024.102077","DOIUrl":"https://doi.org/10.1016/j.jgo.2024.102077","url":null,"abstract":"<p><p>Corticosteroids are used frequently in oncology and many patients require short- or long-term corticosteroid therapy. General clinical guidelines and recommendations exist on the use of corticosteroids; however, evidence is lacking for recommendations on their appropriate use in older adult with cancer. Treatment of chemotherapy-induced nausea and vomiting (CINV) has dramatically improved over the last decade with 5-hydroxytryptamine type 3 (5-HT3) receptor antagonists and neurokinin-1 (NK-1) receptor antagonists or a combination of both. However, corticosteroids continue to play an important role in the management of acute and delayed CINV prevention. While highly efficacious, the toxicity profile of corticosteroids must be considered, particularly in heterogeneous older patients with multiple comorbidities and polypharmacy. Guidance on corticosteroid-reducing/sparing strategies in this specific population is needed. This consensus, supported by the International Society of Geriatric Oncology, aims to provide evidence-based recommendations for the use of corticosteroid therapy in older adults with cancer.</p>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":" ","pages":"102077"},"PeriodicalIF":3.0,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Evelyn Arana-Chicas , Po-Ju Lin , Umang Gada , Hongying Sun , Alisha Chakrabarti , Lindsey J. Mattick , Katherine Rieth , Christopher H. Chay , Janet Ruzich , Benjamin T. Esparaz , Ana P. Cupertino , Brian J. Altman , Paula M. Vertino , Supriya G. Mohile , Karen M. Mustian
S. Maheshwari, D. Hess, A. Tucker, C. Ubersax, G.R. Williams, S. Bhatia, S. Giri
{"title":"SIOG2024-2-OA-016 Association between adiposity and overall survival in older adults with newly diagnosed gastrointestinal (GI) malignancies","authors":"S. Maheshwari, D. Hess, A. Tucker, C. Ubersax, G.R. Williams, S. Bhatia, S. Giri","doi":"10.1016/j.jgo.2024.101886","DOIUrl":"10.1016/j.jgo.2024.101886","url":null,"abstract":"","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"15 7","pages":"Article 101886"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142432337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}