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Geriatric AND cancer

Ronald J Maggiore, Kathryn E Callahan, Janet A Tooze, Ira R Parker, Tina Hsu, Heidi D Klepin
The number of older adults with cancer is growing, necessitating more collaborative training in both geriatric principles and cancer care. We administered a web-based survey to U.S. geriatrics program directors (PDs) addressing cancer-specific training and perspectives on optimal training content and roles for geriatricians in cancer care. Of 140 PDs contacted, 67 (48%) responded. Topics considered very important in training included cancer screening (79%) and cancer-related pain management (70%). Respondents strongly agreed that some of the geriatrician's roles in cancer care included assessing functional status (64%) and assessing physical/cognitive function for goals of care (64%)...
October 17, 2016: Gerontology & Geriatrics Education
Veerawat Phongtankuel, Prin X Amorapanth, Eugenia L Siegler
The World Health Organization, one of the leading authorities on pain management, stressed the need for further guidelines to help manage pain in patients with chronic disease. In light of the impact of pain on morbidity and quality of life, this article summarizes current knowledge about pain experienced by older adults in 3 advanced non-cancer-related chronic diseases (ie, congestive heart failure, end-stage renal disease, and stroke) in which pain is common but not typically a primary focus of disease management...
November 2016: Clinics in Geriatric Medicine
V Giantin, C Falci, E De Luca, E Valentini, M Iasevoli, P Siviero, S Maggi, B Martella, G Crepaldi, S Monfardini, E Manzato
: The Multidimensional Geriatric Assessment (MGA) is currently used for assessing geriatric oncological patients, but a new prognostic index - the Multidimensional Prognostic Index (MPI) - has a demonstrated prognostic value in cancer patients too. The present work was designed to compare the MPI and MGA as predictors of 12-month mortality. 160 patients ≥70 years old with locally-advanced or metastatic solid cancers consecutively joining our Geriatric Oncology Program were administered a Comprehensive Geriatric Assessment to calculate their MGA and MPI scores...
October 10, 2016: European Journal of Cancer Care
Janette Vardy, Prunella Blinman, Erin B Moth
Colon cancer is common and can be considered a disease of older adults with more than half of cases diagnosed in patients aged over 70 years. Decision-making about treatment with chemotherapy for older adults may be complicated by age-related physiological changes, impaired functional status, limited social supports, concerns regarding the occurrence of and ability to tolerate treatment toxicity, and the presence of comorbidities. This is compounded by a lack of high quality evidence guiding cancer treatment decisions for older adults...
October 10, 2016: Expert Review of Gastroenterology & Hepatology
YaoYao G Pollock, Amanda L Blackford, Stacie C Jeter, Jean Wright, Ashley Cimino-Mathews, Melissa Camp, Susan Harvey, Fariba Asrari, Nancy L Schoenborn, Vered Stearns
PURPOSE: In 2004, The National Comprehensive Cancer Network (NCCN) Guidelines incorporated omission of radiation therapy after breast-conservation surgery in women ≥70 years old with stage I, estrogen receptor-positive breast cancer who plan to receive endocrine therapy. One study demonstrated wide variation in implementing this change across 13 NCCN institutions. We evaluated the practice pattern at our institution. METHODS: We identified women ≥70 years old treated at our institution from 2009 to 2014...
November 2016: Breast Cancer Research and Treatment
Mirko Barone, Marco Prioletta, Decio Di Nuzzo, Giuseppe Cipollone, Pierpaolo Camplese, Felice Mucilli
Colorectal cancer (CRC) is one of the most common malignancies worldwide and the lung is one of the most frequent sites for CRC metastasis. The geriatric population is increasing, but clinical decision making is often influenced by the effect of aging. For this reason, the elderly population does not often receive potentially curative cancer treatments as offered to younger ones. From January 2000 to March 2016, 21 elderly patients (older than 75 years) underwent pulmonary resections for colorectal cancer pulmonary metastases...
September 27, 2016: Updates in Surgery
Laura B Kaufman, Michelle M Henshaw, Blase P Brown, Joseph M Calabrese
Oral health for the older adult patient is vital for function, comfort, and communication and is a critical component of overall health. Oral diseases such as dental caries, periodontal disease, and oral cancer may lead to pain, functional limitations, and decreased quality of life. Optimal oral health outcomes are often owing to effective interprofessional collaboration between and among health care providers, in conjunction with patient family members and caregivers. This article highlights 2 cases illustrating how interprofessional team dynamics can affect patient outcomes...
October 2016: Dental Clinics of North America
Lucy Dumas, Alistair Ring, John Butler, Tania Kalsi, Danielle Harari, Susana Banerjee
The incidence of most gynaecological malignancies rises significantly with increasing age. With an ageing population, the proportion of women over the age of 65 with cancer is expected to rise substantially over the next decade. Unfortunately, survival outcomes are much poorer in older patients and evidence suggests that older women with gynaecological cancers are less likely to receive current standard of care treatment options. Despite this, older women are under-represented in practice changing clinical studies...
August 29, 2016: Cancer Treatment Reviews
Shiliang Lv, Min Fang, Jia Yang, Wenming Zhan, Yongshi Jia, Hong'en Xu, Tao Song
OBJECTIVE: The aim of this study was to investigate the efficiency and safety of using S-1 as monotherapy and maintenance therapy combined with definitive concurrent radiotherapy for elderly patients with esophageal cancer. PATIENTS AND METHODS: From January 2009 to December 2010, 68 elderly patients were included. Radiotherapy was delivered with a daily fraction of 1.8-2.0 Gy to a total radiation dose of 54.0-60.0 Gy. Preplanned concurrent S-1 (80 mg/m(2)/d) was given on days 1-14, every 3 weeks...
2016: OncoTargets and Therapy
Amihai Rottenstreich, Geffen Kleinstern, Allan I Bloom, Alexander Klimov, Yosef Kalish
AIM: The utilization of inferior vena cava filter placement for pulmonary embolism prevention in elderly patients has not been well characterized. The present study aimed to review indications, complications and follow-up data of elderly patients undergoing inferior vena cava filter placement. METHODS: A retrospective review was carried out of consecutive admitted patients who underwent inferior vena cava filter insertion at a large university hospital with a level I trauma center...
September 20, 2016: Geriatrics & Gerontology International
Elsbeth Heinzelmann
In vitro diagnostics (IVD) has huge potential. Primary drivers in the global market are the patient's awareness of infectious diseases, the introduction of advanced molecular and tissue diagnostic tests for patient-stratified and targeted anti-cancer therapy and, last but not least, the growing geriatric population. Rapid progress in device miniaturization and information technology (IT) offers new possibilities in decentralized testing. Grand View Research Inc. expects the global market for IVD to reach US $ 74...
September 2016: Chimia
Lore Decoster, Leen Vanacker, Cindy Kenis, Hans Prenen, Erik Van Cutsem, Jacques Van Der Auwera, Ellen Van Eetvelde, Katrien Van Puyvelde, Johan Flamaing, Koen Milisen, Jean Pierre Lobelle, Jacques De Grève, Hans Wildiers
INTRODUCTION: This study aims to evaluate the relevance of geriatric assessment (GA) in older patients with colorectal cancer (CRC) and to study functional status (FS) and chemotherapy-related toxicity during treatment. METHODS: Patients with CRC aged ≥ 70 years were evaluated at baseline using a GA. Results were communicated to the treating physician. At 2 to 3 months follow-up, FS was reassessed, and chemotherapy-related toxicity was recorded. RESULTS: A total of 193 patients, with a median age of 77 years, were included...
August 8, 2016: Clinical Colorectal Cancer
Petr Szturz, Jan B Vermorken
The demographics of squamous cell carcinoma of the head and neck (SCCHN) is marked by a growing number of patients aged 65 and over, which is in line with global projections for other cancer types. In developed countries, more than half of new SCCHN cases are diagnosed in older people, and in 15 years from now, the proportion is expected to rise by more than 10%. Still, a high-level evidence-based consensus to guide the clinical decision process is strikingly lacking. The available data from retrospective studies and subset analyses of prospective trials suffer from a considerable underrepresentation of senior participants...
2016: Frontiers in Oncology
Arti Hurria, Chie Akiba, Jerome Kim, Dale Mitani, Matthew Loscalzo, Vani Katheria, Marianna Koczywas, Sumanta Pal, Vincent Chung, Stephen Forman, Nitya Nathwani, Marwan Fakih, Chatchada Karanes, Dean Lim, Leslie Popplewell, Harvey Cohen, Beverly Canin, David Cella, Betty Ferrell, Leanne Goldstein
PURPOSE: The goal of this study was to evaluate the feasibility, reliability, and validity of a computer-based geriatric assessment via two methods of electronic data capture (SupportScreen and REDCap) compared with paper-and-pencil data capture among older adults with cancer. METHODS: Eligible patients were ≥ 65 years old, had a cancer diagnosis, and were fluent in English. Patients were randomly assigned to one of four arms, in which they completed the geriatric assessment twice: (1) REDCap and paper and pencil in sessions 1 and 2; (2) REDCap in both sessions; (3) SupportScreen and paper and pencil in sessions 1 and 2; and (4) SupportScreen in both sessions...
September 13, 2016: Journal of Oncology Practice
Allison Magnuson, James Wallace, Beverly Canin, Selina Chow, William Dale, Supriya G Mohile, Lauren M Hamel
We present the case of a 92-year-old man, MH, who was given a diagnosis of colorectal cancer. His primary care physician, surgeon, geriatric oncologist, and family members all played important roles in his care. MH's case is an example of a lack of explicit shared goal setting by the health care providers with the patient and family members and how that impeded care planning and health. This case demonstrates the importance of explicitly discussing and establishing shared goals in team-based cancer care delivery early on and throughout the care process, especially for older adults...
September 13, 2016: Journal of Oncology Practice
Ali Alkan, Arzu Yaşar, Ebru Karcı, Elif Berna Köksoy, Muslih Ürün, Filiz Çay Şenler, Yüksel Ürün, Gülseren Tuncay, Hakan Ergün, Hakan Akbulut
PURPOSE: Due to more comorbidities, polypharmacy is common in elderly patients and drug interactions are inevitable. It is also challenging to treat an elderly patient with a diagnosis of cancer. Prevalence and clinical impacts of drug interactions and using potentially inappropriate medications (PIMs) have been studied in geriatric patients. However, these are not well defined in oncology practice. The purpose of this study is to define the prevalence of PIMs and severe drug interactions (SDIs) in elderly cancer patients and investigate the factors associated with them...
September 12, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Allison Magnuson, Beverly Canin, G J van Londen, Beatrice Edwards, Pamela Bakalarski, Ira Parker
A significant proportion of cancer patients and survivors are age 65 and over. Older adults with cancer often have more complex medical and social needs than their younger counterparts. Geriatric medicine providers (GMPs) such as geriatricians, geriatric-trained advanced practice providers, and geriatric certified registered nurses have expertise in caring for older adults, managing complex medical situations, and optimizing function and independence for this population. GMPs are not routinely incorporated into cancer care for older adults; however, their particular skill set may add benefit at many points along the cancer care continuum...
November 2016: Current Oncology Reports
Ellisiv Lærum Jacobsen, Therese Brovold, Astrid Bergland, Asta Bye
OBJECTIVES: Data on acute geriatric patients' nutritional status are lacking, and the associations among physical function, sarcopenia, health status and nutritional status are not sufficiently investigated in this population. The aims of this study are to investigate (1) nutritional status and sarcopenia in a group of acute geriatric patients, (2) the association between nutritional status, physical function and sarcopenia in acute geriatric patients, controlling for health status. DESIGN: A cross-sectional study...
2016: BMJ Open
Amandine Gouverneur, Magali Rouyer, Angela Grelaud, Philip Robinson, Françoise Colombani, Eric Terrebonne, Denis Smith, Annie Fourrier-Réglat, Pernelle Noize
Metastatic colorectal cancer (mCRC) is frequent among elderly patients. However, in the era of new targeted therapies, little is known about real-life mCRC treatment in this population. This study aimed to describe elderly mCRC patients and the current real-life treatment practices. mCRC patients aged ≥65 years were identified using the registry of multidisciplinary team meetings, mandatory for all cancer patients, held between January 1, 2013 and June 30, 2014 at the Bordeaux University Hospital. Data were collected from medical records using a standardized questionnaire...
September 7, 2016: Fundamental & Clinical Pharmacology
Philip Cornford, Joaquim Bellmunt, Michel Bolla, Erik Briers, Maria De Santis, Tobias Gross, Ann M Henry, Steven Joniau, Thomas B Lam, Malcolm D Mason, Henk G van der Poel, Theo H van der Kwast, Olivier Rouvière, Thomas Wiegel, Nicolas Mottet
OBJECTIVE: To present a summary of the 2016 version of the European Association of Urology (EAU) - European Society for Radiotherapy & Oncology (ESTRO) - International Society of Geriatric Oncology (SIOG) Guidelines on the treatment of relapsing, metastatic, and castration-resistant prostate cancer (CRPC). EVIDENCE ACQUISITION: The working panel performed a literature review of the new data (2013-2015). The guidelines were updated, and the levels of evidence and/or grades of recommendation were added based on a systematic review of the literature...
August 31, 2016: European Urology
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