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Geriatric AND cancer AND comorbidity

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https://www.readbyqxmd.com/read/29142786/extraordinary-clinical-benefit-to-sequential-treatment-with-targeted-therapy-and-immunotherapy-of-a-braf-v600e-and-pd-l1-positive-metastatic-lung-adenocarcinoma
#1
Shuyu D Li, Annia Martial, Alexa B Schrock, Jane J Liu
Background: The treatment algorithm for metastatic non-small cell lung cancers (NSCLCs) has been evolving rapidly due to the development of new therapeutic agents. Although guidelines are provided by National Comprehensive Cancer Network (NCCN) for treatment options according to biomarker testing results, sequentially applying the three main modalities (chemotherapy, targeted therapy and immunotherapy) remains an ad hoc practice in clinic. In light of recent FDA approval of dabrafenib and trametinib combination for metastatic NSCLCs with BRAF V600E mutation, one question arises due to insufficient clinical data is if the targeted therapy should be used before immunotherapy in patients with both BRAF V600E and PD-L1 expression...
2017: Experimental Hematology & Oncology
https://www.readbyqxmd.com/read/29128297/role-of-geriatric-oncologists-in-optimizing-care-of-urological-oncology-patients
#2
REVIEW
Jean-Pierre Droz, Helen Boyle, Gilles Albrand, Nicolas Mottet, Martine Puts
CONTEXT: Urological cancers are common. Since the median age of diagnosis is 60-70 yr, many patients require geriatric as well as urological evaluation if treatment is to be tailored to individual health status including comorbidities and frailty. OBJECTIVE: To review the most important features of geriatric assessment and its expected benefits. We also consider ways in which collaboration between urologists and geriatricians and geriatric teams can benefit patient well-being...
November 8, 2017: European Urology Focus
https://www.readbyqxmd.com/read/29120933/an-overview-of-perioperative-considerations-in-elderly-patients-for-thoracic-surgery-demographics-risk-benefit-and-resource-planning
#3
Maria Castillo
PURPOSE OF REVIEW: Increasing numbers of geriatric patients will present for thoracic surgery as the population ages. The changes in physiologic reserve as well as the increase in comorbid conditions among this population must be considered in order to optimize patient care in the perioperative period. RECENT FINDINGS: For elderly patients with cancer, the risk-benefit relationship for thoracic surgery remains favorable. Consideration of comorbidities, especially chronic obstructive pulmonary disease and congestive heart failure, is important in the setting of surgical treatment, as they have implications for perioperative care as well as postoperative morbidity and mortality...
November 7, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29050492/prevalence-of-dementia-in-a-geriatric-palliative-care-unit
#4
Amanda T Lo, Jurgis Karuza, Anna Berall, Giulia-Anna Perri
OBJECTIVES: To determine the prevalence of dementia in a palliative care unit (PCU) and to determine whether there is a difference between length of stay (LOS) and Palliative Performance Scale (PPS) score in individuals admitted with a primary diagnosis of dementia compared to individuals admitted with other noncancer and cancer diagnoses. DESIGN: Descriptive retrospective chart review. SETTING: Geriatric PCU in an academic community geriatric hospital...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29049803/prognostic-significance-of-immune-nutritional-parameters-for-surgically-resected-elderly-lung-cancer-patients-a-multicentre-retrospective-study
#5
Fumihiro Shoji, Naoko Miura, Taichi Matsubara, Takaki Akamine, Yuka Kozuma, Naoki Haratake, Shinkichi Takamori, Masakazu Katsura, Kazuki Takada, Gouji Toyokawa, Tomoyoshi Takenaka, Koji Yamazaki, Tatsuro Okamoto, Sadanori Takeo, Yoshihiko Maehara
OBJECTIVES: The world's population is rapidly ageing, and the age of patients with lung cancer will increase as well. The prognostic nutritional index, controlling nutritional status and the geriatric nutritional risk index (GNRI) are useful parameters for evaluating immune-nutritional status. We aimed to perform a multicentre retrospective study to investigate the correlations of these immune-nutritional parameters with postoperative comorbidities or surgical outcomes of elderly patients with non-small-cell lung cancer (NSCLC)...
October 16, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29034256/integration-of-geriatric-assessment-in-the-care-of-patients-with-gastrointestinal-malignancies
#6
REVIEW
Siri Rostoft
BACKGROUND: The majority of patients with gastrointestinal (GI) malignancies are older. Recently, it has become evident that elements from a geriatric assessment (GA) are powerful predictors of outcomes such as postoperative morbidity and mortality, length of stay, type of treatment received, and survival across several GI tumor types in older adults. A GA is a systematic evaluation of functional status, comorbidities, polypharmacy, cognition, nutritional status, emotional status, and social support...
August 2017: Visceral Medicine
https://www.readbyqxmd.com/read/29034253/risk-factors-for-adverse-outcome-for-elderly-patients-undergoing-curative-oncological-resection-for-gastrointestinal-malignancies
#7
REVIEW
Yukai K Lim, Christopher Jackson, Emilia L Dauway, Konrad Klaus Richter
BACKGROUND: The incidence of gastrointestinal cancer increases with age, with approximately 20% of these cases in people over 80 years of age. Due to pre-existing comorbidities, this onco-geriatric population often presents diagnostic and therapeutic challenges. METHODS: A systematic review of articles on PubMed was performed to determine the predictive ability of screening tools and their components regarding the occurrence of adverse outcomes in elderly onco-surgical patients with gastrointestinal malignancies...
August 2017: Visceral Medicine
https://www.readbyqxmd.com/read/29034078/recent-advances-in-cancer-surgery-in-older-patients
#8
REVIEW
Siri Rostoft, Riccardo A Audisio
Age is the most important risk factor for the occurrence of cancer, and a declining mortality from heart disease and other non-cancer causes leaves an older population that is at high risk of developing cancer. Choosing the optimal treatment for older cancer patients may be a challenge. Firstly, older age and associated factors such as comorbidities, functional limitations, and cognitive impairment are risk factors for adverse effects of cancer treatment. Secondly, older patients are often excluded from clinical trials, and current clinical guidelines rarely address how to manage cancer in patients who have comorbidities or functional limitations...
2017: F1000Research
https://www.readbyqxmd.com/read/29030150/sociodemographic-socioeconomic-and-clinical-determinants-of-survival-in-patients-with-cancer-a-systematic-review-of-the-literature-focused-on-the-elderly
#9
REVIEW
Angéline Galvin, Fleur Delva, Catherine Helmer, Muriel Rainfray, Carine Bellera, Virginie Rondeau, Pierre Soubeyran, Gaëlle Coureau, Simone Mathoulin-Pélissier
Studies on cancer survival have revealed disparities not only between the elderly and their younger counterparts, but also among the elderly themselves. The aim of this work was to identify sociodemographic, socioeconomic, clinical, and care-related determinants of survival or mortality in older patients with cancer by a systematic synthesis of the literature. Understanding these factors is of great value for guiding health policies and programs aimed at reducing cancer survival disparities. We conducted a search of MEDLINE and SCOPUS databases under PRISMA guidelines...
October 10, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28978831/treatment-of-elderly-patients-with-acute-myeloid-leukemia
#10
Tomonori Nakazato
Most patients diagnosed with acute myeloid leukemia (AML) are over the age of 60 years yet optimal treatment strategies for older adults remain unclear. Old age is associated with increased risk of treatment-related toxicity and worse survival compared to younger adults. It is widely recognized that chronological age does not capture the heterogeneous physiological and functional status of older adults. Thus, it is critically important to evaluate both disease-related (adverse cytogenetics, unfavorable gene mutations, secondary AML, etc...
2017: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/28967093/advances-in-geriatric-oncology-a-multidisciplinary-perspective
#11
Ponnandai Somasundar, Loïc Mourey, Laura Lozza, Stefania Maggi, Rob Stepney
A growing majority of people with cancer is composed of older patients. For many such patients, independence and quality of life are as important as prolongation of survival, emphasizing the need for treatments that are not only effective but also well-tolerated. Given age-related decline in organ function and the prevalence of comorbidities and polypharmacy, optimum management is complex and requires collaboration between oncologists and geriatricians. Advances in surgery now include preoperative assessment and, when indicated, prehabilitation of the patient, as well as the enhanced recovery after surgery approach...
September 27, 2017: Tumori
https://www.readbyqxmd.com/read/28966807/skin-cancer-epidemics-in-the-elderly-as-an-emerging-issue-in-geriatric-oncology
#12
REVIEW
Simone Garcovich, Giuseppe Colloca, Pietro Sollena, Bellieni Andrea, Lodovico Balducci, William C Cho, Roberto Bernabei, Ketty Peris
Skin cancer is a worldwide, emerging clinical need in the elderly white population, with a steady increase in incidence rates, morbidity and related medical costs. Skin cancer is a heterogeneous group of cancers comprising cutaneous melanoma and non-melanoma skin cancers (NMSC), which predominantly affect elderly patients, aged older than 65 years. Melanoma has distinct clinical presentations in the elderly patient and represents a challenging question in terms of clinical management. NMSC includes the basal cell carcinoma and cutaneous squamous cell carcinoma and presents a wide disease spectrum in the elderly population, ranging from low-risk to high-risk tumours, advanced and inoperable disease...
October 2017: Aging and Disease
https://www.readbyqxmd.com/read/28942563/polypharmacy-in-the-geriatric-oncology-population
#13
REVIEW
Lauren R Hersh, Kathryn Beldowski, Emily R Hajjar
PURPOSE OF REVIEW: This review explores the multiple definitions, epidemiology, and impact of polypharmacy in geriatric oncology patients. Risk factors and clinical implications of polypharmacy are delineated and potential clinical approaches to reduce polypharmacy are reviewed. RECENT FINDINGS: Most sources currently define polypharmacy as the administration of multiple medications that are non-essential, unnecessary, duplicative, or ineffective. Possible risk factors associated with polypharmacy in geriatric cancer patients include comorbid conditions, prescribing cascades, and hospitalization...
September 23, 2017: Current Oncology Reports
https://www.readbyqxmd.com/read/28933175/-hiv-infection-a-new-disease-of-internal-medicine
#14
Svatava Snopková
Modern antiretroviral treatment belongs to the greatest success of current medicine. HIV infection has gone from a death sentence to a manageable chronic disease which develops several decades. Thanks to treatment advances, people with HIV can and do live long and full lives. In the last two decades, the incidence AIDS defining illnesses have been dramatically reduced especially opportunistic infections and malignancies, whereas the role of non-infection comorbidities has risen than age-matched HIV uninfected adults...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28923227/advancing-treatment-approach-to-the-older-patient-with-cancer-through-clinical-trials-participation
#15
REVIEW
Efrat Dotan
The aging of the population worldwide brings a "Tsunami" of older patients to oncology practices. Oncologists are faced with determining the fitness of patients for therapy and tailoring appropriate therapy. Ongoing treatment of this patient population is challenging because of physiologic changes of aging, comorbidities, and various geriatric syndromes. Underrepresentation of older patients in clinical trials results in a gap in knowledge and lack of clear evidence to guide treatment approach. In recent years, some advancements have been made with publication of elderly specific studies...
October 2017: Surgical Oncology Clinics of North America
https://www.readbyqxmd.com/read/28860112/risk-factors-for-falls-in-older-patients-with-cancer
#16
Xiaotao Zhang, Ming Sun, Suyu Liu, Cheuk Hong Leung, Linda Pang, Uday R Popat, Richard Champlin, Holly M Holmes, Vicente Valero, Colin P Dinney, Debu Tripathy, Beatrice J Edwards
OBJECTIVES: A rising number of patients with cancer are older adults (65 years of age and older), and this proportion will increase to 70% by the year 2020. Falls are a common condition in older adults. We sought to assess the prevalence and risk factors for falls in older patients with cancer. METHODS: This is a single-site, retrospective cohort study. Patients who were receiving cancer care underwent a comprehensive geriatric assessments, including cognitive, functional, nutritional, physical, falls in the prior 6 months and comorbidity assessment...
August 31, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28801975/trends-in-aging-related-services-during-nephrectomy-implications-for-surgery-in-an-aging-population
#17
Hung-Jui Tan, Mark S Litwin, Karim Chamie, Debra Saliba, Jim C Hu
OBJECTIVES: To characterize the extent to which geriatric and related healthcare services are provided to older adults undergoing surgery for kidney cancer, a potential growth area in geriatrics and oncology. DESIGN: Population-based observational study. SETTING: Surveillance, Epidemiology, and End Results cancer data linked with Medicare claims. PARTICIPANTS: Adults aged 65 and older with kidney cancer treated surgically from 2000 to 2009 (N = 19,129)...
October 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28793879/septic-arthritis-significantly-increased-the-long-term-mortality-in-geriatric-patients
#18
Chia-Jung Wu, Chien-Cheng Huang, Shih-Feng Weng, Ping-Jen Chen, Chien-Chin Hsu, Jhi-Joung Wang, How-Ran Guo, Hung-Jung Lin
BACKGROUND: The elderly are predisposed to septic arthritis (SA) because of the aging nature and increasing comorbidities. SA may in turn increase the long-term mortality in the geriatric patients; however, it remains unclear. We conducted this prospective nationwide population-based cohort study to clarify this issue. METHODS: Using Taiwan National Health Insurance Research Database (NHIRD), we identified 1667 geriatric participants (≥ 65 years) with SA and 16,670 geriatric participants without SA matched at a ratio of 1:10 by age, sex, and index date between 1999 and 2010...
August 9, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28781062/value-of-geriatric-screening-and-assessment-in-predicting-postoperative-complications-in-patients-older-than-70-years-undergoing-surgery-for-colorectal-cancer
#19
Katleen Fagard, Julie Casaer, Albert Wolthuis, Johan Flamaing, Koen Milisen, Jean-Pierre Lobelle, Hans Wildiers, Cindy Kenis
OBJECTIVES: This study examines the association between geriatric screening and geriatric assessment (GA) and the risk of 30-day postoperative complications (30d-POCs) in older patients undergoing surgery for colorectal cancer (CRC). MATERIALS AND METHODS: Patients were identified from a prospectively collected database (2009-2015). All patients underwent geriatric screening with the G8 screening tool and the Flemish version of the Triage Risk Screening Tool (fTRST)...
August 3, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28776149/how-do-oncologists-make-decisions-about-chemotherapy-for-their-older-patients-with-cancer-a-survey-of-australian-oncologists
#20
E B Moth, B E Kiely, V Naganathan, A Martin, P Blinman
PURPOSE: Oncologists are making treatment decisions on increasing numbers of older patients with cancer. Due to comorbidities and frailty that increase with age, such decisions are often complex. We determined factors influencing oncologists' decisions to prescribe chemotherapy for older adults. METHODS: Members of the Medical Oncology Group of Australia (MOGA) were invited to complete an online survey in February to April 2016. RESULTS: Ninety-three oncologists completed the survey of which 69 (74%) were consultants and 24 (26%) were trainees, with most (72, 77%) working predominantly in a public hospital-associated practice...
August 3, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
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