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Geriatric AND cancer AND comorbidity

Daniel W Yokom, Shabbir M H Alibhai, Schroder Sattar, Monika K Krzyzanowska, Martine T E Puts
INTRODUCTION: Screening tools in geriatric oncology have traditionally been studied for their ability to identify patients who have abnormal domains on a comprehensive geriatric assessment (CGA). However, an alternative outcome of identifying patients who would receive CGA-based interventions could improve selection of patients whose management will be altered by a CGA. The objective of this study was to assess the performance of three geriatric oncology screening tools for their ability to predict for CGA-based interventions...
March 12, 2018: Journal of Geriatric Oncology
Beatrice J Edwards, Xiaotao Zhang, Ming Sun, Holly M Holmes, Leena Ketonen, Nandita Guha, Peter Khalil, Juhee Song, Shelli Kesler, Jay B Shah, Debasish Tripathy, Vicente Valero, Richard E Champlin
OBJECTIVE: To assess cognitive function in older adults undergoing cancer care. MATERIALS AND METHODS: This is a cross-sectional study, in the University of Texas MD Anderson Cancer Center, in older adults undergoing cancer care. Comprehensive geriatric assessments were conducted prior to surgery, chemotherapy or allogeneic stem cell transplantation, at the Program for Healthy Aging from January 1, 2013 through March 31, 2015. Cognitive assessment was conducted through personal and family interview, and the Montreal cognitive assessment (MoCA)...
March 9, 2018: Journal of Geriatric Oncology
Kah Poh Loh, Jason Zittel, Sindhuja Kadambi, Chintan Pandya, Huiwen Xu, Marie Flannery, Allison Magnuson, Javier Bautista, Colin McHugh, Karen Mustian, William Dale, Paul Duberstein, Supriya G Mohile
OBJECTIVES: Sleep disturbance is prevalent and often coexists with depression, fatigue, and pain in the cancer population. The aim of this study was to describe the prevalence of sleep disturbance with co-existing depression, fatigue, and pain in older patients with cancer. We also examined the associations of several socio-demographic and clinical variables with sleep disturbance. METHODS: This cross-sectional study consisted of 389 older patients with solid and hematologic malignancies who were referred to the Specialized Oncology Care & Research in the Elderly (SOCARE) clinics at the Universities of Rochester and Chicago between May 2011 and October 2015 and completed a sleep and geriatric assessment (that inquires about fatigue, pain, and depression)...
March 2, 2018: Journal of Geriatric Oncology
A Suhool, D Moszkowicz, T Cudennec, K Vychnevskaia, R Malafosse, A Beauchet, C Julié, F Peschaud
BACKGROUND: Few data are available on the management of elderly rectal cancer patients, and especially on the ability to provide optimal oncological treatment. The aim of this study was to determine the feasibility and results of multimodality treatment for rectal cancer in patients 75years and older after simplified comprehensive geriatric assessment (CGA) according to Balducci score. METHODS: We reviewed the charts of elderly patients who underwent surgery for localized middle or low rectal cancer...
March 1, 2018: Journal of Visceral Surgery
Shlomit Strulov Shachar, Trevor A Jolly, Ellen Jones, Hyman B Muss
Triple-negative breast cancer, which affects about 10% of older women with breast cancer, represents a major treatment challenge in this population. Treatment decisions for these patients can best be made based on geriatric assessment, estimated life expectancy, whether the treatment goal is prolonged survival or palliation, the potential benefits and toxicities of a specific treatment, and the patient's personal goals for treatment. Treatment outcomes for healthy older and younger women are similar, but great challenges exist in managing the vulnerable and frail patient...
February 15, 2018: Oncology (Williston Park, NY)
Daniel Boakye, Bettina Rillmann, Viola Walter, Lina Jansen, Michael Hoffmeister, Hermann Brenner
INTRODUCTION: Colorectal cancer (CRC) is largely diagnosed at old age, when comorbidities and frailty are common and might be important prognostic factors of CRC. We aimed to systematically review epidemiological evidence on the prognostic role of comorbidity and frailty in CRC patients. METHODS: We systematically searched the PubMed and Web of Science databases up to August 08, 2017 for observational studies that used a standardized index to assess comorbidity or frailty, investigated and reported odds ratios (OR) or hazard ratios (HR) of their associations with any of the following CRC prognostic outcomes: thirty-day, overall or CRC-specific mortality and disease-free or recurrence-free survival...
February 10, 2018: Cancer Treatment Reviews
Tomohiro F Nishijima, Allison M Deal, Jennifer L Lund, Kirsten A Nyrop, Hyman B Muss, Hanna K Sanoff
OBJECTIVE: A geriatric assessment (GA) assesses functional age of older patients with cancer and is a well-established tool predictive of toxicity and survival. The objective of this study was to investigate the prognostic value of individual GA items. MATERIALS AND METHODS: 546 patients with cancer ≥ 65 years completed GA from 2009 to 2014 and were followed for survival status for a median of 3.7 years. The GA consisted of function, nutrition, comorbidity, cognition, psychological state, and social activity/support domains...
February 7, 2018: Journal of Geriatric Oncology
Masahiro Takahashi
The elderly population is heterogeneous. Chronological age alone does not reflect heterogeneity in the aging process. It is recommended that elderly cancer patients should be evaluated for some form of geriatric assessment(GA)to detect problems, to predict treatment-related toxicities, to predict functional decline, to predict prognosis, and to assist in cancer treatment decisions. It was reported that functional status, nutritional status, mental status, polypharmacy, and comorbidity were independent prognostic factors for survival in elderly cancer patients...
January 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Hidenori Sasaki, Yasushi Takamatsu
Along with the aging society in Japan, the number ofelderly cancer patients is increasing, and hematological malignancy is no exception. Treatment ofhematological malignancy is mainly chemotherapy and furthermore it is necessary to keep its dose intensity. In the elderly, adverse events may be strong due to deterioration oforgan function, comorbidity, etc., and it is difficult for individual differences to decide chemotherapy regimen and dose. Geriatric assessment(GA)used in the field of geriatric medicine is reported to be useful for risk assessment of chemotherapy...
January 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Tetsuya Hamaguchi
The basic principles in the chemotherapeutic treatment of elderly colorectal cancer patients are similar to those of young people, but because of age-related organ function deterioration and comorbidities that are involved in life prognosis, there are risks of side effects in drug therapy. Considering the influence on the quality of life(QOL)is necessary. In the treatment guidelines, recommended initial chemotherapeutic options for unresectable colorectal cancer depends on whether the patient is appropriate for intensive therapy, but there are no criteria on how to divide...
January 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Vivek Agarwala, Neha Choudhary, Sudeep Gupta
Decision-making regarding the use and selection of adjuvant chemotherapy for breast cancer in elderly patients is challenging due to the presence of age-related comorbidities, frailty, and competing causes of mortality. One area, relatively neglected in most guidelines, is the effect of competing causes of mortality on presumed benefit of adjuvant chemotherapy for breast cancer in these patients. This article utilizes a clinical case to illustrate the principles of risk-benefit assessment of adjuvant chemotherapy in elderly patients...
October 2017: Indian Journal of Medical and Paediatric Oncology
Friedemann Honecker, Ulrich Wedding, Gerd Kallischnigg, Axel Schroeder, Jörg Klier, Thomas Frangenheim, Lothar Weißbach
PURPOSE: To gain knowledge about the factors associated with discontinuation of scheduled treatment in elderly men with castration-resistant prostate cancer (CRPC). METHODS: Patients ≥ 70 years with CRPC starting a new line of treatment were included in a prospective cohort study. A geriatric assessment (CGA) was performed at baseline, including comorbidity, mobility, functional/mental/nutritional status, as well as depression. Furthermore, pain intensity, quality of life, ECOG-performance status, and physicians' and patients' perception of health were documented...
January 4, 2018: Journal of Cancer Research and Clinical Oncology
Jin Hyun Park, In Sil Choi, Ki Hwan Kim, Jin-Soo Kim, Kyung-Hun Lee, Tae-Yong Kim, Seock-Ah Im, Se Hyun Kim, Yu Jung Kim, Jee Hyun Kim
Purpose: Currently, there is little information regarding optimal treatment for metastatic breast cancer (MBC) in elderly patients. In this retrospective study, we examined a cohort of elderly patients with MBC receiving a range of treatments, in terms of demographic and clinicopathologic characteristics, treatment patterns, and outcomes. Methods: Patients aged 65 years and older, and diagnosed with MBC between 2003 and 2015, were identified from the databases of three academic hospitals in South Korea...
December 2017: Journal of Breast Cancer
Maria Pisu, Andres Azuero, Karina I Halilova, Courtney P Williams, Kelly M Kenzik, Elizabeth A Kvale, Grant R Williams, Karen Meneses, Margaret Sullivan, Supriya Kumar Yagnik, Hans-Peter Goertz, Gabrielle B Rocque
BACKGROUND: As the population of older adults with cancer continues to grow, the most important factors contributing to their health-related quality of life (HRQOL) remain unclear. METHODS: A total of 1457 older adults (aged ≥65 years) with cancer participated in a telephone survey. Outcomes were measured using the Physical Component Summary (PCS) and Mental Component Summary (MCS) scores of the 12-Item Short Form Survey (SF-12) from the Medical Outcomes Study (version 2)...
December 18, 2017: Cancer
Maria-Jose Molina-Garrido, Carmen Guillén-Ponce, Remei Blanco, Juana Saldaña, Jaime Feliú, Maite Antonio, Rosa López-Mongil, Primitivo Ramos Cordero, Regina Gironés
OBJECTIVES: The aim of this work was to reach a national consensus in Spain regarding the Comprehensive Geriatric Assessment (CGA) domains in older oncological patients and the CGA scales to be used as a foundation for widespread use. MATERIAL AND METHODS: The Delphi method was implemented to attain consensus. Representatives of the panel were chosen from among the members of the Oncogeriatric Working Group of the Spanish Society of Medical Oncology (SEOM). Consensus was defined as ≥66...
December 13, 2017: Journal of Geriatric Oncology
Claire Falandry, Ivan Krakowski, Hervé Curé, Elisabeth Carola, Pierre Soubeyran, Olivier Guérin, Hélène Gaudin, Gilles Freyer
BACKGROUND: Cancer management in the elderly is often considered as suboptimal, highly variable, and rarely evidence-based. Data are needed to understand decision-making processes in this population. MATERIALS AND METHODS: A survey was performed in France to describe decision-making in gynaecologic patients over 70. It followed a three-step method: (1) 101 representative physicians questioned about treatment decision criteria; (2) simplified individual data were collected; (3) as well as detailed data patients receiving chemotherapy...
December 14, 2017: Breast Cancer Research and Treatment
Grant R Williams, Allison M Deal, Jennifer L Lund, YunKyung Chang, Hyman B Muss, Mackenzi Pergolotti, Emily J Guerard, Shlomit Strulov Shachar, Yue Wang, Kelly Kenzik, Hanna K Sanoff
BACKGROUND: Our ability to optimize the care of older adults with cancer and comorbid illnesses is insufficient because most clinical trials lack systematic measurement. The primary purpose of this study was to evaluate the association between patient-reported comorbidity and all-cause mortality using various comorbidity scoring algorithms. MATERIALS AND METHODS: The Carolina Senior Registry was linked with the North Carolina Central Cancer Registry to obtain mortality data...
December 14, 2017: Oncologist
Hisashi Saji, Takahiko Ueno, Hiroshige Nakamura, Norihito Okumura, Masanori Tsuchida, Makoto Sonobe, Takuro Miyazaki, Keiju Aokage, Masayuki Nakao, Tomohiro Haruki, Hiroyuki Ito, Kazuhiko Kataoka, Kazunori Okabe, Kenji Tomizawa, Kentaro Yoshimoto, Hirotoshi Horio, Kenji Sugio, Yasuhisa Ode, Motoshi Takao, Morihito Okada, Masayuki Chida
OBJECTIVES: Although some retrospective studies have reported clinicopathological scoring systems for predicting postoperative complications and survival outcomes for elderly lung cancer patients, optimized scoring systems remain controversial. METHODS: The Japanese Association for Chest Surgery (JACS) conducted a nationwide multicentre prospective cohort and enrolled a total of 1019 octogenarians with medically operable lung cancer. Details of the clinical factors, comorbidities and comprehensive geriatric assessment were recorded for 895 patients to develop a comprehensive risk scoring (RS) system capable of predicting severe complications...
December 11, 2017: European Journal of Cardio-thoracic Surgery
Ekkamol Phaibulvatanapong, Varalak Srinonprasert, Suthinee Ithimakin
OBJECTIVES: To assess factors predisposing to severe chemotherapy-related toxicity and adverse events (AEs) and dose modification in aging cancer patients. METHODS: Cancer patients aged ≥70 years scheduled to receive the first cycle of a new chemotherapy regimen were enrolled. On the day of starting chemotherapy, demographic data, performance status (PS), and geriatric parameters were recorded. AEs and chemotherapy modification were recorded. Quality of life (QOL) was assessed at baseline and 3 months after starting chemotherapy or at the end of chemotherapy...
2018: Oncology
Francisco Javier Martínez Peromingo, Carlos Oñoro Algar, M Elena Baeza Monedero, Cristina González de Villaumbrosia, Diego Real de Asua Cruzat, Raquel Barba Martín
Age is one of the main risk factors for the development of cancer. It is expected that the progressive aging of the population will have an unprecedented impact on the incidence of various tumours. In fact, the management of elderly cancer patients is already a major public health problem in developed countries. However, elderly patients have systematically been excluded from cancer drug studies or protocol development. This has left health professionals in uncharted territory, without proper tools to address the multiple difficulties that arise in the treatment of these patients...
November 25, 2017: Revista Española de Geriatría y Gerontología
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